Clearly understanding their diagnosis and treatment plan is vital for cancer patients in order for them to have an optimal treatment experience. In fact, studies have linked patient education to reduced depression and side effects from cancer therapies. Yet new data shows there are critical gaps in cancer patients’ knowledge about their condition and treatment.
Results from 825 patients diagnosed with or treated for cancer who were surveyed on Phreesia’s PatientInsights platform as they checked in for their doctors’ appointments revealed the breadth of that knowledge gap: More than one-third (34%) of surveyed patients were unaware of how advanced their cancer was.
That’s a percentage that Justin Holko, Vice President and head of the Global Oncology/Hematology Commercial Business Unit at Regeneron, finds troubling. Shubh Goel, Vice President and U.S. franchise head for Immuno-oncology and Gastrointestinal Tumors at AstraZeneca, shares his concerns, calling the statistic “a challenge for our industry to do better.”
Other survey findings further reinforced the conclusion that too many cancer patients are in the dark about important aspects of their condition and treatment. More than one-third (34%) of survey respondents said they lacked a clear understanding of their cancer therapy before starting treatment, while 17% understood their treatment “somewhat,” and a further 17% had little to no understanding of their treatment.
Similarly, only 35% of patients said they had undergone genetic or biomarker testing for their cancer, and 24% were unsure whether or not they had received such testing. The remaining 41% of surveyed patients did not undergo genetic or biomarker testing, depriving them and their physicians of insights that could have informed their care.
Holko sees those findings as evidence of the need for medical, commercial and research and development teams to make sure that every patient, caregiver, nurse and doctor has the opportunity to learn about all of the options available to them. But providing that education, particularly to patients, requires thoughtfulness: When communicating with patients at vulnerable points in their cancer journey, how information is conveyed is just as important as the knowledge itself.
“It’s not just your delivery of the education and facts, but doing it in a way that is uncomplicated, easy to understand, not overwhelming and that makes people feel like they’re equipped with the tools they need to go talk to their doctor or better understand their condition,” Holko explains. “It has to be done in a very personal way.”
Cancer-therapy drugmakers also play an important role in helping patients understand their diagnosis and treatment pathways. “Because we develop and make these cancer treatments, we have the opportunity to be an ally and an educator,” Goel says, highlighting the need “to work hand-in-hand with advocacy partners to advance dialogue with patients and grow our education efforts.”
Additional survey results indicated avenues for activating patients and improving their understanding of their cancer and available therapies. A majority (69%) of surveyed patients said they had sought resources beyond their healthcare provider to learn more about their illness. Online searches (48%), general cancer websites (36%) and specific cancer websites (32%) were cited as the most widely accessed resources.
Meeting patients where they are can better address their knowledge gaps and ultimately improve their cancer treatment, Holko says, pointing to the need for market research that can shed more light on how different patients find and absorb cancer information.
“It really comes down to understanding who your patients are and using every channel available to you to reach the right patient at the right time in a very personalized way,” he says.
Later this month, I am serving on a panel that will discuss how Pharma companies develop “great DTC creative”. While there is no recipe for great advertising (in general), the tactics leading to the goal are the same. Draw attention, make it relevant, deliver a powerful (and if possible distinctive message) and spark action. Basically get the patient to talk with a doctor. When it is done right, DTC advertising delivers an excellent ROI.
For consumer goods, an example of great advertising is the “Like Betty White” Commercial that promoted Snickers. The creative device is a humorous connection between Betty White and the target customer (“Mike”). The TV ad is both memorable and relevant. Don’t be like Betty White, eat snickers, get an energy boost, be cool, play better football.
Is Great DTC Adverting Bold?
While many people (especially advertising agencies) hope for bold DTC creative, it does not happen very often. That is because it either cannot be approved for use or it is not very successful.
Chantix provides a recent example of “funky” advertising creative. Referring to the old chestnut, “going cold turkey”, Chantix questions that appropach. It lets patients know that with its help, patients can quit “slow turkey”. While some patients may find this cute or clever, others may be turned off by the silly reference to their addiction. Like the Snickers ad, Chantix probably draws attention at first. However, unlike Snickers it may miss the mark on relevance and delivery of a compelling message. If the DTC advertising is bold and relevant, it will be effective. Otherwise not.
So What are the Elements of Great DTC Advertising?
Over the past 20 years, we have noted characteristics of DTC advertising which are most likely to produce successful outcomes. These include:
Quickly introduce information about the condition – to gain specific patient attention
Visualize the problem (making it relatable to patients) leading into description of the solution
Use a strong branding device (for Chantix this is the turkey) – that is relevant and ownable
Show relatable (not unusual) situations. While showing backyard scenes can be boring, it is better to show these compared to surreal imagery found in some DTC advertising
Show the brand name throughout the ad
Be distinctive. While this is often very difficult in contested categories, this is where good creative can make all the difference
When possible, use a demo that shows how the medication can help with the condition
If appropriate use testimonials – patients react well to these
If possible, show positive interaction between patients and the HCPs. In this way, DTC advertising can also deliver a positive ROI among the HCPs
In many categories, DTC advertising struggles to differentiate brands. Some complain that DTC advertising does not do enough thinking “outside the box”. These pundits claim that sharp creative would produce strong results. We do not disagree. Occasionally Pharma comes up with very clever ideas, like the “Tubs” used to promote Cialis. However, that should be considered an aspirational outlier. If the advertising can work within the primary guidelines above and leverage a strong branding device (Tubs), great. Otherwise, it is smarter to develop safe and distinctive advertising.
