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August 27, 2020 Linda Ruschau0

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While social distancing is essential, “medical distancing”—staying away from the doctor’s office for fear of contracting COVID-19—is dangerous. Just as’s latest campaign strives to remind people that seeking care is not only safe but necessary, we see it as our duty at PatientPoint to provide patients, physician practices, and brands the support they need to ensure effective engagements are still occurring at the point of care.

Our business is driven by a deep understanding of patient and physician behaviors and desires at critical touchpoints in the care journey. We know your business relies on these insights as well. That’s why we are continually talking to our network of physicians, analysts, and industry insiders to secure proprietary data that we can use to provide you with the most up-to-date insights into the pulse of marketplace.

Here are three new insights, according to patient-level claims data and the latest results of ongoing, independent COVID-19 patient surveys.

1. Patient visits are steadily increasing and now exceeding 2019.

While the impact on patient traffic was significant during the onset of COVID-19 in late March and April, since that time primary care office visits have steadily increased and returned to near normal ranges in June and July.

2. The second COVID surge is not impacting patient traffic in physician offices.

An additional look at trends across the country, using the same patient-level claims data, uncovers that primary care practices in most states have returned to their pre-COVID patient volumes (despite the second surge).

3. Telehealth visits are leveling off.

As more patients return to the doctor’s office, we see the percentage of telehealth visits now comprising approximately 10-11% of all primary care visits (compared to about 25% at the peak of COVID in mid-April). According to our recent consumer surveys, 72% of patients say they prefer in-person appointments.

Through our ongoing data collection, we hope to separate fact from fiction about patient care and COVID-19, and provide an ongoing benchmark of real insights straight from doctors and patients during this unprecedented time. We will continue to apply what we’ve learned to ensure we make every doctor-patient engagement better at all points of care.

Keep up to date on all of our latest research and insights by visiting our COVID-19 News of the Day blog.

August 27, 2020 admin0

A record low price increase on branded drugs and changes in health insurance benefit design are just a few of the reasons that patients in the US are experiencing improved affordability for their medications, according to a new report from The IQVIA™ Institute for Human Data Science. Their research found that 71% of branded prescriptions have a final out-of-pocket cost of below $20, while just 3.6% of branded prescriptions have a cost above $125. The report, Medicine Spending and Affordability in the U.S.: Understanding Patient Costs for Medicines, discovered that “[a] rising number of prescriptions are now dispensed with a $0 payment by the patient, and now amount to 44% of all branded prescriptions in 2019, up from 36% in 2015.”

Additionally, the data found that branded prescriptions costing more than $125 largely affects those with commercial plans (44% of high-cost claims) or Medicare coverage (35% of high-cost claims). IQVIA did also find that “abandonment is higher at higher prescription cost levels, and those prescriptions may be underrepresented as those prescriptions might have been abandoned due to cost.” Of the 9% of branded and generic prescriptions that are abandoned: 5% are for medications of no cost, but 60% are when the medicine costs more than $500.

“Lower drug price growth and improvements in affordability to patients is a testament to the positive market dynamics of the American pricing system and the fact that manufacturers, health insurers and the intermediaries, such as wholesalers and benefits managers, have taken actions to reduce the burden of drug costs to patients,” said Murray Aitken, IQVIA senior vice president and executive director of the IQVIA Institute for Human Data Science, in the news release. The report examined the complexities of our current pricing system, hoping to “contribute to more transparency and understanding of the different levels of cost,” Aitken added.

August 27, 2020 admin0

“Visits to physician offices and other health care practices, which had fallen 60 percent by early April, have now rebounded and plateaued at 10 percent below prepandemic levels,” found the latest wave of research from the Harvard University, Phreesia, and the Commonwealth Fund. In-office visits are still showing a decline, even among those states which saw a surge in cases during the June and July months. However, these declines are still smaller than that of the early days of the pandemic.

Several hot spots states – including early-opening ones such as Arizona, Florida, and Texas – recorded an increase in telemedicine visits, but only a slight decrease in overall visits. “Practices in these states appear to have maintained most of their visit volume by increasing telemedicine visits and creating new safety protocols for in-person visits.”

Telemedicine use peaked in mid-April. While it has shown a decline and its current adoption has plateaued, it is still being used at a “substantially higher rate than prior to the pandemic” the report notes.

