education as marketing in pharma

Education as Marketing in Healthcare

Knowledge driven strategies for better business results

Business issues

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“Drugs don’t work in patients who don’t take them”

C. Everett Koop, former United States Surgeon General

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Non compliance

Compliance and adherence are major issues in chronic diseases even in developed countries

Non-compliance is a major obstacle to the effective delivery of health care. Estimates from the World Health Organization indicate that only about 50% of patients with chronic diseases living in developed countries follow treatment recommendations. In particular, low rates of adherence to therapies for asthma, diabetes, and hypertension are thought to contribute substantially to the human and economic burden of those conditions. Compliance rates may be overestimated in the medical literature, as compliance is often high in the setting of a formal clinical trial but drops off in a "real-world" setting.

World Health Organization (2003)

Adherence to Long-Term Therapies: Evidence for Action

Depression

Pain-Other

Chronic bronchitis

Heart problems

Cancer

0% 25% 50% 75% 100%

50%

52%

54%

61%

62%

50%

48%

46%

39%

38%

Adherence rates in chronic diseases

Yes No

Source: Rob Blazek, April 2005

http://en.wikipedia.org/wiki/World_Health_Organization

http://en.wikipedia.org/wiki/Developed_country

http://en.wikipedia.org/wiki/Asthma

http://en.wikipedia.org/wiki/Diabetes

http://en.wikipedia.org/wiki/Hypertension

http://en.wikipedia.org/wiki/Clinical_trial

http://www.who.int/chp/knowledge/publications/adherence_full_report.pdf

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Low treatment compliance is a big problem for an optimum health care delivery…

Cancers

Cardiovascular diseases

Endocrine and metabolic diseases

Musculo-skeletal conditions

70% 75% 80% 85% 90% 95%

86%

93%

79%

84%

85%

93%

78%

82%

Cost Admission rates

vs non-engaged patients = 100%


World Health Organization (2003) (PDF).Adherence to Long-Term Therapies: Evidence for Action


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…and decreases dramatically drug effectiveness (and revenues)

Diabetes non-compliance (98% in US) is the principal cause of complications related to diabetes including nerve damage and kidney failure

Hypertension non-compliance (93% in US, 70% in UK) is the main cause of uncontrolled hypertension-associated heart attack and stroke

Asthma non-compliance (28-70% worldwide) increase the risk of severe asthma attacks requiring hospitalization

Source: Discovery Health


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Reasons for non-adherence are related to product, patient and physician communication Product

Perception on effectiveness Easy of administration Cost

Patient issues Memory Problem solving skills Lack of health literacy Patient beliefs

Patient-physician communication Non effective and trusted communication

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Approaches that don’t focus on persons don’t work

1. One-size-fits-all

2. Expecting others to do the work

3. Nagging direct mail reminders

4. One-way communication

5. Complex technology


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Approaches removing obstacles work…

Changes in product Reducing patients’ out-of-the-pocket costs Packaging improvements Dosing changes

Technology Electronic medical records SMS and Call Centers Reminders systems Brand websites

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…but those focused on people work better

Patient perspective Patient education Patient assistance programs Discounts Changing patients belief Involving family Patient experience programs

Physicians and medical staff Pharmacy interventions Training physicians Increasing access

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Many of adherence and compliance causes can be addressed with educationDisease Health care system interventions Patient interventions

Asthma Education on use of medicines; management of disease and treatment in conjunction with patients; adherence education; multidisciplinary care; training in monitoring adherence; more intensive intervention by increasing number and duration of contacts

Self-management programmes that include both educational and behavioural components; memory aids and reminders; incentives and/or reinforcements; self-monitoring

Depression Multidisciplinary care; training of health professionals on adherence; counselling provided by a primary care nurse; telephone consultation/counselling; improved assessment and monitoring of patients

Counselling; relapse-prevention counselling; psychotherapy; family psychotherapy; frequent follow-up interviews; specific advice targeted at the needs and concerns of individual patients