At the Minimum, Great DTC Advertising Should Catch Their Attention
It was always important to quickly introduce the condition and brand. Now that requirement is critical. In most cases patients will have an opportunity to tune advertising out, or to skip it entirely at the very start. On YouTube you have exactly 5 seconds. If the advertising is not relevant to the target, they will skip. And a very large percentage do skip. Given this hurdle, it is amazing to see that many DTC ads continue to build a slow story – sometimes vaguely referring to the problem before talking about the condition. As the clock ticks, viewers skip.
Entyvio DTC Ad Has Strong Elements
Entyvio offers a good example of Great DTC advertising. Right out of the gate (“0” seconds) the spot says, “With moderate to severe ulcerative colitis or crohn’s disease, your plans can change at any time…” Only 1% of the US population suffers from this disease, so the makers want to be sure that the target knows immediately that the ad is for them. This significantly increases the likelihood that the patient will continue to watch the ad past 5 seconds.
Describing Condition and MOA
In its ad, Entyvio also deploys a very effective tactic. It explains that Entyvio is “GI focused” on the problem introduced at the start of the ad. “Entyvio is made for this.” It goes on to say, “Entyvio works specifically in the GI tract to prevent an excess of white blood cells from entering and causing inflammation.”
Patient interest in this type of information, especially when it is creatively visualized like this, is very high. It will trigger both interest and discussion with a doctor.
Great DTC Patient Education
We are also seeing examples of strong DTC advertising that focuses on developing patient awareness of conditions. GSK recently launched a campaign to build awareness of Shingles. One in three adults over the age of 50 experience this condition, but most of them do not realize it. Thus it is critical for the ad to quickly draw attention to the problem and make it relevant to the patient. “Shingles doesn’t care” says the ad. You need to protect yourself against this serious medical condition.
There are many other examples of successful DTC advertising. Most of them deploy variations on the tactics described above. Some are more exciting than others. Our research shows that being exciting is not a prerequisite to being effective.
We acknowledge that it may be possible to violate all of the suggestions we identify above and still produce a great DTC ad. However, so far as we know it has not happened yet.
I decided to use this forum to celebrate some of the bravest and boldest work I have seen over the course of the past year. By that, I mean those brands that continued to re-set the bar for what “excellent” looks like in the DTC space. Those that help remind us all why we are in this business in the first place The following are all examples of work that really stuck with me in 2022. They run the gamut from an out of home stunt to print to innovation and film. All different mediums, but all are crown jewels of bringing great insights to life with exquisite execution.
Image Source: Twitter @booneoakley
Agency: BooneOakley, Charlotte Client: StarMed Healthcare Title: “Wilmore Funeral Home”
I remember the first time I saw this striking, unconventional way StarMed Healthcare chose to generate COVID vaccine urgency. It was ballsy and poignant and atypical of how most vaccine awareness messaging was being promoted at the time. This sobering and raw campaign sneaks in with a message that’s seemingly unrelated to the “advertiser”—and it’s one that, once it hits you, is impossible to forget. The campaign was a local North Carolina push as the Delta variant surged. The mobile billboard in the image says it all with unbelievable stopping power that really makes you think. I believe the billboard also offered a quick way to help folks sign up for the COVID vaccine. Really well done.
Agency: Eversana Intouch, New York Client: TheChrysalisInitiative.org Title: “Erase the Line”
This campaign is an excellent use of print in its purist form. Creating such impactful awareness around an extremely important and under-shared fact: “Black women are 40% more likely to die from breast cancer than white women.” Hats off to every detail in this campaign, from the core idea of ‘Erase the line’ and the unique visual depiction of the art direction, to even the painstaking craft of the typography. Every aspect of this work creates even more awareness that our systemically biased healthcare system needs. You can’t not notice this work. Nor should you.
Agency: Leith, Edinburgh Client: Justin Edinburgh 3 Foundation Title “The Extra Time Badge”
If a person suffers a sudden cardiac arrest, every minute without CPR could be the difference between life and death. When most people think of industry innovation in this arena, they’d typically think of big partnerships with cutting edge tech companies, but this life-saving approach is the complete opposite. Ironed onto footballers’ shirts in the place where CPR should be performed, the badge contains key information to help people learn about giving CPR. What a remarkably straightforward and effective way to get information to people when and where they might need it. ‘The Extra Time Badge’ educates young footballers, coaches, and parents in the key steps of CPR, giving anyone and everyone the quick, on-the-spot education about how to resuscitate someone in need. It’s great how a Lo-Fi technology as simple as an ironed-on patch can save lives. Such a simple and clever idea.
Agency: Arch Film Studio Client: Human Society International Title “Save Ralph”
This may be my favorite piece of work this year. It touches on a topic we are all aware of, likely feel bad about, yet don’t do much to further awareness or change our habits to address… cosmetic testing on animals. ‘Save Ralph’ hits you in the gut by showing the daily routine of a rabbit tester, while humanizing the lead character with emotions and a relatable back story. Every aspect of this short video hits it out of the park—the casting, directing, voiceover—even the well-written, dark humor script is off the charts. After seeing this I have made a personal vow to only buy products that are free of animal testing.
