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September 28, 2016 Scott Ehrlich1

Part 2: The Blood Glucose Monitor

Editor’s Note: This is the second installment in Scott Ehrlich’s multi-part series, What’s a Diabetic to Do? Join us as he shares a first-hand account of his experiences as he moves along his treatment journey after having been diagnosed late this summer. Click here to read his first article on this subject.

A few months ago, I went for a blood test and found out my A1C was over 10%. This, combined with an unexplained weight loss of about 30 pounds, lead doctors to the obvious conclusion that I had joined the ranks of about 30 million Americans who had diabetes. At this point, the two major questions were which type of diabetes, and how can I treat it? Because it came on suddenly and quite severely, my doctors suspected type 1. I, knowing my diet and physical activity regime over the last 30 years, suspected type 2. I decided to detail my experience as a newly diagnosed diabetic and the challenges I have faced, having spent so much of my time on the marketing side, to now be on the patient side.

In this article, I detail my experiences with the blood glucose monitors. My future articles will deal with the medications available and the overall consumer experience of being a newly diagnosed diabetic.

After going to my GP with my initial blood results, I went to an endocrinologist for a follow-up. I was sent home with an Accu-Chek Aviva Plus meter. However, my insurance prefers OneTouch meters, so I acquired one of those, a OneTouch Verio. I also received an offer for a free Abbott FreeStyle meter, which I took advantage of as well. Lastly, I took a trip to Europe and was able to acquire an Abbott FreeStyle Libre wearable monitor, which isn’t yet available in the United States. My impressions of all of these monitors are detailed below.

avivaplus-packagingAccu-Chek Aviva Plus

The Accu-Chek Aviva Plus monitor was my first experience using a blood glucose monitor. It looked similar to a stopwatch and had some pretty good functions on it that allow you to mark when you did your test, get averages, and transfer to a computer. It takes 0.6 µL of blood for a successful test that go into a strip from the front. You know you have enough blood when the strip sucks it up. All in all, upon first glance, it didn’t seem that difficult.

My actual experience with the monitor itself was far less pleasant. It took me quite awhile to figure out how to use it properly. The biggest issue I had was that it would often flash that too much time had passed from when I inserted the strip to putting blood on it, and that I had to try again. This meant I had to prick myself again AND waste another testing strip (which weren’t cheap), even when I knew I had done the test promptly. It was only after a few weeks that I learned that this message really meant that there wasn’t enough blood on the strip.

While 0.6 µL didn’t seem like that much blood, compared to some older and cheaper monitors that took 1 µL, it was often more than I got from a single finger prick, meaning I had to do lots of squeezing or additional pricking to get enough blood for a sample. And once you put blood on a strip, if there wasn’t enough, you couldn’t add more blood, so that strip was lost. I wasted probably 1 out of every 2 strips at first and even after a few weeks, I was still wasting 1 out of every 4 or so. That’s a lot of money on wasted strips.

Another thing I disliked was how it transmitted your data. It came with a wireless way to connect and transfer data to your cell phone, for storage and further analysis, which I thought was great. It was only when I tried it that I learned the wireless wasn’t compatible with my Droid phone so all of that functionality was out the window and I could only import some raw numbers via USB.

Between the strips’ issue and cost, the large amount of blood needed for testing relative to other current meters, the lack of alternate site testing, and the mediocre interface, this was my least favorite meter I used. I still have it for emergencies, in case something happens to one of my others, and it’s certainly functional, but I didn’t find anything on it that was comparatively excellent and it definitely had many shortcomings.

VerioIQOneTouch Verio IQ

The next meter I tried was a OneTouch. My insurance said they preferred OneTouch so I was allowed to get one of a variety of meters for no cost. I opted for a OneTouch Verio IQ. This meter was advertised as only needing 0.4 µL of blood and had some alternate site testing. It also had an analysis program that you could do through computer. And, since my insurance worked closely with the makers of OneTouch, I thought the strips would be very affordable.

On some accounts, this meter was all that it advertised. Taking it out of the box, it was by far the slickest looking meter, looking like a modern iPod, with a full color interface. It had the best graphics and definitely looked like a modern monitor should look. It also took less blood to work, which was nice. The blood, however, was inserted into the side of the strips (which were much smaller than the Accu-Chek strips); I found that to be easier after a few tries. It was a promising meter but it did have a few shortcomings.

Firstly, it wouldn’t turn on when I took it out of the box. I realized it has a rechargeable battery, unlike the rest, and needs to be charged before use. That’s not a big issue, but can be a problem if you need to test right away or frequently and don’t remember to charge it regularly. Another issue is that the alternate site testing was somewhat limited. Think your palm or sides of fingers but not other places on the body, if that matters to you. Finally, it only came with ten strips and, despite being the preferred (and, in fact, only covered meter) by my insurance, they still wanted nearly a dollar a strip, considerably more than I was paying for the Accu-Chek. Because of this, I opted not to continue use past the ten included strips. For the limited time I used it, it seemed like a quality monitor and if someone really needed a lot of analytics on their blood tests and tested frequently, it could be very useful, even if it still left some things to be desired.

InsuLinxFreeStyle InsuLinx

The final monitor I tried was the Abbott FreeStyle InsuLinx. I received this through a coupon I found on the Abbott FreeStyle website. While the coupon has proven incredibly difficult to use (more on this in a future article), I found the trouble to be worth it with this monitor. I was excited about it because it only required 0.3 µL of blood and allowed testing in many sites. When I first used it, I was hoping it would make my testing, which I had done quite frequently at that time, much easier. It’s nice to see I was proven correct.

