Latest News

June 30, 2017 Bob Ehrlich0

First, I am now back writing my weekly column after taking a couple of months off to recharge my batteries. Happy to be back giving my thoughts on issues affecting our DTC community. As I was watching CNN discuss healthcare reform yesterday I was surprised to hear host Chris Cuomo say drug prices were the main driver of rising insurance costs. He said this to Senator Dick Durban a democrat from Illinois. Durbin promptly said DTC is a big culprit in rising drug bills.

Ok, Chris and Dick. You are both wrong. The drug bill in America is a relatively minor cost at 10% of total health care expenditures. DTC spending is about 1% of total drug sales, hardly a driver of rising costs. While some high profile drugs are very expensive for cancer and hepatitis C, most branded drugs are not. The facts say Americans spend about $1100 annually versus $770 in Canada and $740 in Germany. (OECD study 2014) That difference is significant but not the driver of out of control health insurance premiums and deductibles.

Bob Ehrlich
“Reducing information flow…is not the answer to lowering health care costs.”
-Bob Ehrlich

The bottom line problem in America is we have an incentive for all providers to do services to get paid. We reward treatment not prevention. Doctors and hospitals get paid for procedures not watchful waiting or advice on prevention. Defensive medicine encourages added tests to protect from lawsuits. The latest technology we all love is expensive to install and providers recover their costs by high utilization. Americans want fast answers to their health issues and providers are more than willing to accommodate us with MRI’s and diagnostic procedures.

Drug companies are under attack and the lack of facts used by reporters like Cuomo are troubling. Durbin has no basis for saying DTC is a major problem driving up prices. His actual basis is his own distorted view that if patients ask their doctor for an advertised drug, then that must be for a drug not really needed. While DTC advertising is designed to encourage patient initiated discussion it is the doctor who decides whether it is needed. Drug companies have a chance to make their case to the consumer and doctor through DTC, detailing and medical advertising. Reducing information flow as Durbin seems to want is not the answer to lowering health costs.

The better solution to health care cost control is to incentivize consumers to shop around. We can do this by total price transparency from providers and by consumers having some skin in the game with their deductibles and copays. Hospitals and doctors want their fees to be opaque to patients. As long as someone else pays our bills most consumers do not ask or care. As we all face higher deductibles we are starting to care more what we are being charged.

Obamacare has caused significant increases in premiums, deductibles and copays. If we are to continue it, then we either can care more as consumers about prices we pay or ask the government to subsidize insurance companies to keep those premiums, deductibles and copays under control. I would recommend the former. If we give consumers the knowledge and incentive to negotiate with providers for lower prices, it will happen. There are many ways to provide consumers with price and quality information on providers. We have health technology companies who have that information and are happy to provide it. If we just ask government to continue to pay insurance companies to subsidize high provider costs we continue the fee for service model.

What unfortunately is happening is each side of the political aisle has reduced the discussion to simplistic slogans. We need moderates on both sides to create a coalition to solve the problem not to say ridiculous things like millions will die if we change Obamacare or Americans must be free of government mandates. Maybe I ask too much that reasonable people emerge to create a more workable health care system. I can still dream that the warring parties will actually think more about solving problems for America than destroying the opposition.

June 30, 2017 admin0

Earlier today, Nebraska Senator Ben Sasse sent a letter to President Trump urging him to separate the actions of repealing and replacing healthcare, rather than doing them simultaneously, if there is still no resolution by July 10th. Since not enough progress has been made on healthcare, during an appearance on Fox & Friends this morning the Republican Senator recommended that repeal be handled first and then “have the President ask us to cancel our August state work period and stay here [to] then work on replace separate. We made promises to the American people, we should fulfill them.” Sen. Sasse – who is a supporter of as much repeal as allowable – stated in his letter to the President: “We should include a year-long implementation delay to give comfort to Americans currently on ObamaCare that a replacement plan will be enacted before expiration.” President Trump agrees with the idea of separation, tweeting this morning, “If Republican Senators are unable to pass what they are working on now, they should immediately REPEAL, and then REPLACE at a later date!”

June 30, 2017 admin0

PatientPoint announced this week that it received $140 million in capital from private investment firms, allowing for significant digital growth in its point of care networks. Serving as a strategic advisor, the Peter J. Solomon Company secured the financing from Searchlight Capital Partners and Silver Point Capital.

A leader in patient education and engagement programs in the point of care space, PatientPoint provides trusted content, which is largely created internally, that is tailored to particular healthcare professionals’ specialties. The programs are offered through a variety of channels, including digital screens in waiting rooms and interactive touchscreens in exam rooms – currently found in more than 31,000 doctor’s offices and 1,000 hospitals across the country. While today’s impact levels reach over a half a billion patient and caregiver visits annually, founder and CEO Mike Collette stated via news release that “by 2019, our goal is to provide programs that can impact 60-70% of brand prescribing volume in the most strategically important specialties.”