Constipation affects millions of Americans each year, but many patients have not yet found an adequate medication to control their constipation symptoms, new Phreesia data shows. However, there’s a key opportunity to boost education and help patients get on the proper treatments—and that’s by reaching them at the point of care.
Half (50%) of surveyed patients said they experience constipation all or almost all of the time, and 45% reported having dealt with their condition for more than 5 years, according to survey results Phreesia Life Sciences collected in October and November 2021 from 6,780 adults diagnosed with or treated for constipation as they checked in for their doctors’ appointments. Unsurprisingly, patients’ symptoms also seriously affect their quality of life, with 62% of survey respondents saying that constipation has a moderate or great impact on their everyday life.
Despite the prevalence of their condition, many patients do not have a strong understanding of the health risks associated with constipation—61% of surveyed patients said they understood its risks “somewhat well” to “not at all.” This lack of comprehension points to the need for more education that can activate patients and urge them to address their constipation symptoms with their healthcare providers, which many rarely do. Phreesia survey data shows that nearly one-third (31%) of patients have never discussed constipation with their doctor, and among those who did raise the topic, 41% said they brought up their symptoms in fewer than 1 in 4 appointments.
And when it comes to initiating conversations about constipation with their provider, a significant portion (43%) of surveyed patients said they haven’t done so because they either didn’t realize it was an issue to discuss, or they felt uncomfortable bringing it up to their doctor.
“Patients must first understand that their symptoms are worth talking about and worthy of prescription therapy,” says Thomas McCourt, CEO of Ironwood Pharmaceuticals. “Many of these patients feel as though constipation isn’t a serious condition; they believe that it’s their own fault because they aren’t eating right or getting enough exercise. Once they understand that it’s actually a chronic disorder causing their symptoms, they’re more likely to believe they’re entitled to more effective therapy and feel an urgency and confidence to speak up to their doctor.”
In addition to improving patients’ treatment education, better-informed provider conversations are also key to helping get patients onto prescription therapy. Despite not being meant for long-term use, home remedies and over-the-counter (OTC) medications are still the most widely used constipation therapies, according to Phreesia survey data. And while 90% of surveyed patients agreed that OTC drugs are not meant to be used long term, half (50%) of those who have used OTC medications said they have taken them for more than a year.
Reaching patients while they’re in a healthcare state of mind with relevant resources about their condition can help support them as they navigate conversations with their doctor about constipation treatments that are more suitable for long-term use. And Phreesia survey data suggests these conversations tend to lead to prescription uptake, as 32% of surveyed patients have discussed prescription constipation medications with their physicians, and 31% have tried them.
The point of care “is one of the most valuable places for patients to discuss their symptoms and educate themselves about their condition,” McCourt says. Equipping them with doctor discussion guides, prescription savings information and other relevant materials at this critical moment of their healthcare journey not only raises patients’ awareness of prescription treatment options but also empowers them to initiate the discussions with their providers that will drive adoption of appropriate long-term therapy options.
The health care insurance industry is preparing for open enrollment (OE) in the fall. Insurers are plotting their approach for effective use of consumer advertising to drive OE success. There are three unique and challenging characteristics of OE advertising for insurers:
specific, short time period (October – December)
marketplace is cluttered with advertisers
enrollment is a complicated, multistep process
The following are some OE advertising best practices using these three attributes as a guide. They serve as both a reminder and, in some cases, a “checklist” during successful planning and deployment of OE advertising.
Short window demands starting early
Begin as early as possible. Don’t wait for October to start.
Plan your approach by layering awareness tactics first then followed by direct response marketing.
Most consumers don’t respond until the week before the end of the OE window so consider incentivizing earlier enrollment with deadlines —e.g., “get peace of mind before Thanksgiving by enrolling today,”. There may be limitations with government–funded program.
Break through the clutter
It is critical to differentiate in a crowded market and especially given increasing parity across product offerings.
Invest in creating a unique message and imagery.
Maximize the currency and ease-of-use of all information sources and channels
Craft proactive, authentic messages that deliver information needed to make decisions – remember to simplify the concept of insurance.
Robust websites with in-depth and proactive content should feel authentic and build trust with consumers.
Layer in a steady stream of social media content.
Employ a standalone landing page for open enrollment to keep messaging laser-focused.
Deploy a full-funnel marketing strategy
Have a strong call to action that drives to high-touch contacts — e.g., phone, in-person enrollers.
A call center with well-informed, trained staff is key to helping consumers through the consideration process
Valuable to have “brick and mortar” locations
Collect leads from digital advertising.
Don’t forget the importance of direct mail.
Tightly integrate CRM and sales into advertising.
These advertising best practice approaches, when implemented thoughtfully and effectively, can help ensure a successful OE. While these tactics are effective for many consumers, they might not be sufficient to overcome certain barriers to obtaining coverage (e.g., gaps in healthcare literacy, language or cultural barriers or internet access). That’s why it’s important to start as early as possible.
Many Type 2 diabetes patients worry about their disease, leading to a significant impact on their mental health—especially for younger diabetics. However, those concerns present fresh opportunities for pharma companies to ultimately improve outcomes for Type 2 diabetes patients by offering them the support tools and resources they most want.