Firstly, it required only half the blood as the Accu-Chek monitor and about 75% as much as the already low amount needed by the OneTouch. Secondly, you can test nearly anywhere you like. So if you are getting sore or have an aversion to testing on your fingers, you can use forearms, upper arms, wherever. And finally, my favorite part, if you don’t get enough blood on the strip when you test, you have 60 seconds to add more. This gives you plenty of time for one or two additional pricks if need be, meaning you almost never have to waste a strip. The strips themselves are also tiny and allow you to put blood in from either side, giving a lot of flexibility that way as well. From a simple testing standpoint, this is by far the best monitor of the three in every way.

This is important because the in-monitor features, at least the ones I’ve found, are minimal. You can only do a small bit of labeling, analytics are pretty much none existent, and I have not found out how to do any sorts of averages on the monitor itself. The interface is also nothing special, with the ability to choose a background image the most advanced thing I have found.

Still, analytics aren’t that important to me as I just need to stay in a fairly wide range of sugars and don’t have to treat often with insulin or other meds throughout the day. So for me, simple functionality with little blood and little wasted strips is paramount. And to that end, this monitor is by far the best of the ones I have used.

DexcomContinuous Glucose Monitors

Despite that, I still felt there had to be something more. Pricking your finger, testing a few times a day, getting a few snapshots of blood sugar readings. All of these things seemed very archaic with today’s technology. So, in researching for something better, I found two continuous blood glucose monitors. These were wearable devices that would give you your blood sugar on a fairly constant basis without finger pricking or strips. The first, which is currently available in the United States, is made by Dexcom. This is a device you can wear on your arm for seven days and get consistent blood sugar readouts. Unfortunately, the cost of $700 or so for the initial device and its lack of coverage by insurance made testing it a bit out of my reach.

Another device I had seen was the Abbott FreeStyle Libre. This device, at a cost of $80 for a wearable patch and another $80 for the scanning device, along with a wear time of 14 days, was much more in my wheelhouse. When I found out that you can use an app on your cell phone instead of purchasing the reader, bringing down the cost of trying it even further, I was even more intrigued. There was one hitch, however; this device has yet to be submitted to the FDA for approval and is therefore not available in the US. In fact, you can’t even access the website or apps from a US computer.

This was quite discouraging. As luck would have it (or as lucky as someone can be when having diabetes), I was headed to Germany for an extensive vacation around this time, where it was for sale, so I made some arrangements to procure a single pod for trial. I was curious to see how my newly diagnosed body would hold up to the diet of beer and pretzels I planned on feeding it, as well as how my blood sugar reacted outside of my normal testing hours or while I was sleeping.

LibreAfter getting my device and downloading the app, I watched YouTube videos on how to set it up. Seeing the size of the needle I would need to put into my skin to “install” it, however, made me quite queasy (although seeing six-year-olds putting it in themselves without even flinching both put me at ease and made me realize how big of a baby I was). Still, after a copious dose of liquid and pretzel courage, I had my wife put it into the fatty part of my left arm. To do this, you put the pod (about the size of a quarter) in an applicator-type object, push down almost like a stapler, and take it off. Shockingly, not only did it not hurt, I didn’t even feel it go in. And yet there it was, on my arm. I initialized it with the app and took the first reading on my phone. I then checked it against my blood glucose monitor. They were nearly identical.

I was enthralled with this device, how it could be there, attached to my arm and I could just wave a phone over it to get my blood sugar, cursing that this wasn’t available in the US. I checked my blood sugar over and over, amazed at this new technology. Oddly, though, my sugar readings dropped, first to slightly low, then very low, then to the point where I would be in a hypoglycemic coma, then to the point I would be dead. I confirmed on my blood sugar monitor that I was not, in fact, dead at that point, nor were my readings even low, and thus I began to see a flaw in my new toy. Further research told me it could take 1-3 days to calibrate the device. With only 14 days of use and it being basically useless for the first few, I became less enthralled. Furthermore, my wife noticed a fairly massive (albeit painless) bruise forming from the insertion site, taking up most of my upper arm. Perhaps technology wasn’t as great as I thought it would be.

After toying with removing the device, I waited out the few days and it did, in fact, calibrate. The results would deviate from my blood sugar monitor, sometimes by five points, sometimes as much as 20. I read that because this was measuring your sugar through fluid in your skin rather than blood, the readings wouldn’t be as current as finger testing and weren’t to be used if your sugar was rapidly changing, such as after eating or if you needed it for insulin doses. This was a fairly severe limitation of the product. I am not sure if this calibration time or inaccuracy was a result of the device itself or the third party app I used to read it, but it is definitely an issue.

Still, this device was amazing. I could swipe my phone over my arm for a few seconds and get an instant reading. I could test as much as I want, wherever I wanted, in seconds. I could have, at a glance, all my results for days, including during when I was sleeping. I could see my highs and lows, when I was rising and falling, what really caused my sugar to spike and drop. It was very instructive and I could see this sort of device is the future.

After 12 days (and another few beers), I took it off. It peeled off fairly simply and painlessly, and the bruise itself started to go away. I don’t feel the need to get another device because of the trouble involved in procuring one and the lack of support once I had it, as well as the fact that it is also a bit cost prohibitive now since it is a cash payment. I do, however, think that when Abbott submits this to the FDA in 2017 or 2018, assuming it’s approved, I would definitely consider using it again, maybe even as a replacement for my other device. Right now, at $80 every 14 days, I am not sure the value is there. But cut that to $10-$20 with insurance and improve the issues with calibration, this could cause testing compliance to skyrocket. Improve the life to 30 days and this device would really take off. As much as I find my other Abbott FreeStyle InsuLinx to be useful, it’s obvious that a wearable CGM, integrated with apps and analytics on common cell phones, is the future of testing.