Collette, who recently returned to his leadership post at PatientPoint, explained, “We have invested a significant amount of financial and human capital into product development over the past six months to ensure that our programs are truly best in class.” Traver Hutchins, Chief Growth Officer, added, “While much of our growth will be through amplification of existing programs, we will also be solidifying several acquisitions and partnerships that will further strengthen our product offerings. We have also significantly increased our data-driven marketing expertise, allowing us to provide more personalized, relevant communication to patients for a truly enriched healthcare experience.”

The rapid growth of the point of care industry combined with PatientPoint’s innovative patient programs, reliable analytics and insights, management experience, and the trust of healthcare providers, solidified commitments from investors. PatientPoint enhances the healthcare experience for patients and caregivers through its cohesive, end-to-end communication platform, whether it be in the primary care space or complex specialties.

Click here to read the full news release.

June 29, 2017 Amanda Rhodes0

The concept of coaching is pervasive in today’s culture with many popular forms: life coach, fitness coach, personal coach, wellness coach, and behavioral coach. Regardless of the topic, coaches help us to take the next step towards achieving our goals. But understanding the purpose behind behavioral coaching is particularly important as we seek to meet patient needs. Behavioral coaching uses evidence-based clinical strategies and interventions to engage patients in behavior change to better self-manage their health[1]. The ultimate goal is to improve health outcomes, lower risk, and decrease costs[2].

Using behavioral science to address adherence barriers is not new to sponsored patient support; in fact, behaviorally based programs have been around for years. However, the application of live, two-way support to identify barriers in real time and deploy specific messaging, resources and coaching support is on the rise.

Digging into behavioral barriers and their importance

Behavioral coaching encourages a two-way, patient-led conversation to uncover barriers to adherence, express empathy, and offer personal support that results in a collaborative action plan to maximize adherence.

Results demonstrate that frequent, personalized interactions with patients create opportunities to reinforce messages about adherence and allow patients to take an active role in managing their own healthcare. By using behavioral-based techniques, pharmacists and trained contact center agents can help deliver impactful conversations with patients.

Increased financial responsibility for rising healthcare and drug costs is a significant issue. However, most non-adherence is not due to drug cost. It is estimated that 69% of the problem is behavioral, such as perceived benefits, poor doctor-patient relationship, medication concerns, or low self-efficacy[3].

Leveraging behavioral coaching techniques

In order to be impactful, therapeutic class insights can be critical to truly understanding patient needs and delivering support that drives improved outcomes. While each patient’s situation may be unique, our experience in behavioral coaching reveals similarities across therapeutic conditions which can be used to infer best practices in addressing patient challenges across brands and patient populations. For example, sensitive conditions (HIV, hepatitis C) have social implications that may require more empathetic messaging than more mainstream chronic conditions (diabetes, hypertension). Patients with a visible dermatological condition (psoriasis, onychomycosis) often face quality of life issues that may require significantly different support.

Helping to overcome these barriers is individualistic in nature, and takes investment, patience, and experience. Behavioral conversations can identify a patient’s position on their treatment paradigm, help them to clearly define their treatment goals, and create a path to reach those goals with dynamic support provided at every step along the journey.

Alignment of goals between the coach and the patient is one of the most important steps in improving outcomes. Patients are more likely to succeed if goals have personal meaning, as opposed to focusing on achieving an external reward or avoiding punishment. A patient’s active engagement is the key to setting goals designed to help them commit to behave consistently and have greater focus on attaining a goal.

Techniques like active listening and reflective response involve patients digging deeper into their personal barriers, which is critical to help set goals, as well as work towards achieving them. Both techniques require focus and effort. It is more than simply listening in order to reply, but listening to understand – not just the words, but the emotion behind the words, that influence the patient[4].

Patient-centered behavioral coaching is designed to help patients determine the way in which THEY believe they need to change their behaviors to achieve their goals. Patients who feel listened to are more comfortable with the care they receive and are more likely to adhere. The way in which the coach responds is equally as important as listening[5]. A good example is smoking cessation. While a smoker knows that smoking is bad, telling the patient to stop rarely, if ever, encourages them to do so and often forces them to defend the very behavior we are attempting to influence. As a result, the patient resists, and presents arguments to counter the proposed change.

How coaching can build an integrated brand experience

Behavioral conversations are designed to “meet the patient where they are,” but this also can refer to the channels through which patients can be coached. The same patients can be touched across multiple channels to enhance the overall patient experience and outcomes. Paramount to building a consistent, impactful support program is to place the patient needs in the center, then build an integrated experience across channels, internal stakeholders, and budgets. Channels where pharma brands may reach patients through coaching include:

  1. Phone Coaching: Research shows that phone coaching for people with chronic conditions can improve health behavior, self-efficacy, and health status. Planned phone coaching sessions appear to be most effective for improving self-management skills in people from vulnerable groups. Phone coaching services have the advantage of regular contact – helping people develop their skills over time – and the tailored conversations allow the coach to support the patient’s individual needs[6].