Diabetes has a pervasive effect on patients’ lives, with more than one-third (37%) of Type 2 diabetes patients reporting that they worry about their condition often or all of the time, according to data Phreesia Life Sciences collected in December 2021 and January 2022 from more than 4,000 adults diagnosed with or treated for Type 2 diabetes as they checked in for their doctors’ appointments.
Those worries can often be debilitating, as 42% of surveyed patients said their Type 2 diabetes has a moderate-to-great impact on their mental health. And Phreesia survey data shows that mental health concerns are even more significant among younger patients, with 31% of Millennials and Gen Z reporting that their diabetes has a great impact on their mental health, compared with 23% of Gen X and 9% of Baby Boomers.
Listening to and understanding Type 2 diabetes patients’ mental health struggles before engaging with them is crucial to alleviating some of the burdens they face, explains Mark Materacky, Vice President of Consumer Marketing at Novo Nordisk.
“It starts with a deep understanding and empathy for the challenges people who live with Type 2 diabetes experience,” Materacky says. “Addressing the person first—not the disease—is critical.”
Despite the condition’s negative effect on many patients’ psychological well-being, more than three-quarters (77%) of surveyed Type 2 diabetes patients said they have not sought any mental health support. Those who do seek support most commonly said they talk to friends or family (16%), followed by seeing a psychologist or counselor (5%). This notable gap between the prevalence of Type 2 diabetes patients’ mental health concerns and their uptake of support spotlights a marketing opportunity to connect with these patients and share resources that can help them.
In addition to their need for mental health support, Type 2 diabetes patients also want personalized resources to help them manage their condition. For example, nearly half (49%) of surveyed patients cited nutritional information specific to their needs as their most desired resource. Other top requests included tips on recommended lifestyle changes when taking diabetes medications (37%) and resources that could help them better understand how their medication works (31%).
Pharma companies can deepen their engagement with Type 2 diabetes patients and raise their awareness of the support materials available to them by taking a more personable approach in their marketing communications, suggests Christine Mormile, Director of Media at CMI Media Group.
“It’s very easy to get caught up in talking about financials or why you should get on a medication,” Mormile says. “Something that all pharma products—not just in the diabetes space—can do better with is creating messaging that asks patients, ‘How can we listen to you?’ or conveys that ‘We’re here to support you, and this is how our product can help your long-term diabetes care-management plan.’”
One of the strongest ways to engage with Type 2 diabetes patients—and to connect them to the types of support they seek—is by reaching them with these thoughtful messages at the point of care. Phreesia survey data suggests that diabetes patients discuss various treatment and disease management options with their providers. For example, 60% of survey respondents have talked about weight loss and nearly half (44%) have discussed new prescription medications with their main doctor who treats their Type 2 diabetes.
Given Type 2 diabetes patients’ demonstrated willingness to discuss treatment options with their providers, there are multiple opportunities for pharma marketers to reach them, not only with medication-awareness campaigns while they are in a healthcare state of mind, but also with nonpharmacological resources that can holistically support their treatment plan. Pharma companies should leverage the point of care to help diabetes patients access the many support tools available to them, empowering them to implement key lifestyle changes that can help them confidently manage their disease.
The last decade saw an explosion of health data from sources including the digitization of health records, genomics, wearables, insurance claims, and more – which by some estimates now represents about 30% of the world’s data volume.
When combined with the power of machine learning, this data has the potential to reveal new insights into patients and their unique care journeys. Just imagine an AI model that improves the accuracy of cancer diagnosis, or can help isolate the genes responsible for rare genetic conditions. Innovations like these are already beginning to improve patient outcomes, and they raise the question of how else we can replicate the beneficial application of health data more generally across the entire healthcare system in a privacy-safe way.
Digital marketing in pharma seems like a prime candidate for this type of innovation. For example, what if we could glean broad, population-level insights to deliver relevant information exactly when patients need it? Or what if we could improve the experience for the 42% of consumers who say that the relevance of the pharma ads they see are poor or very poor?
Considering that our past research has found that pharmaceutical ads can empower patients to take a more active role in researching treatments – which is also the most common factor that patients state influences their medication adherence – that would be powerful indeed. So let’s examine the state of programmatic advertising in healthcare today, dig into some of the trends holding back the use of privacy-safe health data in advertising, and explore the opportunity for pharma marketers who successfully combine the two.
The State of Pharma Marketing in 2022
For a number of reasons, linear TV has long dominated the marketing mix for pharmaceutical brands and their agencies, but viewing habits change and audiences are fragmenting. In fact, some estimate that up to 70% of streaming audiences can’t be reached by linear-only campaigns – driving many advertisers to explore programmatic formats like digital video and connected TV (CTV). The pandemic further changed the way many pharma brands view advertising, with many appreciating the important difference it made in educating consumers and providers alike.
This major landscape shift toward programmatic media by pharma represents an opportunity to rethink both ad relevancy and measurement for the industry.
First, programmatic channels offer much more precise targeting than traditional TV – with as many as four or more variables like location and household income, compared with traditional demographics. Incidentally, this aligns with what patients say they want: relevancy. According to research conducted by DeepIntent and LG Ads Solutions, 65% of the more than 2,900 adults surveyed said that targeted ads improved their experience – and 57% said CTV ads were more relevant than linear or traditional TV ads. However, the deprecation of third-party cookies in 2023 will impact the precision of some programmatic channels, making it important to invest in new tools and strategies that allow for privacy-safe audience building, targeting, and measurement. CTV, for instance, doesn’t rely on third-party cookies for audience identification and measurement.