September 28, 2016 Natalie Hill0


In recent years, as a result of advances in technology, expansion of channel reach and increased focus on patient outcomes, the Point of Care channel has grown to be a more important part of brand marketing strategies – most notably for healthcare marketers. Campaigns at POC have been successfully fueled by data-driven targeting and a high degree of consumer engagement with relevant content, but what has made POC most attractive to marketers can be summed up in one word… measurability.

POC has offered marketers the unique opportunity to track the consumer journey from the healthcare provider visit (at the doctor’s office, hospital, or pharmacy) to the point of sale. And now, with heightened focus on understanding outcomes on every campaign, measurement design has become equally as important as the campaign design itself.

To best position yourself for success – as well as get the most accurate read on your campaign’s performance – it’s important to recognize both the benefits and limitations of measurement. Below are three key questions to ask yourself before finalizing your measurement plan:

1. Is my campaign large enough to measure?

Not every campaign is large enough to measure – statistically speaking.

A campaign (often in the form of a “test campaign”) may be too small in scale to allow you to detect a more immediate and/or statistically significant impact. This doesn’t mean your campaign isn’t working. Rather, it suggests that you need to adapt your measurement design to account for the size of your campaign. For example:

  • Conduct a feasibility study to understand if statistical significance can be achieved given size of sample, timeframe for measurement, and assumptions around magnitude of impact;
  • Use insights captured via primary research (qualitative or quantitative) versus transactional purchasing to obtain earlier indicators of program success;
  • (If married to secondary analytics) Analyze transactional purchasing over a longer period of time to increase the size of the sample subject to study.

1603186942. Do my research metrics align to my campaign’s objectives?

ROI is not the only indicator of campaign success – though it is of course among the most important. 

Marketers have a variety of metrics at their disposal to understand campaign performance – from ad awareness and message recall captured via primary research to purchase lift and brand adoption captured via transactional-level analyses. Using pharmaceutical marketing as an example, product life cycle will have a considerable impact on key performance indicators of a campaign. Marketers of brands entering growth and maturity will focus on new patient starts, impact on market share, and return-on-investment; whereas, launch marketers may expand KPIs beyond new patient starts to increase in brand awareness, consumer message recall, and adoption of the brand among non-prescribing physicians.

Communicate your brand’s objectives up-front so that all key performance indicators are addressed in your measurement plan.

3. When should I look to first measure my campaign… and how frequently should I track performance?

Campaigns take time to resonate. 

It’s hard to wait to evaluate the performance of a campaign. In the pharmaceutical industry, data is available as frequently as weekly (if not daily). And while tempting to consider weekly measurement of a campaign at the Point of Care, we know from experience that campaigns take time to gain momentum. While a large percentage of impact is observed within the first 30 days of campaign exposure, residual impact is seen for up to 90 days. Measuring a campaign in its infancy may set a false expectation of performance and set your campaign up for “failure.”

Establish expectations on timing upfront, allowing six months for measurement where possible, but no sooner than three months, to first assess your campaign’s impact. From there, more frequent tracking/follow-up reads may be established, assuming data from the initial read supports. Patience – in terms of data availability – pays off.


Republished with permission. Click here to read the original posting on MediaPost.

September 27, 2016 Reagan Tully1

As patients experience greater financial risk and responsibility for their healthcare, patients are becoming more active decision makers. They are no longer passive and accepting of healthcare decisions made by providers. Patients are consumers of healthcare and we, as an industry, must change how we think about patient-centricity and focus the lens of our business around what the patient needs.

As we look at the healthcare consumerism trend, what can pharma companies do to better support patients?

We must change internally from a commercial perspective and invest to get patients the information and education they need at critical decision points.

Clinical landscape

Treaters are changing, and the way we treat patients is changing. Today, the number of PCPs has dropped, but the population, particularly the baby boomer generation, is increasing. A reduction in PCPs and increase in patient volume is resulting in less time spent with patients.

As a result, we’re seeing a stakeholder approach to treatment. When we start to look at how we plan HCP strategy – we cannot focus exclusively on physicians as the education of patients is increasingly happening with alternative stakeholders, such as pharmacists, case managers, and health coaches. An impactful HCP strategy should include these providers who are spending more time with your patients.

Financial landscape

High deductible health plans are on the rise, passing increased financial responsibility to patients. Employers are scrambling to adjust benefits to avoid substantial tax fines as patients struggle to adjust to the “new normal.” Patients are not only responsible for higher deductibles, but the type of deductibles are changing as well. Previously applied to medical benefits, now these deductibles are being integrated and include pharmacy benefits. For example, I was picking up an Rx that is normally $25 and was told it was now $170 – my thought: “how much do I really need this Rx?”

Patients are asking themselves the same questions. When you look at your patient savings programs, make sure that you’re working with someone, or building competencies internally, that can manage patient savings programs ensuring two important capabilities: the ability to impose flexible benefit structures and an intelligent application of that benefit. This ensures that you are delivering savings to the patients who need savings – not just a one size fits all approach – which can have a substantial impact on profitability.

As we look to the future, value-based reimbursement will increase in focus. Over the last few years, we have anticipated an increase in value-based reimbursement, but in early application, many physicians didn’t see the linkage between required outcomes and reimbursement.