Diabetes Multidisciplinary care; training for health professionals on adherence; identification of the treatment goals and development of strategies to meet them; continuing education; continuous monitoring and re-assessment of treatment; systems interventions: health insurance for nutrition therapy, telephone reminders to patients, chronic care models

Behavioural and motivational interventions; assessment of psychological needs; telephone reminders to patients in order to reduce missed appointments

Common Multidisciplinary care; training in educating patients about adherence; good patient–provider relationship; management of disease and treatment in conjunction with the patients; more intensive intervention in terms of number and duration of contacts; adherence education; training in monitoring adherence; uninterrupted ready availability of information

Mutual goal-setting; incentives and/or reinforcements; behavioural and motivational intervention; counselling/psychotherapy; assessment of psychological needs; self-management of the disease and treatment that includes both educational and behavioural components;memory aids and reminders

World Health Organization (2003) (PDF).Adherence to Long-Term Therapies: Evidence for Action

Education on use of medicines

Behavioural and motivational interventions

Training for health professionals on adherence



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Education can also help to fix other business issues

Awareness Prevalence Complications Interactions Side effects

Loyalty Provided value


Our approach

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Traditional educational “top-down” approach is a long and inefficient path

1•M

SL

2

•International Advisory Board

3

•National Advisory Board

4

•Trainers

5

•GPs, specialists and other

6

•Patients and families


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New approach can be much faster and effective…

MSL, Marketing

GPs and specialists

Other medical staff

PharmacistsFamilies

Patients


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Dosage Efectivenness

Target Interactions

Tolerability

KOL

Specialty Physicians

General Physicians

Patients

Families

Other medical staff

Safety

ûûûû

ûûû

ûûûû

û

ûû

û

…more customized…

This is only an example


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…and more responsive and long-term sustainable

MSLMarketing

GPs and specialistsOther medical staff

PharmacistsPatients

Other targets

Sp

ecif

ic n

eed

sS

pecific ed

ucatio

n


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Education must be not only information, …

Student Content

Specialist defined purpose

Target needs

Sequenced for optimal retention

Presentation, practice, feedback and assessment

User defined purpose

Discipline carachteristics

Sequenced for optimal reference

Presentation

Training Information


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…but a structured process of knowledge transfer that combines different strategies…

Experience Based Learning• Mentoring, Role Playing, Case

Studies, Coaching

Collaborative Learning• Virtual classrooms, e-Labs, Web

conferences, e-Teams

Interactive Learning, Games and Simulations• CBT/WBT, Multimedia, Games,

Simulations

Support and Reference Materials• Web sites, video, audio, books, e-

books

Learning from CollocationGetting together, Meet as a

community, Develop relationships, Live it, Do it

Learning from CollaborationDiscuss it, Practice with others,

Create virtual communities of practice

Learning from InteractionExamine it, try it, interact with it

Learning from InformationRead it, watch it, listen to it

Strategy Technology resourcesMethods

LMS

LMS

face-to-face*


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…to achieve measurable behavioural changes (and business objectives)


Customer satisfaction is the first step to get business results

Behavioral changes in the customers are difficult, but not imposible to measure

Education effectiveness measurement is key

Finally, you should try to relate behavioral changes with business results

Customer satisfaction

Knowledge transfer

Behaviour changes

Business results

Our experience

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Xeristar is educating general physicians to increase treatment compliance in depression


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AFAL (Alzheimer Families Association) is educating relatives in appropriate patient care

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Our approach is based in value, end-to-end solutions, technology, innovation and customer satisfaction

Value: a learning solution is always an investment with an expected return

End-to-end solution: the customer expects a complete solution with minimum management effort

Technology: technology allows organizations reducing costs, growing in reach, increasing flexibility and shorting time to market

Innovation: we develop each unique always trying to find new ways to improve learning process

Customer satisfaction: an excellent service is critical for student satisfaction and for learning effectiveness

Madrid Frankfurt

Jose María Fernández Quinquer Santiago Moral

[email protected] [email protected]

+34 609 022 180+49 (0) 151 2830 7404+34 639 241 094

Contact

education as marketing in pharma

Health & Medicine

term therapies

compliance

marketing

long

evidence

patients

setting

adherence