Second, linking digital ad campaign data and health data allows advertisers to go a step beyond traditional reporting metrics. Instead of simply tracking top-level data points like the number of impressions or clicks an ad received, marketers can go much deeper and analyze real-world patient outcomes, such as the number of new patients who actually follow through with filling the prescriptions written by their doctors after viewing an ad. This is also where there is the greatest opportunity to improve audience targeting, activation, and measurement over time – and is what will soon transform digital marketing in pharma.
Supercharging Pharma Marketing With Real-Time Data and Campaign Optimization
Health data isn’t actionable on its own, and a number of challenges have historically prevented its use for advertising.
For starters, data siloing and property systems have made it difficult to extract data and collect insights from connected data sets. The need for privacy and regulatory compliance further complicates its use for advertising purposes. Plus claims data, when available, is often lagged, and a lack of integration between marketing platforms and measurement tools has made campaign optimization a difficult, time-intensive process that is nearly impossible to automate at the same depth other industries enjoy today.
But why should healthcare marketers be relegated to using tools and solutions that are second-rate and downright inferior compared to what other marketers can do? The answer is they shouldn’t, and thankfully, the latest digital marketing technology leveraging real-time data, clean rooms, and machine learning makes it possible to optimize campaigns toward real-world outcomes using digital health data in a privacy-safe way.
Within just a few days, healthcare marketers using this technology can begin to determine which of their channels and demographics are most effective at achieving their campaign goals such as audience quality and new-to-brand scripts. That information can then be interpreted using machine learning to optimize variables including creative, audience, frequency, inventory geography, and more that impact whether an ad is both timely and relevant.
For an industry that has traditionally lagged behind others like retail or finance in its adoption of programmatic, the consequences of this shift are huge. Marketers will gain a much better understanding of campaign performance, and can optimize their campaigns faster and more effectively than ever before. And for patients who may rely on a new drug or therapy, the effects of this transformation can be literally life-changing.
The LGBTQ+ community encompasses a wide range of patients across all races, ethnicities and gender identities. However, when seeking healthcare resources and support, many of these patients feel underrepresented and mistrustful of pharma advertising, new data shows.
Less than half (44%) of LGBTQ+ patients feel that pharma ads reflect their experience as members of the LGBTQ+ community, according to survey data collected by Phreesia Life Sciences and Klick Health from more than 1,500 patients in early 2022 as they checked in for doctors’ appointments. Similarly, only 45% of surveyed LGBTQ+ patients feel that pharma understands their unique needs, with those who identify as transgender or female being even less likely to feel understood by the pharma industry.
This lack of representation and understanding has affected LGBTQ+ patients’ overall trust in pharma, with 2 in 5 surveyed patients (41%) reporting that they don’t trust pharma ads at all and another 26% saying that they trust them “only a little.” And while representation is vital for building and maintaining that trust, outreach to the LGBTQ+ community also is crucial for bolstering these patients’ confidence in pharma, says Thea Briggs, Associate Director, Content Strategy, Phreesia Life Sciences.
“Representation matters, but it’s not enough to address disparities on its own,” Briggs says. “Pharma marketers must actively pursue robust outreach efforts, such as learning about LGBTQ+ individuals’ healthcare experiences, hiring LGBTQ+ people and partnering with community organizations to create effective campaigns, as well as dedicating consistent energy and attention to addressing the issues that this community experiences.”
Those issues range from having higher rates of either being uninsured or underinsured to postponing or avoiding medical treatment because of bias and discrimination. Additionally, although more than 50% of surveyed LGBTQ+ patients say they are aware of many preventive care services, the percentages of those who have recently used such services are much lower. For example, while 59% of LGBTQ+ patients are aware of blood-pressure screening, only 32% got screened in the past year.
As for outreach, many LGBTQ+ patients feel that pharma still has more work to do: Slightly more than one-third (34%) of surveyed LGBTQ+ patients “strongly disagree” and another 22% “somewhat disagree” that the pharma industry conducts sufficient LGBTQ+ outreach beyond HIV and pre-exposure prophylaxis (PrEP) medications that high-risk individuals take to prevent getting HIV.
To improve LGBTQ+ patients’ perceptions of the pharma industry, as well as their preventive care knowledge, Amy Gómez, PhD, Senior Vice President, Diversity Strategy, Klick Health, emphasizes that it’s important to include members of the LGBTQ+ community at every stage of the pharma-marketing process, including foundational research and concept and message testing. Doing so can help pharma companies develop a deeper understanding of these patients’ attitudes, beliefs and behaviors and ensure that those attributes are accurately reflected in pharma communications.
“We can and should use our skills to create empathy and urgency,” Gómez says. “We can partner with our clients and providers to develop model programs that demonstrate the positive effects on community health outcomes when empathy for LGBTQ+ people and awareness of the health issues that impact them help to ameliorate implicit bias.”