This February, CMS and a number of private insurers met and came to consensus on the first eight areas of healthcare and 22 areas of quality measures. This helped to start streamlining and clarifying the expectations of both physicians and health systems to support reimbursement. Additionally, it helped providers that are participating in value-based reimbursement to understand the implications of performing and not performing. We anticipate this trend to continue, and accelerate.

In the movement toward value-based reimbursement, we should anticipate the rise of value-based contracting. Gone will be the days of deep discounting to secure preferred formulary status (with the possible exception of generics). When you look at innovative medications, we’re going to have to come to the table taking on some of the risk and responsibility – preferentially in a shared risk model. We will have to prove outcomes of our treatments, inclusive of the associated services and solutions we provide, to improve the overall financial profile to the plan.

Operational landscape

Patients are seeking information through non-traditional channels, which are critical for optimized engagement. Ninety-five percent of people have a mobile phone. By 2017, 65% of patients will be actively seeking health solutions via mobile device. Engaging patients via mobile is becoming a fundamental requirement. So how do patients want us to communicate?ReaganTully_artwork-Sept2016

When personalized resources and education are delivered in real-time, from a trusted healthcare source, adherence rates for medications have increased 3x over baseline.

Less fundamental, but growing in popularity, is engagement via social media. Forty-two percent of patients are engaged in social media and of that group, 40% act on something from social media. Historically, manufacturers have been more reluctant to participate in social media due to risk containment. With these engagement numbers growing, manufacturers will need to re-evaluate how to get involved, in a responsible and effective manner, to provide patients with the information and resources they need when and where they’re having the conversation about the company or the products.

Behavioral landscape

Beyond C.F.O., there is a critical 4th dimension that can be overlooked – behavioral.

As they walk out of a physician’s office, 50% of patients do not remember what they discussed. Patients walk out with a prescription and often do not recall instructions around dosing or lifestyle changes. Assuming they take the prescription to the pharmacy, only about 50% are adherent and only 10% make the requested lifestyle changes.

Most non-adherence is not caused by drug costs. Express Scripts recently reported that 69% of the problem is behavioral – simple procrastination and forgetfulness, barriers which can be overcome with the right support resources. Improving these statistics can have a significant impact on outcomes – which are increasingly important to value-based care.

In summary, patients are becoming more engaged and empowered, leading to the importance of the trend of patient consumerism. How should Pharma respond? By addressing the 3E’s of healthcare consumerism:

  • Empathy: mobilize our organizations to be able to serve patients differently – to be able to serve healthcare differently. Everyone must understand the patient and the value of the patient. It is important that all members of the organization – inclusive of support functions (legal, regulatory, finance, etc.) – understand what patients are going through as they make decisions.
  • Engagement: expand how we think about patient engagement. We can no longer work on education and resources to HCPs exclusively. Our HCP strategy must include complementary providers who are spending more time with patients. Today’s patients want individualized information in the channels in which they normally engage. Brands must integrate tools and services within these channels to deliver the right information for the right need at the right time.
  • Empowerment: prioritize patient resources. Patients are becoming active participants in decision making with their physicians and at the pharmacy. This is being driven by the increased proportion of cost that has shifted to the patient. Pharma can no longer deprioritize patient resources as budget reductions are made. These resources must take a minimum of a shared priority within strategic plans and spends.

Ultimately, as an industry we must invest in the education, tools, and resources to help patients become more informed and active participants of healthcare. As healthcare consumerism continues to rise, this investment must happen. If not, we will miss an opportunity that we have to impact overall brand and, most importantly, patient health.

September 27, 2016 Kevin Connolly0

Today’s best adherence programs emphasize the critical role of patient engagement in driving success. In my first article, I discussed the overall value of patient adherence programs and how implementing best practices for program design can make your programs more relevant to patients.

Taking this approach one step further, engagement programs can and should occur on many levels and within the various stages of adherence programs. Let’s explore how.

  1. Understanding the product

Building patient engagement begins with a comprehensive understanding of the brand and the product. First and foremost, it is necessary to have a discussion about various factors that define a drug going to market, including indication (use of drug), therapy duration, side effect profile, distribution channel, and cost, before you can develop a patient adherence or support program. Consider, for example, how the level of engagement will vary greatly between specialty drugs, conventional products, and long-term or short-term therapies.

Remember: Adherence solutions are not “one size fits all.” For every brand, there can and should be a different approach. The level of services, types of services, and positioning of services will first be defined by the product.

  1. Selecting the optimal channels

Once you have an understanding of the product, you can begin to evaluate the best channels for engaging with your patient. Adopting an omnichannel approach, whereby you provide many channel alternatives and let patients determine their channel of preference, is ideal. Just keep in mind that an omnichannel approach differs from multichannel — it involves not solely offering a variety of pathways, but serving patients with equally beneficial resources in each one.

Your investment and the product type influences the level of engagement, which in turn determines channel/communication type. For instance, 24/7 live nurse support — a necessary protocol for certain treatment protocols or serious health conditions — is vastly different than sending out basic text message reminders to take a medication, and the engagement within these programs should be recognized as such. Similarly, therapies that are dosed at varying intervals (once per month, every three weeks, etc.) require a different approach than a drug dosed at once daily. Conventional drugs treating asymptomatic diseases would likely focus on reminder-type messaging (perhaps with some disease management/wellness reinforcement), whereas an approach to an infused biologic product that may have a more serious side effect profile may try to optimize a full patient engagement strategy, pairing an experienced health care coach to interact, on an ongoing basis, with patients to assist them to remain on therapy and make it to their next infusion appointment.

