www.ephmra.org

CHAPTER MEETING REPORT21st February 2017, London

EphMRA UK Chapter Meeting Highlights and Insights

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OverviewFrom the uses of real-world data (RWD) to new ideas on how to listen to respondent feedback, EphMRA’s One-Day Meeting covered a great deal of ground. There were presentations and panel discussions on subjects such as the willingness of patients to pay for treatment, and the way that smart phones might help market research in future. In addition, there was the fi rst update from the newly-formed EphMRA Fieldwork Forum. 30 Euston Square in London, the HQ of the Royal College of General Practitioners, was the venue for a day of lively debate with an engaged audience who off ered many searching questions from the fl oor as well as taking advantage of the opportunity to chat with colleagues and clients - and enjoying a post-event networking evening hosted by The Research Club in association with EphMRA. As ever, a huge thank you goes to our convenors for all their eff orts and to our presenters for giving up their time.

The views expressed by those quoted in this report do not necessarily represent the views of EphMRA.

Programme Committee and Convenors:

IN THIS REPORT

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BREAKING NEW GROUND WITH REAL-WORLD DATA

Real-world data (RWD) is a new source of insight bringing new opportunities: the most important thing is that market researchers should embrace RWD, rather

than fearing it.

REAL-WORLD EVIDENCE: POWERFUL INSIGHTS FOR IMPACTFUL DECISIONS

RWD is being used to support business intelligence - and case studies illustrate exactly what value it can bring in terms of supporting the commercial strategy

for a brand.

PANEL DISCUSSION ON RWD

Drawing together the threads from the morning sessions, there was an in-depth discussion of the practical uses to

which companies can put real-world data.

GETTING TO THE HEART OF THE PATIENT EXPERIENCE THROUGH SMART PHONE RESEARCH

Pharma is wary of using mobile ethnography - but smart phones can produce intimate and rich responses that have the potential to create true commercial insight.

PATIENT WILLINGNESS TO PAY IN THE REAL WORLD

Getting patients to realistically evaluate the price they would pay for a novel product they haven’t yet tried can be very challenging - but researchers can fi nd a way.

FIELDWORK: UPDATE FROM THE NEWLY-FORMED FIELDWORK FORUM

Screening questionnaires are too long and their wording is not tailored to the market - and this is turning doctors off . EphMRA is on a mission to solve these problems.

A WHOLE LOT OF DIFFERENCE BETWEEN LISTENING AND HEARING

The importance of listening to respondent feedback cannot be underestimated, but it is also crucial to think about the sorts of feedback that you aren’t hearing - and why.

Anthony Nealon AbbVie

Marianne Fletcher Pfi zer

David HanlonKantar Health

Sarah PhillipsPrescient Healthcare Group

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BREAKING NEW GROUND WITH REAL-WORLD DATASpeaker: Adam Collier, QuintilesIMS

Defi ning what is - and what is not - real-world data is vital, said Adam Collier from QuintilesIMS. But the most important thing is that market researchers should embrace it.

In her conference introduction, Marianne Fletcher from Pfizer promised that delegates could look forward to a day getting to grips with the nuts and bolts of real-world data (RWD) as it applied to pharma market research. Adam Collier from QuintilesIMS began his presentation by explaining that his focus was medical and scientific uses of RWD and observing that there is increasing interest from commercial functions in the use of patient data. Market researchers might be worried that RWD will make redundant the use of professional staples such as panel-based work. “I think the opposite,” he insisted. “The opportunity for people in this room with analytical skills is to provide richer insights to the companies we work for - this is a wonderful future.” So RWD is not a threat - but researchers need to embrace it.”

Adam gave some definitions to create common ground:

• RWD is patient-level data not collected in conventional randomised controlled clinical trials, such as from electronic medical records, insurance claims, registries or chart reviews

• Real-world insights (RWI) are generated from RWD using scientific or commercial analytics

• Real-world evidence (RWE) is RWI intended to support a claim or belief to produce evidence for multiple stakeholders

RWD sourcing has exploded in recent years, particularly in terms of hospitals and insurers. Wearables are also beginning to be important, as is social media where people talk online about their condition, along with pharmacies, registries (some commercial, some charitable/academic), as well as laboratory/biomarkers data. Not included is data from randomised clinical trials or market research. There are some questions which can only be answered by RWD, Adam insisted. Often there is increased robustness and direct patient insights that can improve healthcare outcomes. The typical pharma company has many people who can use RWD, including HEOR, safety and R&D - but to maximise return on investment these capabilities must not be in silos. Instead the data must be made available more widely. Although these are quite expensive investments, RWE allows accurate market sizing to drive forecasts and investments, tapping into larger samples than small studies, literature searches or primary market research. The value capture from use of RWD is substantial, Adam said. “For a top 10 pharma company, we think $1 billion a year is the potential.”