The research continued to find a large difference in visit patterns between adults and children, with adults still outpacing children. Those aged 18-64 years old showed a -4% change in visits (the smallest percent change for the week starting 7/26/2020), while children ages 3-5 represented the largest percent change at -36%. Children ages 0-2 were tracked at -32%; ages 6-17 recorded a -17%; and those aged 65-74 and 75+ both came in with a -9% each in visits.

Initial data findings were published in April 2020, with this research partnership team providing monthly updates to track trends in outpatient office visits. Click here to view more of the findings – including what impacts insurance type has had on visit rebounds and the adoption of telemedicine by Federally Qualified Health Centers (FQHC) and non-FQHC.

August 27, 2020 admin0

With the rapid use of telehealth resulting from the pandemic, the Centers for Medicare & Medicaid Services (CMS) released a new toolkit to help the Medicaid and Children’s Health Insurance Programs (CHIP) accelerate their adoption of telehealth coverage during this time. The toolkit is designed to walk states through identifying policies that they will need to address to facilitate virtual health services as well as what issues or obstacles they should be considering as they implement or expand their usage of telehealth.

As states navigate their virtual health needs and coverage policies, they need to review the patient populations that are eligible for these services, what coverage and reimbursement policies are or will be, and what special considerations may be needed for pediatric patients. States also need to evaluate whether a practitioner or provider can appropriately deliver care using virtual health. Are there any limitations or training needed for the delivery of such services? If the medical professional can provide care in this manner, issues such as eligibility, licensure, credentialing, and payments need to be factored in next. Additionally, technology requirements need to be considered as there are a variety of options that fall within the the virtual health category – video chat, audio-only communications, and remote patient monitoring to name a few.

“While not all patient interactions can be delivered through telehealth, our clinicians on the frontlines need every tool in their arsenal to fight this invisible enemy,” said CMS Administrator Seema Verma in the news release. “I’m urging states to use this toolkit to make sure our Medicaid patients, particularly our children, can continue to receive needed care from the safety of their homes.”

August 26, 2020 Bob Ehrlich0
The multiple sclerosis (MS) category is increasing its DTC use. Historically, low incidence diseases have used print and digital targeted efforts rather than mass. That has changed over the last few years as drugs for Hep C, HIV, lung cancer, and other lower incidence categories have gone mass media including television.

Approximately 1 million Americans have MS with 12,000 newly diagnosed cases each year. This is more prevalent in women. New treatments have been making this a more competitive marketplace. Novartis’ Mayzent and EMD Serono’s Mavenclad joined the mix in 2019. Genentech’s Ocrevus was approved in 2017. Genzyme’s Aubagio has been around since 2012.

The big spender is Ocrevus at about $100 million over the past 12 months. While MS has been advertised using limited print historically, Ocrevus has gone full multimedia, including a huge television investment. Ocrevus started its campaign in late 2019. They use print, TV, and display ads along the theme “Dear MS.” This is an MS patient telling the MS disease they found a new treatment to help them take back control.

Using a vignette approach, each patient profiled tells MS that they used to be controlled and defined by the disease. Now, they found Ocrevus and have more space to live their lives. The ad is impactful, using real sufferers and an arresting first visual. The 60-second ad is nicely balanced with 25 seconds of benefits, 25 seconds of fair balance, and 10 second wrap up stating MS does not get to control the sufferer, with the end line “MS can’t own us.” The print ad is themed the same as television with the “Dear MS” headline. It states Ocrevus is a 2x a year treatment in the headline.

Aubagio has done a good job with their print based campaign. With a lower budget than Ocrevus of about $18 million, they used a headline in a two-page spread that reads, “To Find A Way to Keep Moving Forward.” Above the headline is an explanatory smaller type saying “With Relapsing MS Your Goal Is.” I am a big fan of eye catching headlines in an easy to read font, on a background that makes the headline stand out. Using white lettering on blue background accomplishes that. Aubagio, also in a sub headline, states it is a once a day pill.That is important since some MS drugs require infusion.

What I also like about the Aubagio campaign is its consistency. They have used the same headline for the past two years. The only change has been the color of the background which seems to be rotating with the blue version. Both versions show a 30-something female jogging along which goes with the moving forward headline.