  1. Recognizing the ways patients define your program

ThinkstockPhotos-470104764Although the product and investment determines level of service and engagement, at every point, the patient profile should be assessed. Consideration should be given as to how individual patients want to be engaged (or not) and at what level. This holistic understanding of a patient’s history, current condition/medical situation, and mindset will determine how a patient engages in meaningful conversation. These factors will ultimately play a role in determining whether patients are likely to be compliant in adherence programs. In fact, putting yourself in the patient’s shoes to get a 360-view relates back to one of the most basic principles of designing effective adherence programs — to be aware of any and all potential barriers to adherence.

The typical patient profile (considering demographics, medical history, etc.) and the nuances of individuals themselves can influence engagement design and program services. These may entail more specialized services that go beyond more traditional medical care/support. Consider, for instance, a Hepatitis C drug prescribed orally: on paper, it may be “simple” to stay on the treatment, but because a subset of patients with this health condition could be more likely to have a history of drug addiction — a finding that could be uncovered in the patient-profile research and discovery stage — these patients may need the added support of a social worker to stay engaged in the program and adherent. In certain cases, the patient profile is as simple as recognizing the typical patient tendencies, such as in vaccinations that require a multi-dose regimen, where staggered timing can make it difficult for patients, like students going back to school or frequent travelers, to stick to the routine.

All in all, these various factors, considering both the product and the patient, will help you develop a well-rounded program that sets the stage for compliance. Along the way, remember to track and measure your successes and areas of improvement, and patient and product challenges. Doing so will allow you to continually innovate and successfully implement patient engagement tactics in the future.

September 27, 2016 Robert Palmer0

Marketers are aware that the rules of engagement with their customers have dramatically changed. Brands now need to offer content and information that is much less promotional, offering more of a shareable – and shared – experience. Online channels have driven much of the change, and the digital experience has rapidly evolved to short-form content that is easily consumed and can be shared among like-minded people and communities. Video is playing an ever-increasing role in our online experiences. It makes sense; humans react to visual stimulation very differently than they do to the written word – it’s just the way we’re wired. A short video that has free rein to use body language, facial expressions and vocal tonality to emphasize a range of emotions can be dramatically effective. When people hear information, they remember only 10% of that information three days later. But if a relevant image is paired with that information retention increases to 65%.

A number of video marketing statistics make a compelling case for developing a video strategy. Invodo reports that 92% of mobile video consumers share videos with others. Forrester research shows that video in emails leads to a whopping 200-300% increase in click-through rate, and including a video on a homepage can increase conversion rates by 20% or more.

Pharma may be using video as a tactical tool, but is video’s strategic value being fully realized? As with every strategy, in order to realize the full value there are strategic pillars that mark the difference between success and failure. At first glance the strategic pillars are the same for video as they are for any other medium, but there are significant nuances that make video strategy quite different.

  1. Know the video viewers

Telling a coherent, end-to-end brand story is a thing of the past. It has been disrupted in the digital age. Video content has to be entertaining, useful and relevant or the user will quickly click away. Users pick and choose when and where they tune in – and it’s easier than ever to tune out.

An enhanced understanding of what motivates the online video viewing audience, emotionally and psychologically, is needed. An emotional punchline at the end of your messaging is useless if the viewer isn’t willing to take the journey.

Psychodynamic theory says that both conscious and unconscious forces lead to ingrained desires and beliefs. When we understand both the open and hidden motivations of a given patient population it allows us to understand the patient on a gut level that can lead to deeply personal video engagement that is both relevant and useful.

  1. Be shareworthy, be short

Creating content is different with video. From the dawn of civilization, when we see something interesting and useful we have an ingrained need to pass the experience on. It so happens that online video begs to be shared – if and when it’s compelling. In order to be shareworthy, your branded video content can’t resemble anything like a traditional advertisement that talks at you instead of with you. The viewer is only watching based on his or her personal needs. If your brand connects quickly a viewer is then willing to watch and, hopefully, share.

Poor video content creation often falls into a structural trap when a marketer’s project brief is based on what he or she thinks should be in the video – a brand’s selling points – rather than exploring content that will most efficiently effect behavioral change in this medium.

According to statistics found in AdAge’s DigitalNext column, if you have not fully engaged your audience after the first 30 seconds, you’ve likely lost 33% of your viewers. After one minute, 45% have stopped watching, and the percentages go downhill from there. A rule of thumb is to keep the video as short as possible – but a variety of mitigating factors intervene (not the least being fair balance).

So what is the optimal video length? Well, it depends on where and how the audience is viewing the video. The optimal viewing on Facebook is 30- to 45-seconds while the average video on YouTube runs 4 minutes and 20 seconds. Video primarily intended for mobile viewership should almost always be shorter than video created primarily for desktop viewing. A short video that has free rein to use body language, facial expressions, and vocal tonality can connect with your audience like no other medium.

  1. Develop a smart distribution strategy

Now that you have great video, how will you get it in front of the right viewers? Distribution management is at the core of a successful video strategy. The combination of paid, owned, and earned media can be powerful.

Paid media placement should use the most effective technologies available – such as programmatic buying that targets users at page level, allowing brands to control the relevance of the environment in which the video is viewed. Page level targeting, as opposed to tracking with cookies, is much more relevant to the viewer because he or she has algorithmically chosen the type of environment in which the content is viewed.

Owned media, where the brand controls the channel, provides an opportunity for stickiness for branded and unbranded websites and other destinations like your YouTube channel or Facebook page.