RWD can help in clinical development (with a possible saving of $100-200m), launch ($100m) and in-market ($200-600m). Add to

that launch planning and tracking ($150m), commercial spend eff ectiveness ($200-300m) and productivity and cost savings ($100m). He directed EphMRA delegates to an IMS Health free white paper which runs through these points in detail. Turning to specifi c examples, RWD sources have been used to forecast epidemiology in breast cancer. In one case study, the client designed a simulation forecast model using RWD to predict patient outcomes based on distinct set of characteristics.

This meant it was possible to look at fi ve variables (including annual incidence, transition rules, and external events such as smoking cessation campaigns) and to make changes to assumptions which created new estimates for late-stage breast cancer patients. Qualitative input is still required to feed these models, Adam insisted - but the benefi t of having RWD is that it allows companies to ask questions which are easier for people to understand. His next example showed how to bring together market research and RWD. Traditional survey methodologies have to deal with bias in recall and selection, and are reliant on perception - but RWD is comprehensive, representative and longitudinal. “Add them together and you come up with something far more powerful and interesting,” Adam continued. Combining the two means it is possible to augment e-health records with patient-reported outcomes, physician surveys and so on, fi lling in gaps and adding new information that’s not collected routinely, thus allowing researchers to address the ‘why’ questions. He cited DIAREG, a database of patient-level data for a cohort of Type 2 diabetes patients in Germany, which uses electronic medical records, combined with full questionnaire and patient-reported outcomes.

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This illustrates that the two approaches are not mutually exclusive, Adam went on, giving researchers the opportunity to see what is happening with their patient population and allowing them then to ask questions, which gives a “very, very rich and granular view”. RWD is still at the stage where 90% of the work done is around data preparation and management, he added, but only 10% is insight. He believes the time taken to work out what the data means must increase, but he reiterated that RWE was not going to replace traditional market research methods. Instead, it would augment them, he concluded. Data standardisation is key to the process: if you’re doing a multi-country study in Europe, you can’t just write a piece of code and

apply it across all countries - which is why data management and preparation takes so much time. He said the solution to this problem is the OMOP Common Data Model, now in its fifth iteration, which enables EMR data from Germany or the UK, for example, to be compared with claims data from the US. IMS thinks this is going to be the standard, as it allows researchers to write a question on one dataset and see how it comes out on other sets. About 80-85% of data is common across the top five markets, he added, but this model can reduce your work by a factor of five which is far more efficient, and speeds up insight. It will also allow a broader range of users within a pharma company to derive insights, and this will in turn improve return on investment.

KEY TAKEAWAYS

• RWD can be worth $1 billion to a pharma company

• Putting market research and RWD together gives rich, granular data

• RWE allows accurate market sizing to drive forecasts and investments

• OMOP Common Data Model is the future for getting insight from multi-country data

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REAL-WORLD EVIDENCE: POWERFUL INSIGHTS FOR IMPACTFUL DECISIONSSpeakers: Anita Agier & Samantha Morrison, GfK RWD is being used to support business intelligence - and case studies from Anita Agier and Samantha Morrison of GfK illustrated exactly what value it can bring.

Anita started by outlining what RWE offers marketing teams. She said that pre-launch activity can start as early as Phase II - by giving a baseline understanding of the disease landscape - and go right through to forecasting. “If you get the right database it can answer multiple objectives,” she said. “Post-launch marketing teams can use it to shape prescribing behaviour, for example.” Samantha took over, explaining that in market access RWE is used to enrich global value dossiers which improves formulary positioning and impact pricing reviews. In HEOR it can be used to enhance drug value stories. Meanwhile, patient value teams use it to mobilise patient involvement in treatment decisions and to improve loyalty and satisfaction. “If we can engage patients, we can impact on their outcomes,” she added. RWE can also support pharma in trial decisions, then in the launch phase teams can look at segments of the market to see what the price points are and whether there’s a way to compare outcomes differently. Once a product is on the market, RWE can be used to assess utilization and prescribing patterns, Samantha said. As Anita then explained in a case study, one of the most valued insights from RWE is comparative evidence. The client was launching Product X, third in its class, into the highly competitive atopic dermatitis market. The key objective was to use RWE to gather a thorough understanding of the market and its opportunities which could then feed into the treatment’s positioning and launch strategy. The research undertaken provided a behavioural understanding that influenced commercial strategy, as well as insights on best positioning for the greatest market impact. Physician interviews combined with patient-level data created real practice understanding, segmentation and enabled an unmet needs analysis to be drawn up.