Mayzent has just started its consumer print campaign with a two-page spread. They are going for an emotional approach of a woman with a cane, pictured with her child. Their indication is for secondary progressive MS where there is a worsening condition.

Zeposia, an oral pill from Bristol Myers Squibb, was approved March 2020 so we can expect that to be added to the DTC mix likely in 2021. Numerous drugs in oral and infusion doses are in phase 3 trials so this category will remain active for DTC. What is increasingly clear is that most new brands believe DTC is an important part of their marketing strategy.
Bob Ehrlich, Chairman
DTC Perspectives, Inc.

August 19, 2020 Bob Ehrlich0

There are a number of drug makers that do disease education ads. Those companies have a drug that treats the disease or have one about to be approved. Disease education ads make financial sense when a drug company has the only drug to treat the disease or are the dominant competitor. Most disease education ads are followed with a branded campaign when competition emerges or when the addition of a branded campaign can help increase patient requests.

Neurocrine Biosciences is a a San Diego based company that currently gets 97% of its revenue from one product called Ingrezza, a pill that helps reduce uncontrolled eye, mouth, and body movements in people taking medications for schizophrenia, bipolar disorder, and depression. Tardive Dyskinesia (TD) is the name of this disease. Ingrezza was approved in 2017.

Neurocrine decided in early 2019 to do a disease education campaign on television and digitally. The current campaign rotates three executions. The 60-second spots do a very good job introducing the disease with an actor stating the problem and an animation that explains where on the body the symptoms might occur. The campaign is called “Talk about TD.” The campaign has the difficult job of educating patients, families, and caregivers to understand Tardive Dyskinesia. I never heard of it until I saw the campaign.

TD is a disease that affects about 500,000 people. About 58% of patients taking anti-psychotic drugs were unaware those treatments can cause TD. Thus, the need for patient education. Ingrezza is a premium priced drug at about $300 a pill retail. The dose is once a day so the revenue potential for Neurocrine is up to around $9,000 a month per patient. Of course, they get less from payers who negotiate the formulary position. Neurocrine reports revenue of about $5,700 per month per patient.

The educational challenge here is threefold. First is to identify the symptoms of TD which can affect any part of the body, and a second is to get patients to understand that these movement symptoms are something you can treat. Third is to explain how to get more information on treatments. Each of these challenges is dealt with well in the campaign. The ads are visually interesting in how the scenes shift from actor to animation of the symptoms.

Disease education on heart disease, diabetes, or cancer is common place. The TD campaign spending is relatively high for a small company. MediaRadar reports the television spending at around $19 million since the launch. An additional $2 million was spent on digital. Based on reported sales, Ingrezza has done very well. In 2019, it did about $750 million. In 2020, it looks like the drug could top $1 billion. The ad campaign seems to generate a very good ROI given the growth in 2019 and anticipated growth in 2020.

The trend towards doing DTC for limited size categories continues with Ingrezza. In the past, categories of this size would have used highly targeted patient marketing programs. What makes DTC enticing is the revenue per patient, as a $21 million disease education investment would require only a few hundred new patients to be successful. Without having any inside Ingrezza data, I think this campaign exceeded that break-even level.

Bob Ehrlich, Chairman
DTC Perspectives, Inc.

August 13, 2020 Bob Ehrlich0
Covid-19 has raised a major societal issue on health disparities in America. In many diseases, minority populations suffer more and get less treatment. This is not a new finding, but Covid-19 along with the Black Lives Matter protests on discrimination have given rise to new possibilities of addressing health disparities.

Is this the time that health disparities will be taken on? Most drug companies have some efforts related to minorities. The reality, however, is that DTC budgets do not usually allocate significant spending towards these communities. This is interesting given that traditional DTC efforts under reach these audiences, and most minority groups over index in digital, social, and mobile. I expect that will change as big Pharma realizes they are missing an opportunity to contribute to the disparities solution. It will be good business to devote more resources to minority health. A Biden victory would add to the impetus to deal with health disparities through both disease education and special branded efforts towards minority communities.