And earned media, to the extent that user-generated and collaborative content can be created, is a powerful catalyst for deep engagement. While it’s true that pharma marketers remain somewhat handcuffed when it comes to social media, if a compelling video experience is collaboratively created with and for the audience it will be shared again and again. “Build it and they will come” can better be stated as “build it right and they will share,” which is the best media placement you can get.

  1. Pay attention to real-world performance

When you publish your video, you are not even close to being finished. You have to analyze, optimize, and analyze again. Careful analysis of your video viewership is as important as the analysis of any other strategic or tactical endeavor. A key metric is the point of abandonment while viewing; aggregation of this data can quickly lead to significant optimization of the video content. You should begin to monitor the viewers’ point of abandonment as soon as your video is online. You may be able to tell within a few days if you’ve hit the mark or you need to re-edit your award-winning masterpiece. To post it and forget it leaves the job unfinished and your ROI unrealized.

Video should be a key component in the current digital marketer’s toolkit. Its effectiveness depends on the key factors mentioned above. But a coherent, well thought-out approach following these four imperatives can make the difference between successful video tactics and a lost opportunity to engage your audience.

September 23, 2016 Givi Topchishvili0

The worst part of the Zika story we know so far, is that we do not know nearly enough to combat it in a meaningful way. First it was just an exotic STD from South America. Then it turns out to be a virus that could cause severe disability in newborns. As of August 2016, the CDC has reported that there are 2,722 Zika cases across the United States, another 14,110 in the US Territories (not counting the sexually transmitted cases), active mosquito-borne transmission in every country from Mexico, south through the Caribbean and Central America, to Ecuador, Colombia and Brazil in South America.  New studies indicate the virus is associated with brain disorders in adults, for example Guillain-Barré syndrome.  According to Florida State University researchers, the Zika virus directly targets the development of brain cells, in as little as three days after exposure, effectively stunting the cells’ growth.

The United Nations Health Agency noted in its new warning on the virus that “the more we know, the worse things look,” while World Health Organization’s Director-General Dr. Margaret Chan said that in under a year, the status of Zika has changed from ‘a mild medical curiosity’ to a disease with severe public health implications. Meanwhile, the CDC reported just a few days ago that they are almost out of money to fight this growing epidemic, which is unfortunate for many states and Puerto Rico which heavily rely on Federal help.

We still do not know what type of global impact on the spread of Zika the past Olympic games will play, but with the fast approaching annual rainy season in South America we are in for a perfect storm of factors that could become the tipping point to spreading the virus globally, unless concrete steps are taken now.

Clinical trials to make vaccines are still in process, and won’t progress anytime soon for that matter, if the stock market is any indicator.  Companies like Sanofi (NYSE:SNY), Inovio Pharmaceuticals (NASDAQ:INO), Intrexon Corp (NYSE:XON), and others have announced Zika vaccines initiatives, but the investors are clearly not impressed.

That leaves us with the next most logical option: detection.  Making easy to use, rapid, reliable, and cost-effective testing tools widely available across the affected region will help slow the spread and is a key preventative measure for this global epidemic.

Dr. Yelena Budovskaya, Ph. D., whose company Xnsion is at the cutting edge of rapid testing development, explains the difficulty labs face when tackling the problem with traditional methods. According to Dr. Budovskaya, “Most new technologies target the development of an instrument or adapting already existing instruments to allow rapid detection of one or few potential causes of infection. These instruments are expensive and would require significant investments for a diagnostic lab to adapt and adopt these instruments for the detection of various disease and infections; and in this case – Zika. Combined with the high cost of tests and limited testing availabilities, very limited information is available about the epidemiology of Zika: from its geographic origin, patterns, down to the possibility of health impacts and studies regarding Zika co-infections with other mosquito- or tick-borne viruses. The other fundamental problem with current Zika testing technologies is that they heavily rely on antibodies against the Zika virus. However, the Zika virus is very similar to other mosquito-borne viruses which makes those test unspecific. “

Yet, while, companies like Xnsion do appear to have the answer, it has yet to reach the market. The stalemate seems to be in the partnership that should have been a fertile ground for growth and innovation: between the public and the private sectors. One is in the business of advancement of public health, while the other is in the business of offering effective solutions for a profit. Inertia of one, causes inertia in the other, and rightfully so.

Big corporations do exist for the ultimate goal of enriching their shareholders, and they simply cannot afford to invest into solutions that will not have the backing of the public sector. Right now the “best” (CDC recommended) test costs ~$20-25 per sample that makes it out of reach in many struggling economies, which also happens to be the countries most affected by the virus at the moment.

Public health experts say that a viable test should utilize standard molecular laboratory equipment, be simple enough to be performed by any laboratory technician without necessity for in-depth knowledge in molecular biology, and should cost below $10 per test.

I believe we could get there, and the price will be driven down by normative market laws of supply and demand through increased competition if the private sector sees a serious commitment from the Federal government here at home, the World Health Organization, and of course local governments across the region.

Combating the Zika virus falls out of the normative boundaries of global responsibility. It is not about more affluent countries providing aid to developing nations. The threat to global health is real, and is a joint responsibility of the leading nations and each individual government in the affected region to step up to the plate. One cannot expect the private sector to go at it alone, although one can expect them to deliver, if the other side does their job, as opposed to the ongoing jockeying currently happening in the US Congress, such as blocking President Obama’s request for the necessary funds.