The team was able to identify a symptom impacting daily life, including sleep quality, and provide a lot of evidence of the consistent recycling of sub-optimal therapies in this area. As Samantha pointed out, a lot of patient segments are very small (such as in orphan conditions) and patient registries can add a lot of value in areas including the limitations of current therapies. RWE can even help companies in determining what stakeholders need and how they want to hear it - for example, payers will want to know about better value, doctors want their patients to get better, and so on - which means RWE should have a key role in whatever communications plan you prepare. But it must be borne in mind that there are often gaps in registry data in different markets. “Sometimes we have to look at other data,” Samantha said.

However, RWE from registries can effectively support publications, she added, citing the FOS database which contains information from over 3,000 patients and has been the basis for 52 peer-reviewed publications. The final case study looked at a client launching a product which it thought addressed physical symptoms better than the market leader. The key objective was to provide evidence of controlling symptoms better than other products, with the research used to feed publications. Comparative evidence was created by looking at patients’ disease burden and their clinical journey, and then cross-analysing the two with clinical scores paired to quality of life (QoL) data. The bottom line is that RWD can provide valuable insights, which are highly relevant to clinical practice, to all of an organisation’s cross-functional teams.

KEY TAKEAWAYS

• RWD can provide insights to all of an organisation’s cross-functional teams

• One of the most valued insights from RWE is comparative evidence

• Gaps in registry data in different markets can make comparison challenging

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PANEL DISCUSSION ON RWDPanellists: Adam Collier, QuintilesIMS; Anita Agier, GfK & Doreen-Allen Kahangire, AbbVie

Drawing together some of the threads from the morning session before the lunch break, there was an in-depth discussion of the practical uses to which companies can put RWD.

Presenters Anita Agier of GfK and Adam Collier of QuintilesIMS were joined by AbbVie’s Doreen-Allen Kahangire to talk about RWD. Anita began by saying that it can feed into many areas of market research, including segmentation and monitoring. Adam felt that the way it is used depends on the therapy area and the research question, and that some companies are a long way behind. Some clients are embracing and adopting RWE and they are starting to see quite a difference but other clients aren’t ready yet - and there are also therapy areas where the data doesn’t exist - particularly for specialty care in hospital. “The plumbing is not in place,” he said. But in 15 years we will have seen a gradual change which, looking back, will seem like a revolution. However, he added, there is a huge need for understanding the human side of what is happening when we look at RWD.

Doreen-Allen said pharma needed to look at RWE if it is going to acquire a compound, asking questions such as what is the landscape, is it worth the investment and what do payers want? But it was important to “maintain the landscape” of RWE from pre-clinical through to post-marketing, and that the challenge here is knowing the key people internally. Marianne Fletcher from Pfizer picked up this point, candidly admitting that the only RWD she had used in her market research work is syndicated patient panels, and that the data tends to sit with colleagues in HEOR and medical. Adam agreed that siloing in companies is the problem. He knew of one UK company which had to put a request into epidemiology, which took two years: “We have to see how the value can be exploited more widely.” Anita commented that it was impossible to force people from different functions to work together. “We meet with them all to explain what’s available but end up typically working with one only,” she said. One questioner from the floor suggested that

people don’t trust their colleagues with data and that RWE is scary because it’s unpredictable, containing real people, from a range of different sources (for example, on social media people reporting whatever’s on their mind).