Using dynamic, two-way conversations, coaches can identify adherence barriers and provide targeted messaging to help overcome those barriers, connecting with patients using proven health behavior change tools and techniques. This approach can, with proper consent from the patient, also align personalized messaging with a patient’s co-pay program level data, as an example. Recognizing that adherence barriers change over time, as well as patients’ information and education needs, brands can integrate out-bound support and multi-channel communications to maintain personalized support for patients throughout their treatment journey.

Diabetes Coaching Case Study

Adherence Barriers: The life of a diabetic patient is a juggling act to maintain glycemic control: blood-glucose testing, exercise, and diet. Many Type II diabetics struggle with the condition from the point of diagnosis, and consequently have feelings of failure if they progress to an insulin-dependent state. These issues create multiple challenges to medication adherence, and disease and blood-glucose management. It’s easy for these patients to feel out of control with the regimen complexity and the associated long-term complications. Studies show a significant number of patients don’t take their medications as prescribed, which may reduce effectiveness and lead to additional complications. Increasing adherence in diabetic patients is a tri-pronged approach and an important consideration when supporting the patient.

Program Goal: Improve adherence through providing behavioral coaching individualized to the needs of patients segmented on level of engagement. Results demonstrated that patients who were coached were 25% more adherent to therapy vs. control during a 9 month study. This 25% increase in adherence translated to an increased length of time on therapy of nearly 31 days. The primary conclusion proved coaching increases adherence and is effective across all behavioral segments.

Symphony Health Analytics, 2016

  1. Hub Support: Delivering a consistent experience through all patient support programs, from therapy initiation and throughout the patient’s journey, is increasingly important. Many brands have different decision makers leading these initiatives, resulting in a lack of integration between various hub services, patient support programs, and co-pay card vendors. This lack of integration leads to a disjointed patient experience and a missed opportunity to maximize patient impact. Integrating access with adherence is crucial to a patient’s success – and coordinating that support, data integration, and a seamless patient experience, increases patient success.
  2. Specialty Pharmacy: With the dosage complexity and costs associated with specialty medications, pharmacies offer varying levels of patient support. When building a comprehensive patient support program, it is critical for brands to understand how the pharmacies’ approach to patient support compliments its distribution model and patient experience goals. For example, Biologics, one of the leading specialty pharmacies in the country, provides patient support through oncology nurses, who are experts in setting appropriate expectations, providing empathy, identifying psychological challenges, and linking the patient to brand approved resources.

The use of behavioral coaching is growing significantly within oncology to support patients moving from an end of life diagnosis to living with a chronic disease. The unique characteristics of oncology patients present complex challenges that impact the best approach to help patients achieve positive outcomes with emerging, specialty pharmacy treatments.

Improving medication adherence

To effectively combat non-adherence, industry must explore patient-centric approaches that increase adherence rates and improve patients’ quality of life. This requires a shift from short-term initiatives to longer-term strategies, recognizing that behavior change takes time.

Behavioral coaching conversations that leverage powerful tools, such as active listening, open ended questions, and reflective response have consistently increased adherence. These conversations allow patients to dig deeper into their own personal barriers, to help coaches and clinicians set appropriate product expectations, leverage available resources, and develop a plan of action to prevent non-adherence. Ultimately, the strategic balance between patients’ needs and brand goals results in a scalable adherence solution that builds patient engagement, giving brands the ability to optimize patient spend and identify communication strategies most likely to meet the needs of targeted patients.




[1] Huffman M., Miller C. (2015). Evidence-based health coaching for healthcare providers (3rd ed.). Winchester, TN: Miller & Huffman Outcome Architects, LLC. Google Scholar

[2] Judith H. Hibbard and Jessica Greene What The Evidence Shows About Patient Activation: Better Health Outcomes And Care Experiences; Fewer Data On Costs Health Affairs 32, no.2 (2013):207-214 doi: 10.1377/ hlthaff.2012.1061




[6] (Aust Health Rev. 2013 Jun;37(3):381-8).

Nurses today are in an optimal position to help pharmaceutical companies. According to the American Nurses Association, nursing professionals have high levels of trust in terms of consumer perception for the past 15 years, and nursing reliability and expertise is recognized within the healthcare profession.

Yet the critical functions of nurses within the pharmaceutical industry can be easily overlooked in comparison to traditional clinical positions. That’s despite the fact that nurses play vital roles in communicating information both to and from the patient in pharmaceutical settings.