It is easy to call out the pharma industry for being the bad guys. But maybe, now is the perfect opportunity for the public sector to show them what good guys look like, and help create the market conditions for an affordable, accurate, scalable, adaptable and, most importantly, rapid Zika diagnostics.

September 22, 2016 Bob Ehrlich0

Everyone has an opinion on drug ads. From skits on Saturday Night Live, to the halls of Congress we hear critics mock DTC. Last week I criticized the 9/12 Ad Age story citing terror tactics used by drug marketers. The managing editor, Ken Wheaton, of Ad Age decided to write a follow up column telling pharmaceutical marketers to take a chill pill because he was surprised how they defended their ads in their “terror” story. Ad Age decided to double down in their criticism of drug marketers.

Bob Ehrlich
Ad Age’s Mr. Wheaton is wrong about the facts.”
-Bob Ehrlich

Mr. Wheaton says drug companies are jacking up ad prices to pay for the advertising. This is why these anecdotal stories are so off base. Mr. Wheaton has decided that it is obvious that DTC raises drug prices. Why? Because he says it must be so from his experience. He may be very knowledgeable about general advertising as his title would suggest. He is dead wrong that drug advertising causes high prices. The facts do not support his views. Drug marketers spent a bit over $5 billion on DTC in 2015. That is only about 1.5% of sales. Drug companies do not set their prices based on ad budgets. That might be true in advertising driven consumer brands where ad budgets make up 30% or higher of sales but not where multi billion dollar brands are spending a $50-100 million.

Mr. Wheaton makes some fair points that the drug industry has a reputation problem. He is certainly on point that drug makers must be aware of the negative impact high prices have on this industry image. They have not helped themselves with the recent EpiPen pricing hearings or Martin Shkreli smirking during his hearing day in Washington. Drug companies have the unenviable task of justifying higher prices in the United States versus price controlled developed countries. The American consumer does not like paying more but they also want drug innovation. While the media and political critics doubt the claim that cutting prices will reduce innovation, the economics of the drug business say otherwise. If drug prices were cut 30% to match Europe and Canada, that is coming right out of the bottom line. I challenge any business to reduce its profit in its biggest market by 30% and not affect R&D.

Advertising, however, is not the cause of the pricing issue. Drug companies have had this problem pre and post DTC advertising.  Drug ads have become a convenient symbol for criticism of the entire industry. Drug companies do weigh the pros and cons of advertising in terms of causing criticism versus the projected sales increase. What is disturbing is Mr. Wheaton making the unsupported statement that only drug marketers and their marketing partners support their right to advertise. Where is his data that says that? Many consumers would be happy to see drug ads banned, and those folks may even be greater in number than those who want to see drug ads remain on air. Clearly it is not a unanimous view and I suspect many consumers against drug ads feel that way because they think that DTC ads raise their prices.

Mr. Wheaton recommends drug makers stop their ads. Does he feel the same about ads for other products often criticized? What about fast foods, violent video games, beer, explicit music, unproven health supplements, and many others often criticized for causing harm? Mr. Wheaton has taken drug marketers to task for lawfully trying to build awareness of their highly regulated products where every word in their ads is reviewed by FDA. There is no doubt that drug ads are meant to sell product. Drug makers are in the profit business. Profit leads to investment. Advertising allows new competitors to compete with the category leaders.

In a world of no DTC, drug makers will still price as high as the market will bear. That is the same strategy used by every business including what Ad Age charges their advertisers. Mr. Wheaton is very convinced in his anecdotal and observational argument. Ad Age’s Mr. Wheaton is wrong about the facts, however, and in his cynicism about the value of drug ads.

September 16, 2016 Bob Ehrlich1

The latest critical DTC story just appeared in Ad Age on 9/12. It deserves comment because it seems off base.  In the title it says big pharma is using terror tactics to scare up sales. The crux of the story is how drug companies are shifting to creative approaches using scare tactics in their ads.

The article cites several examples in the vaccine area for meningitis, whooping cough, anaphylactic shock, and HPV. I take issue with the tone of the article that drug companies are taking a new approach that scares people. These vaccines are meant to prevent life threatening illness and the consequences of not vaccinating can be deadly.

Bob Ehrlich
“There is no new trend to using scare tactics.”
-Bob Ehrlich

The reporter says that drug ads used to be more cheerful. I guess that is referring to beach scenes, mountains, wheat fields that many had used to show satisfied patients. There were such ads but the idea that drug ads have evolved from cheerful to scary is false. There were ads for drugs in the 90’s that showed wheat fields and others that showed more somber scenes meant to be scary. Ads today also vary greatly from cheery to somber.

Drug ads are meant to motivate discussion with doctors. A scary disease caused by failure to get a vaccine deserves a sober assessment of the situation. Showing a person dealing with a life threatening allergy shows reality. Meningitis can kill, and HPV can cause cancer. Advertising deadly consequences is meant to be scary. The ads referred to as cheerful were those for conditions that were bothersome, but not deadly, such as allergy ads.

The writer, citing industry experts, says that drug companies are using scare tactics as a way to justify high prices. While EpiPen may be high priced, no one can dispute that a child that cannot breathe from an allergic reaction needs a rapid solution. Price has nothing to do with the advertising showing the dire consequences of being without the EpiPen. Would Mylan make a cheerful ad if the drug cost $100 vs. $500?

Drug ads are meant to motivate action. Showing what can happen when not vaccinated is not fear mongering. I have been reviewing DTC ads for over 20 years and there is no new trend to using scare tactics.