And while engaging with LGBTQ+ patients to better understand what they need from their healthcare experiences can help boost preventive care usage, Phreesia survey data shows that greater inclusion also translates into more opportunities to positively impact LGBTQ+ patients’ perceptions of the pharma industry. Overall, 82% of surveyed patients said they have more positive feelings toward pharma companies that conduct outreach to the LGBTQ+ community.
“We’re proud to be using our platform to connect with members of the LGBTQ+ community to learn from them directly about their experiences in navigating and accessing healthcare,” says David Linetsky, Phreesia’s Senior Vice President, Life Sciences. “Our hope is that the insights we generate from this work will help advance and guide efforts among providers and pharma manufacturers to address biases and create more equitable healthcare experiences for these communities.”
Actively engaging with members of the LGBTQ+ community and gathering data that educates providers and better equips them to meet these patients’ needs is crucial for continuing to build their trust in the pharma industry, Briggs explains. However, fostering that trust must be a broadly inclusive, long-term commitment for life sciences organizations if they want to make true progress within this community.
“It’s easy for marketers and public health professionals to fall into the trap of becoming prescriptive— assuming we know how problems are experienced by individuals without asking them and deciding that we’re going to go in with our preferred solutions, regardless of community buy-in and participation,” Briggs says. “That’s not effective or respectful. Building trust and designing effective interventions and campaigns that will be well-received and work in patients’ real lives requires a lot more listening and learning than talking.”
It was a typical Thursday morning in Medical, Legal, and Regulatory (MLR) review, and we were about to review a simple branded banner ad for a prostate cancer drug. The team has always been accustomed to allotting 15 to 30 minutes at most to review a tactic as simple as a banner ad, but this was certainly not the case that day. The banner ad was pulled up onscreen for review and within two seconds of it being displayed, the legal reviewer abruptly said one word: “Nope.” Everyone in the room and on the phone was confused, so naturally, the lead marketer asked if there was a problem. The legal reviewer explained that the first frame of the banner ad displayed an African American male representing a patient with prostate cancer, and then the reviewer followed up by indicating that the prominent use of an African American male misrepresented the brand.
Before diving into the rationale that this legal reviewer provided for this decision, let us briefly discuss the reality of the prostate cancer patient population. This year, an estimated 268,490 men in the United States will be diagnosed with prostate cancer. The number of new cases diagnosed in Black men is 73% higher than the number of new cases diagnosed in White men. Black men in the United States and the Caribbean have the highest incidence rates of prostate cancer around the globe.1 In addition to being more likely to be diagnosed with prostate cancer, African Americans have the world’s highest incidence of prostate cancer and a more than two-fold higher mortality rate compared with White men.2
Now back to the MLR review where the legal reviewer refused to review the banner ad due to the representation of the patient in the first frame. You could hear a pin drop in the room when this decision was made. There was an overwhelming sense of discomfort among the marketers, ad agency partners, and even certain MLR review team members, especially since this was at a point in time when we as a nation were at the height of sensitivity around racism and racial disparities, including health disparities. It was at a time when Diversity, Equity, and Inclusion (DE&I) was at the forefront of corporate culture across all industries in our nation. But let it be clear that this legal reviewer was not acting on or making a decision under any racial or prejudicial ideologies or ways of thinking. The legal reviewer stated that we were misrepresenting the brand because the clinical trial of the product we were promoting had less than 1% African American patients represented in the study population. Consequently, this reviewer deemed it as a substantial legal risk to prominently represent an African American male on a branded piece promoting the product. All other reviewers then followed suit and the decision was made to replace the Black patient with a White patient—all because it misrepresented the clinical study population when in reality, it was most representative of our national population fighting prostate cancer.
The intent here is not just to tell a story about an instance that occurred in one MLR review, but to use this story to set the stage on a topic that runs rampant in the pharmaceutical and healthcare marketing and advertising industries. The topic of patients being underrepresented or misrepresented in marketing efforts across various disease states is neither novel nor unique. It has been an issue plaguing the pharmaceutical and healthcare marketing industries for quite some time now. Although many companies are actively attempting to address this issue, especially with the recent uptick in DE&I efforts, we still have a way to go when it comes to matching our industry’s multicultural representation with the multicultural reality. Therefore, the intent here is to briefly highlight just a select few of the fairly recent and successful trends in our industry that are being used to combat this issue, with a focus on three specific points: (1) representative clinical trial recruitment, (2) representative patient inclusion within pharmaceutical advisory boards, and (3) the importance of effective multicultural marketing.
Representative Clinical Study Recruitment
Let us first address one of the main principles that will help shift the narrative of multicultural representation in the pharmaceutical industry, which is the corporate recognition that multicultural recruitment efforts for clinical trials need to be significantly better and truer to the epidemiology of each respective disease state’s population. Ensuring people from diverse backgrounds join clinical trials is key to advancing health equity.3 Participants in clinical trials should represent the patients who will use the medical products. Unfortunately, this is often not the case as people from racial and ethnic minorities and other diverse groups are underrepresented in clinical research. So, while it may seem obvious, one significant step researchers and medical product sponsors can take to confront healthcare disparities is to ensure clinical trials for medical products are more inclusive of multiple populations.