For example, a nurse health coach delivers key information and support to the patient during medication adherence and patient engagement programs. Likewise, nurses on pharmacovigilance (PV) teams process information from the patient, applying their analytical skills and clinical knowledge to improve the safety profile of a drug or device.

Both the patient engagement and PV nursing roles necessitate empowerment and smart decision-making. Research demonstrates that empowered nurses empower patients, resulting in improved outcomes. Nurses within the PV sector need to be empowered to make the best decisions given the information at hand.

Bringing their best work

On a typical day, a nurse on a PV team may receive and review safety information from a variety consumer and healthcare professional sources. Using clinical and analytical expertise, the PV nurse summarizes the information and submits safety data for pharma representatives’ assessment against the safety profile of their drug or device. PV nurses are also a resource for investigative sites with respect to reporting safety information that protects consumers. Soliciting and processing follow-up information is a key responsibility of PV nurses to ensure that pharma companies, regulatory authorities, healthcare professionals, and patients have complete information regarding the safety of consumer drugs and devices.

At every step of the way, PV nurses should be empowered to do their best work. This starts with their clinical expertise. I encourage the nurses on my team to build upon their clinical experience to better understand disease processes or conditions beyond what is apparent at the “surface level.” As part of that process to dig deeper, nurses need to understand the gray areas and be prepared to navigate murky waters. That involves knowing what is important to extract from the data they receive and applying the right analytical skills, in addition to using their clinical background knowledge.

What’s the benefit?

While in a conventional sense PV nurses may not be considered for their significant role in disease education and awareness, they certainly serve a crucial role as protectors of the consumer. Their work affects research processes and outcomes that will influence disease or condition management in the years to come. The work done and the information processed by the PV nurse have the power to improve drugs and devices, change clinical practice, and improve patient safety outcomes.

In the end, nurses within every role — whether pharma or clinical, health coaching or PV — play a vital role in our healthcare system. Pharmaceutical companies should leverage the vast experience and knowledge nurses can bring to the table. Empowered nurses are powerful agents of change that have positive effects on the pharmaceutical and healthcare industries, and within society at large.


June 28, 2017 Linda Ruschau0
Sponsored Content

As patient centricity continues to become the industry priority, the need to get the right information to the right patients at the right time in the right format is more important than ever—especially for pharma.

Our recent white paper touched on the disconnect patients feel with pharma companies. Today, only 9% of patients say pharma does all it can to help.1 That is, if these patients even know who the pharma companies are: Nearly 40% of patients don’t know any of the companies behind their treatments.2

I’d venture to guess, however, if pharma companies offered these patients the information they needed, in the format they desired, at each point in their healthcare journey, those stats would quickly change. They are for our clients, at least, who are leveraging a variety of our point-of-care solutions.

No marketing campaign is complete today unless it covers a variety of channels – digital, social, mobile and, yes, even print. We know different media will work more effectively for different demographics and different locations and different specialties. That’s why the PatientPoint solution set features the widest range of channels in the POC market; each is meant to maximize the meaningful impact pharma brands can have on patients.

Take, for instance, a 50-year-old man waiting to see his urologist. It’s unlikely he’s willing to grab a brochure on ED in front of others in the waiting room. But he will watch a digital screen displaying a segment on his condition. Once he gets into the exam room, we know he prefers more in-depth printed pieces he can read and refer to later when deciding on treatment.

How to communicate with your target audiences doesn’t need to be an either/or decision between print and digital. Both are perfect complements to each other – and both are necessary to a holistic, satisfactory patient experience.

That’s why I’m always surprised when I read articles declaring print as a communication of the past. It’s certainly not true in our industry – just ask our clients who are using our print program as part of their multi-channel marketing strategy and seeing great results (as in +12.5% incremental NRx).

Print remains a vital part of the patient experience and an important connecting point to both patients and physicians:

  • More than half of patients rank printed brochures or booklets that give disease or drug information as the most useful communication method3
  • 55% of HCPs say they rely on printed communications when talking with patients over any other form of communication4

Having your brand be a part of trusted materials a physician hands to his or her patients offers a unique level of credibility and implied endorsement. It also shows you’re considering many patients’ personal preferences, which will help relieve some of that disconnect patients are feeling, which I mentioned earlier.

In the end, what matters most is the experience created for patients. A communication strategy that combines a variety of media offering highly relevant, personalized content will ultimately power the greatest effectiveness.



  1. MM&M, “Patient Engagement: All Grown Up—Patient Engagement Comes of Age,” 2015
  2. Ed Miseta, “Patient Survey: Tech Use Up, Pharma Disconnect Remains,” Clinical Leader, 2017
  3. eyeforpharma/Health Perspectives Group report, 2017
  4. Marc Iskowitz, “In health education, providers prefer paper: study,” MM&M