Ads have always reflected the seriousness of the disease treated by the drug. Toe fungus and seasonal allergy commercials can have a lighter tone than HIV or heart failure ads. While it is true that many of the ads cited do scare people, there is no happy way to say Meningitis shots are needed. I do not support unjustified fear based ads. I do not agree that any of the current ads are fear mongering or falsely amplifying the consequences of non-treatment.

There are more vaccine ads on the air now than in the past. That could be why the author sees this as a trend in advertising fear. Today DTC ads reflect a wide variety of creative devices that run the gamut of emotions. Fear is one of those emotions used but is certainly not new or a tactic to justify premium prices. Of course advertising analysis is somewhat subjective so those experts who see a shift towards fear can find examples to make that case. I would like to see more evidence before I can begin to agree that any shift has taken place.


September 9, 2016 Bob Ehrlich0

The drug companies made Hillary’s enemies list earlier this year along with Iran, the Republicans, and the NRA. She now has a plan to ensure drug prices do not rise higher than whatever she thinks is fair. The essence of her plan is to allow government to decide whether a drug price increase is justified. She had earlier announced her desire to end the tax deduction for drug marketing. I have included a good summary of the full plan from

Bob Ehrlich
“Regulating prices will lead to less R&D.”
-Bob Ehrlich

While some drug companies have had extraordinary price increases, it is a rare event. EpiPen has made the news recently for a 500% increase. They have responded to the criticism by offering extensive reductions for those people who cannot afford it and saying they will launch a generic. Free market criticism led to free market price reductions. We did not need a government overseer to decide what price is fair.

Ms. Clinton feels like her $250,000 per speech fee is a fair price for her wisdom. She charges public universities that price even though it is a canned presentation. Somehow she believes in free market pricing for herself but not for drug companies. Bill and Hillary both give that aww shucks answer that they just take what is offered them and how amazing it is that people are willing to pay them so much. Her cost of production for that 30 minute canned speech is $0 but she likes to get what the traffic will bear. A drug company that takes years and a billion dollars of R&D to find a winning drug must be made to justify its price to a group of bureaucrats in her new plan.

I admit some drug companies have had surprisingly large price increases on some drugs. The solution is obvious. Free markets will generate competition for alternatives to these drugs. EpiPen will see competition enter the market just because the market is so profitable. The real danger of Ms. Clinton’s “plan” is at what point do the price controls stop. Once the government is allowed to decide what is a justified price for a few selected drugs eventually we will evolve to full price controls for all branded drugs.

There are many politicians who want exactly that. They want drug full price controls and government run health care. As I have said on many occasions, higher U.S. drug prices provide incentives for innovation. Regulating prices will lead to less R&D. That means the next time a new virus or anti-biotic resistant bacteria emerge we will be fighting them with outdated drugs.

Maybe government will take over the R&D function but government innovation is usually an oxymoron. Our government data is hacked routinely, our VA health care is a mess,  and our TSA often seems to have trouble spotting a pistol in a carry on bag. So I’ll trust private industry to innovate better than the government. I know Bernie Sanders and Michael Moore envy more advanced health care countries like Cuba where everything is regulated. After all, we know Havana is now the capital of new drug development and medical technology.

Hillary Clinton never misses an opportunity to take on the politically popular foe. I fully admit drug companies are ripe targets and often their own worst enemy. Drug companies must do more to have a consumer oriented pricing strategy. Her “plan”, however, is nothing more than political pandering and will do much more harm than good. She or Bill could of course buy 1000 EpiPens for each $250,000 speech and donate those to needy Americans. Now that sounds like a good plan.

September 2, 2016 Bob Ehrlich0

Restasis, the dry eye drug from Allergan will soon see major competition. Shire’s drug Xiidra was recently approved and now widely available. Their unbranded DTC campaign just began with A list star Jennifer Aniston as its spokesperson. This huge market of 16 million sufferers will now have two brands battling it out on the DTC front.

Bob Ehrlich
“Enlisting Jennifer Aniston is a big get.”
-Bob Ehrlich

Analysts say Xiidra has potential to be a billion dollar drug. Restasis has sales of around one billion so this should be a category with significant branded DTC presence. Restasis spent over $16 million in 1Q this year and they should be investing heavily to defend against Xiidra in 4Q.

Shire enlisting Jennifer Aniston is a big get. Getting a movie star to promote the dry eye condition must have cost Shire a lot in talent fees. Obviously they think she is worth it. Her ad just went on air under the “myeyelove” title. They have a website which tells her story of dry eye and has the commercial currently airing. The site has the usual education component with symptoms, causes, prevention and treatment options.

Jennifer Aniston is getting lots of commercial endorsements these days. She is touting skin care brand Aveeno and plugging the comforts of Emirate Airways. I am sure Shire considered whether we at a Jennifer saturation point. My feeling is we can take a couple more campaigns before she gets overused.

The commercial is very well executed with Jennifer telling her story of how dry eye interfered with her life. The 60 second spot uses the Beatle’s song “All You Need Is Love” the classic Lennon-McCartney song recorded in 1967 as background. I do not know if Jennifer will do any branded DTC, and my guess is no. Having her remain non-branded is probably a better use of her celebrity. She can tell a friendly story advising sufferers to consult their eye doctors without needing to deal with fair balance.
I expect a heavy branded component to appear late this year or early next year. Just doing non-branded ads will help Restasis as well, so expect Xiidra to tout its efficacy profile versus Restasis. The Jennifer campaign will help get attention to the launch from both providers and patients. Long term, however, this will be a brand to brand fight and likely a boon to DTC media sellers who love a multi brand battle.