In fact, the US Food and Drug Administration (FDA) issued final guidance in late 2020 with the agency’s recommendations of designing and executing clinical trials of drugs and biologics that include people with different demographic characteristics (e.g., sex, race, ethnicity, age, location of residency) and nondemographic characteristics (e.g., patients with organ dysfunction, comorbid conditions, and disabilities; those at weight range extremes; and populations with diseases or conditions with low prevalence). This guidance provides the FDA’s current thinking on steps to broaden eligibility criteria in clinical trials through inclusive trial practices, trial designs, and methodological approaches. In turn, it aims to provide recommendations for how sponsors can increase enrollment of underrepresented populations within their clinical trials.4
Ultimately, this will allow medical product manufacturers to reach their respective patient populations more accurately and effectively through even more targeted marketing efforts. It will also help prevent any uncomfortable conversations around potential risk due to legal technicalities associated with clinical trial recruitment and promotion of the product at hand.
Representative Patient Inclusion Within Pharmaceutical Advisory Boards
It is exceedingly important to understand that now, more than ever, patients of all socioeconomic or demographic statuses have access to self-research medical information. DeepIntent fielded a study in which they found that while stuck at home during the pandemic, people saw more pharma ads than ever and it was not just on televisions, but on computers and mobile devices. The study also found that consumers watching ads and searching for health information online weighed almost equally when measured against their physician-provided knowledge.5
As patients take their health and future into their own hands with the help of digital health tools, they also should be treated as equal partners within hospital, pharmacy, and even pharmaceutical company settings. For this reason, pharmaceutical companies are increasingly employing patients who have experience with the given company’s products on their advisory boards, and better yet, accurately represent the most affected patient populations. This allows companies to capture detailed patient information to inform future strategies and effective targeting approaches.
As an example, Novo Nordisk is committed to incorporating the patient voice at all stages of their product development process. They believe it takes a multistakeholder approach to develop new treatments for patients living with chronic diseases, and Novo Nordisk is convinced that patient partnerships are the best starting point for all medical innovations. As a result, in 2020, Novo Nordisk established patient advisory boards called DEEP (Disease Experience Expert People), which is a framework for placing patients center stage and providing an environment for their input to affect the patients’ care delivery model, as well as future patient communication strategies for Novo Nordisk products.6
Importance of Effective Multicultural Marketing
Multicultural marketing is the process of representing diversity within a brand’s collateral, messaging, and content, as well as speaking directly to diverse cultures, races, and groups. The multicultural or cross-cultural segment constitutes the largest, fastest-growing consumer segment in the US market. This is due to the significant treatment gaps across therapeutic areas that not only represent potentially millions of new scripts but also represent the strong brand upside and a reputational boost from the opportunity for the pharmaceutical industry to improve patient outcomes on a national scale. The multicultural segment is also at the forefront of the consumer movement when it comes to digital, mobile, and social media use and when communicated in a way that is relevant and resonates, has a higher promotional response. To address this growing populace, the number of pharmaceutical companies investing in multicultural marketing teams has more than tripled within the last decade. The good news is that although the industry is a bit behind, the needle is certainly moving in the right direction as many pharmaceutical companies have also adopted multicultural or multiethnic corporate strategies.7
A key part of effective multicultural marketing is that to close some of the gaps, an incremental investment is needed to specifically target these audiences, as traditional efforts can prove less effective. Using Nielson media data, a direct example of this can be seen in a breakdown of primetime TV viewers. When the top 10 English language networks were compared to the top Spanish language networks, it was determined approximately 70% of US Hispanics (18 years or older) are exclusively tuning in to the Spanish-speaking Univision. The data clearly show that traditional investments in the English language TV space are underreaching this audience.7
It is also important to gain the necessary vocabulary and language for essential conversations around cross-cultural marketing and to hear directly from leaders in cross-cultural marketing on how to create a business case for the investment internally and how best to collaborate successfully externally. Consideration of necessary ways to apply existing tools and data sets to communicate with a diverse audience more effectively is what sets apart a truly successful multicultural campaign from the status quo. For example, social media marketing and the content shared on various platforms, should mirror the diverse audience it’s targeting and seek to engage them, which will undoubtedly prove far more successful than those brands choosing to employ a more blanketed approach, designed to appeal to a broader and more general audience. Now is the time for marketing teams to appropriately budget for a targeted multicultural, multichannel approach to adequately communicate health information directly to communities of color through the specific platforms where they most engage. The inevitable result? Better DE&I practices by marketers, better brand visibility and results, and more informed and engaged target audiences.
In conclusion, a key takeaway is that multicultural marketing is simply marketing. It should now be the standard across any marketing strategy throughout any industry. But when speaking directly to the pharmaceutical industry, the main point is that patients want to be heard and most importantly want to understand treatment options available for their conditions, and that especially goes for the most at-risk patients, which for the most part, happen to be ethnic minorities in low socioeconomic geographic areas. However, it will be difficult to notice a significant shift without effectively addressing at least the three trends that were just highlighted: (1) representative clinical study recruitment, (2) representative patient inclusion within pharmaceutical advisory boards, and (3) the importance of effective multicultural marketing. It is imperative that all three items feed into each other, and as such, strengthen each other when done properly. Lastly, it is critical for the pharmaceutical companies in collaboration with all their partner agencies to continue to fight for appropriate, accurate, and necessary representation of patient populations not only as they pertain to clinical studies, but as they are truly represented in those most affected, especially in the underserved ethnic minority communities. Because as many of the team members in that MLR room reviewing the banner ad that one Thursday morning can attest, they never want to have to sit through a conversation like that ever again.