Despite the challenges, Adam insisted that pharma must be cognizant of the fact that RWE is cheap. You do not need a $10m study to get insights, which means that clients will already be using it themselves. This means pharma must make sure this data is taken and used round the company: if you wait for the payers to do it, you will not be in control of the process. The data ultimately cannot be controlled because it will get out into circulation anyway. Convenor Sarah Phillips of Prescient Healthcare Group asked what pharma should do when RWE goes against you. Doreen-Allen acknowledged that there is always the challenge that it might be negative but that the ABPI recommends transparency and there is a duty of care to publish data. If you look at interim results, for example, you have to make a decision on whether to terminate a trial or change the protocol. Sarah asked whether there were other strategies to aid communication internally and how risk should be dealt with from a pharmacovigilance point of view.

Adam felt there was a diffi culty when you blend market research and RWD into an enriched study because the rules are not keeping up with the level of innovation and there were diff erences in interpretation. Regulations will need to evolve as this becomes a more common study design, he said, although he pointed out that traditional approaches still account for 99% of the work carried out. From the fl oor, one questioner suggested that immediate action had to be taken on adverse events picked up in RWD if we were to have a claim to being an ethical industry. If we want to ensure the safety of the patient then it doesn’t make sense for adverse events not to be reported if they are found in real-world studies. Anita said that guidelines are already in place and that in RWE we are fi nding gaps and identifying optimal treatment. Since the goal is to improve healthcare and outcomes, that information should be reported - but the system now is not set up for it and that needs to be addressed. Adam explained that it was not the responsibility of the sponsor to make the report, unlike in primary, but he agreed that regulation needs to improve. Doreen-Allen commented that there needs to be a balance between reporting eff ectively and over-reporting adverse events.

Another questioner suggested that sometimes the treatment of rare diseases is quite aggressive. This means that if RWE is collected, even retrospectively, it still represents an opportunity for the industry to keep an eye on what’s happening in the marketplace outside the clinical trial environment. Adam pointed out that a lot of rare disease drug approvals are based

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on having to run a registry as well for approval: in other words, for the 300-400 patients who were likely to be taking it, the manufacturer needs to prove the drug is working and risk/benefit profile is good. EphMRA president Thomas Hein insisted that market researchers must be analysing RWD ourselves and that we should be aware of what is out there to be prepared - regardless of where it sits in a given company. Anita said that waiting for someone else to come up with RWD is probably not a good plan. You want to be on the front foot, she added - you can’t compare RCTs with each other but you’ll know for trial results what works. This means that the best RWE studies are proving something that you pretty much already know.

RWD should not be going against clinical trials, Doreen-Allen insisted, and that is why it is important to assess interim results. It all depends on how business is structured, but the most important things are accountability and knowing what you can publish and what you can’t. A contributor from the floor insisted that RWD requires a “very good relationship with doctors” since there are additional data protection issues involved and there was a need to reassure doctors they are not in breach of confidentiality. It can depend on therapy areas - for example it is relatively easy for diabetes but for cancer it is much more difficult because of worries over identification of patients. Sarah wondered whether this meant you would end up with selection bias, with perhaps the same group of doctors doing market research as do real world studies. The consensus was that the groups tend to be slightly different and that they should be approached differently.

The major issue is that fair market value on real-world studies is higher because you are asking them for a lot of commitment. It is always good to show them a public report so they can see what their data is going to be used for, said one delegate, and if you can share that data at a later date then that’s even better. Summing up, Doreen said that organisations such as ABPI and FDA need to come up with guidelines on where they stand on RWE. While it is good that they are saying it is a ‘must have’, it would be useful to get their guidance on how the practice of using RWD should evolve within pharma companies. Anita said that RWD will help us to reduce the amount of studies - where physicians are perhaps today being saturated - and enable more time to be spent doing qualitative research.

Adam concluded that RWD will replace or augment clinical trial systems and that this would be absolutely necessary as we get to payment by performance, outcomes-based medicine. There will quite a revolution - but slowly, he added. Things will change beyond recognition but it is a great opportunity for anyone involved in the analytics of healthcare data to step up to the challenge and show some leadership.

KEY TAKEAWAYS

• Pharma companies must be on the front foot when it comes to RWE - otherwise payers will be doing their own research

• Market researchers must be aware of what RWD is out there

• As with any form of research, there will be bias

• Adverse event reporting needs to be looked at carefully in ‘blended’ studies

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GETTING TO THE HEART OF THE PATIENT EXPERIENCE THROUGH SMART PHONE RESEARCHSpeaker: Alex Marriott, Kantar Health

Pharma is wary of using mobile ethnography - but smart phones can produce intimate and rich responses that have the potential to create true commercial insight.