As I searched for those doing minority efforts now, I was impressed by a campaign on Multiple Myeloma done by Amgen. This digital campaign targets African-Americans with unique creative. Amgen has a drug, Kyprolis, and decided to do a separate education effort to African-American patients leveraging both disease education and branded content. This is not just showing African-Americans as part of a general vignette ad. Instead they created, along with their agency EMCAY, a dedicated branded campaign to address key needs of this important segment. The site is rich in African-American focused content and a dedicated place for consumers to share their stories. They also use quotes around the photos of patients, from leading African-American historical figures and authors to inspire the fight against the disease.

The campaign, “Its On”, highlights the treatments available to fight Multiple Myeloma, which includes Kyprolis. The educational component is excellent as to risk factors, an explanation of how the disease affects blood cells, discussion guides with your doctor, and patient trackers for labs and doctor visits. The “It’s On” theme covers patient (It’s on You) and drug company/caregiver (It’s on Us). Clearly the site was well-developed with relevant language that emphasizes spirituality and community. That is not something you see on general sites.

The need for special outreach is because health discussions within communities can vary greatly by race, ethnicity, and economic status. The clinical journey is at times widely different. African-Americans frequently consume health information differently and have unique health issues, such as higher prevalence of co-morbidities like diabetes and hypertension. The site encourages African-Americans to be part of the treatment process and reduce some of the gaps.

The “It’s On” campaign tries to understand and talk to these unique needs. Amgen and EMCAY recognized that special efforts are going to get better results among African-Americans than just assuming the general effort is sufficient.
Bob Ehrlich, Chairman
DTC Perspectives, Inc.

August 6, 2020 Bob Ehrlich0
Hmm, Aflac or Chantix. Duck or Turkey. What a feast! I have written about the Chantix Turkey when it launched. I liked it then and like it now. I said then that I did not see the use of the turkey as a long term campaign. Apologies to Pfizer and their agency VMLY&R. They have extended the campaign with numerous new executions.

Starting with Turkey by the pool in early 2019, Chantix has added Turkey campingsightseeingice skatingsnowball fightinglounging at homeat a local carnival, and at the beach. The theme has stayed the same. The Turkey represents not having to quit smoking cold turkey. 

This campaign is quite interesting and innovative for DTC. It is a far cry from patient testimonials and actor Ray Liotta, which were done earlier and also well done. I have no data on its success versus the earlier approaches. I can say with certainty that Chantix ads are memorable, likable, and unique.

“Once you land on a great strategy, you can’t shy away from it. We were certain that offering smokers a gentle alternative to cold turkey would motivate them to try quitting again. The Slow Turkey character is really just the most natural expression of that idea,” John Bollinger, Executive Creative Director at VMLY&R, told DTC Perspectives.

Use of a cute character has its limits. It really depends on the therapeutic category. It is hard to imagine using a Turkey for cancer ads. No, the cute character needs to stay within categories we do not consider immediately life threatening. Of course smoking can lead to heart disease and death, but not imminently like stage four cancer. Cute characters have worked for toe fungus, urinary incontinence, gastrointestinal ailments, and dry eye. Lamisil (Digger), Myrbetriq (walking bladder) and Xiidra (eye critter) are examples where levity was considered useful.

Chantix apparently decided that a cute character would help break through the DTC clutter of testimonial, lifestyle, vignette type ads that dominate drug advertising. I think it certainly does that well. Whether the Turkey can endure much longer is up for debate. Chantix has proven me wrong that the Turkey can be extended to numerous situations. Clearly in other categories, characters have lasted for years and have not shown any viewer fatigue. The Geico Gecko and Aflac Duck have had staying power.

Chantix has the benefit of a relatively simple selling message. You can stop smoking over time with Chantix. No need to go through the withdrawal going cold turkey. With that simple message, Chantix can focus on a memorable creative device. Many drug ads have so much information to convey that they need to be more straightforward in their presentation and use real patients or doctors, or actor portrayed patients or doctors, to recite multiple points. Chantix had the luxury of being able to focus on stopping power since the message can be nicely conveyed through the voice over.

What is very interesting about the campaign is the lack of print ads. The campaign is over 90% television with the rest digital. I would think the Turkey would make a nice visual in full page ads. That said, Chantix knows what works and has their reasons to eschew print for television. Good job Pfizer and VMLY&R for trying something very unique among DTC ads that have a tendency to look the same.
Bob Ehrlich, Chairman
DTC Perspectives, Inc.