References
Cancer.Net®. Prostate Cancer: Statistics. Accessed July 20, 2022. https://www.cancer.net/cancer-types/prostate-cancer/statistics
Hoffman RM, Gilliland FD, Eley JW, et al. Racial and ethnic differences in advanced-stage prostate cancer: the Prostate Cancer Outcomes Study. J Natl Cancer Inst. 2001;93(5):388-395. doi:10.1093/jnci/93.5.388
Clinical Trial Diversity. US Food & Drug Administration. Accessed July 20, 2022. https://www.fda.gov/consumers/minority-health-and-health-equity/clinical-trial-diversity
FDA Offers Guidance to Enhance Diversity in Clinical Trials, Encourage Inclusivity in Medical Product Development. US Food & Drug Administration. Accessed July 20, 2022. https://www.fda.gov/news-events/press-announcements/fda-offers-guidance-enhance-diversity-clinical-trials-encourage-inclusivity-medical-product
The Patient Perspective: Paving the Path to Awareness, Ad Relevance and Empowerment. DeepIntent+®. Accessed July 20, 2022. https://www.deepintent.com/the-patient-perspective-paving-the-path-to-awareness-ad-relevance-and-empowerment/
Coquerel C, Kuruvilla S, Eichmann L. Inside Novo Nordisk’s Patient Advisory Board Meetings. Accessed July 20, 2022. https://www.clinicalleader.com/doc/inside-novo-nordisk-s-patient-advisory-board-meetings-0001
Nielsen. The Multicultural Edge: Rising Super Consumers. Accessed July 20, 2022. https://www.nielsen.com/wp-content/uploads/sites/3/2019/04/the-multicultural-edge-rising-super-consumers-march-2015.pdf
While the notion has long prevailed that rural Americans live in the “digital dark,” new data suggests that rural patients are actually online just as much as their urban counterparts. And, thanks in part to widespread smartphone and data-plan usage, pharma marketers can now reach all patients—no matter their geographic location—more easily than ever before.
Still, there’s no denying that city dwellers have better wireless and internet services. Rural residents were found to be twice as likely to have “somewhat weak” to “no wireless coverage” (24%) compared with urban residents (12%), according to data gathered from Phreesia Life Sciences, which surveyed more than 4,700 patients—including more than 1,800 rural patients—as they checked in for doctors’ appointments in December 2021 and January 2022. But despite these infrastructure challenges, smartphones are helping close the digital-access gap.
“There are a lot of misperceptions about life in rural settings, often portraying rural folks as less tech-savvy or less connected to online services,” says David Linetsky, Phreesia’s Senior Vice President, Life Sciences. “We’re really proud to be able to do this work of actually talking to patients who live in rural communities to better understand their stories and experiences.”
Phreesia survey data found that only 7% of rural patients say they don’t have access to smartphones and data plans—just a percentage more than the 6% of urban patients who say they lack such access. Therefore, given that rural patients are becoming just as accessible online as urban patients, pharma marketers should tailor their efforts to meet these populations in the digital spaces they frequent, Linetsky advises.
“Digital platforms such as Phreesia, telehealth services, and other digital communications technologies are making healthcare more accessible to rural patients and also making it easier for manufacturers and marketers to reach those patient audiences with important health information that can help them better engage in their care,” he says.
The top activity for smartphone users across geographies is checking email, with some 82% of rural patients and 84% of urban patients listing it as an activity they use the internet on their smartphones for. Web browsing rates as all users’ second-most-popular activity, with 70% of rural patients and 72% of urban patients reporting that they browse the internet; and social media rounds out the top three, with nearly two-thirds (60%) of rural patients using their smartphones to scroll through social media, even more than the 55% of urban patients who use the internet for the same purpose.
Considering these browsing and scrolling percentages among rural patients, smartphone-optimized content is a great way to engage them. Even more notably, rural patients most want tools to help them manage their health. Top requests include: personalized resources specific to their health condition (44%); remote physician or nurse support (36%); and resources that can teach them where to find health information (27%).
“In places with lower population densities, a lot of traditional out-of-home marketing tactics are ineffective,” Linetsky says. “Reaching patients that live in rural communities is best done through the use of digital platforms that are capable of identifying high-quality audiences that meet the specific clinical and demographic criteria you’re looking for.”
Still, in determining digital-marketing strategies, it’s important to note that rural patients find it slightly more difficult to gather healthcare information online than their urban counterparts. For instance, a little more than one-quarter (26%) of rural patients are uncertain about how to use the medical information they gather in an internet search to make health decisions, versus 23% of urban patients. In addition, rural patients tend to consider the online health information they track down less helpful than urban patients do. Fewer than one-fifth (19%) of surveyed rural patients categorized the information they found online as “very helpful,” compared with 23% of urban patients.
That disconnect underscores the importance of making sure that the online health information marketers provide to patients is easily understandable and based on their specific needs. In addition to engaging with patients in the online spaces they already frequent, such as social media and email, optimizing pharma educational and support materials for mobile devices further increases opportunities to connect with rural patients by helping them build their healthcare awareness.
Agency: Leith, Edinburgh
Agency: Arch Film Studio