Alex Marriott of Kantar Health began his presentation by explaining that healthcare is moving away from the concept of a patient journey to one of a patient experience. “Five years ago it was more linear,” he said. “We talked about symptoms, diagnosis, treatment and cure or management. But that’s changing.” The breadth of the patient journey has also changed. We now know more than ever about our health predispositions. Genetic testing - now offered at a lower cost, with higher sensitivity, and with more genes linked to conditions - is an important development because the testing itself creates a different attitude to the idea of ‘wellness’. Alex cited the example of Angelina Jolie and breast cancer, saying that her experience broadened the patient journey into an experience.

Clinical versus real-world experience is still an important emphasis for market access, where there is increasing evidence of risk management as clients are looking more and more at what drives adherence, he continued. This shift in breadth and depth means well-being has become a focus - people who don’t look after their own wellbeing may well even be penalised in future, Alex went on. Intervention points are important when it comes to understanding adherence - so can mobile ethnography with smart phones help us in this drive to understand the patient? There is an opportunity to gather richer data, since patients find it so much easier to produce audio, photos of their day, and ‘in the moment’ responses -

not to mention recording biometric activity with increasing numbers of apps. However, while technology such as Apple’s Health app or Fitbits represent a growing area, there is still some hesitation about mobile ethnography - because of significant internal barriers over privacy issues and questions about what it actually offers versus qual or quant activity. Alex explained that they carried out a pilot of patients who were in regular treatment with conditions such as asthma or COPD.

A web survey of 42 people with chronic diseases looked at profiling data, baseline metrics and general attitudes to their condition. A daily survey looked at daily disease management, compliance, and diet, during which the original sample of 42 went down to 18. The number of steps these respondents took in a day was captured to see the link between how much exercise they said they had taken and their actual exercise. There were only four admissions of non-compliance, raising the questions of whether respondents were being dishonest, or genuinely compliant - or whether simply asking the question of them itself stimulates compliance. While Alex said he had not got answers to those queries, further research with this group threw up some interesting points about the sources to which they turned for information about their health. Responses showed that the HCP was still in a strong position, with the GP at the top - but five respondents said that the internet was the most important, primarily because it was easy to access.

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Another question found that, following a visit to their HCP, most respondents felt hopeful, relaxed and in control - but the five people for whom the internet was their main source of health information did not. Having a smart phone over a week allowed a greater intimacy with respondents, who seemed happy to let us in, Alex said, sharing multiple pictures of the food they were eating, for instance. This closer connection was also useful in tracking the ups and downs of the patient journey.

Although none of them chose to do video, they seemed happy to send sound recordings to researchers. Tiredness had a big impact on how respondents felt on a given day, which means the time that certain questions are asked is crucial: when asked about how tired they felt waking up, overlaying biometric data revealed that some respondents were clearly projecting their current (8pm) levels of tiredness when they answered. Another interesting finding was that the more satisfied with their doctor they were, the less respondents did to manage their health - so perhaps people who do more are more demanding of their doctor (or maybe they don’t trust their doctor and think they need to do more than the doctor says). Either way, the patient journey will continue to be part of market research, Alex concluded. Smart phones represent both an active and a passive gateway to the patient - and we are only at the start of understanding how this can be applied to our business.

KEY TAKEAWAYS

• Patient journey will continue to be part of our business

• Smart phones are both an active and passive gateway to the patient

• There is still hesitation in pharma about using mobile ethnography

• We are only just beginning to understand how smartphones will aff ect our business

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PATIENT WILLINGNESS TO PAY IN THE REAL WORLDSpeaker: Rachel Howard, Research Partnership

A critical part of any self-paid healthcare product’s launch strategy is to set the right price - but getting patients to realistically evaluate the price they would pay for a novel product they haven’t yet tried can be very challenging.

Various healthcare products, such as vaccines, have to be paid for by patients. In emerging markets, for instance, nearly all medicines are paid for ‘out of pocket’. This means there is a research need to establish how much the consumer considers it is reasonable to pay, explained Rachel Howard of Research Partnership. If the manufacturer prices too low, for instance, they will sell more but get lower return. It is obviously important that patients’ answers to these questions are meaningful, which means that not recruiting the right patients is a real pitfall, especially in emerging markets where there might be wide disparities in household income. Yet while income is important, there is still an emotional and philosophical element to willingness to pay, Rachel continued. It’s highly correlated to disease impact - so someone with degenerative disease would be more likely to pay, for instance - but some patients will still be philosophically opposed to paying. And it’s not just about the patient, she continued: it is also important to incorporate the views of all stakeholders who will influence the purchase decision (since, for example, a physician strongly recommending a product might also make them more likely to pay). Market researchers must ensure the patient knows about the benefits of a drug, Rachel said, by setting up as realistic a scenario as possible. While challenging, this is particularly important if the product is novel so the patient can fully understand what they are being asked to evaluate. “We’d usually blind the product’s profile,” she went on. This is significant because some people would pay more for a Nurofen than an unbranded ibuprofen - and pack size is another issue. In emerging markets, sachet marketing is prevalent for those who have smaller incomes. Also, the majority of medical purchases are not one-offs - so the idea of chronic usage needs to be considered.

All of our decisions are affected by context - for instance, if you think about a purchase overnight you can be 30-40% less likely to pay. It might be worth thinking about another behavioural idea, such as what patients would be willing to give up, e.g. would you delay buying new mobile phone to pay for a product? It is important to ask questions that reflect how patients actually make decisions. So how do we ensure the outputs of ‘willingness to pay’ are accurate, Rachel asked. Researchers need to exclude people who would pay more than they can afford - or those who wouldn’t buy it at any price - since there is no point in them being included in the volume revenue analysis.

The Juster Scale can be used to work this out. She outlined a case study which started with an intensive definition phase to establish a feasible price range, which is critical to set the ‘breakeven’ threshold. Researchers also needed to understand the client’s forecasting assumptions to ensure their screening was right. There was a qualitative assessment of expectations regarding the acceptable out-of-pocket price range for Product X among influencers and end purchasers, followed by a quantitative phase when patients’ attitudes to their condition and intent to purchase at prompted price points were established.

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This allowed the team to generate a price elasticity curve, illustrating the extent to which a higher price created an increase or decrease in revenue. Those willing to pay a higher amount tended to be younger and female.

In conclusion, Rachel said that having a qualitative phase means that it’s possible to bring the emotional side of decision making into play. The questions are hypothetical for a pre-launch product, but translating things into words patients can understand helps to ensure the right answers will be given.

KEY TAKEAWAYS

• Think beyond income and include attitudinal questions too

• Anchor the survey in reality by asking patients in a way that refl ects how they make decisions

• It’s not just about patients - physicians’ views might also need to be modelled

• Weight the data: don’t include those who report unrealistically high willingness to pay - or who wouldn’t pay at any price

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FIELDWORK: UPDATE FROM THE NEWLY-FORMED FIELDWORK FORUMSpeakers: Mo Rice & Antonio Tropea, M3 Global Research and Akash Degan, SERMO This session turned the spotlight onto the EphMRA audience, asking how members felt that the big problems in screening questionnaires should be overcome.

Mo Rice and Antonio Tropea of M3 Global Research, and Akash Degan of SERMO, took the floor to open up an issue which the newly-formed EphMRA Fieldwork Forum was working on: screening questionnaires. There are two main issues, said Mo: the screeners are too long and their wording is not tailored to the market - and this is creating problems. Notably, doctors might spend ten minutes filling out screeners, only to be told they don’t fit the profile. Now, if they’ve only had to answer 8-10 questions it doesn’t tend to be a problem - but if they’ve sat through 20 questions then they can feel rejected, leading to comments such as: “I’ve worked in the NHS for 20 years and you’re telling me my opinion doesn’t count.” “All round, it’s not good for any of us,” said Mo. Akash pointed out that a lot of screeners ask similar questions, so researchers are collecting the data although they don’t necessarily own it. There was a feeling that it was legitimate to sometimes have 20 questions in a screener - but that there should be a charge for anything over, say, 11 questions. Delegates agreed that the physician should receive an honorarium, but it was pointed out from the floor that there is more and more pushback from clients about paying doctors. Mo said that the EphMRA Fieldwork Forum was aiming to create a guide to successfully putting together screeners, but that EphMRA wants to ensure that it is being inclusive and not just dictating. “We want to find solutions that work for everyone,” she explained. Respondent engagement is crucial, and there was a widespread feeling from the floor that some information, such as demographic data, could be simply checked with respondents. Equally, screening out after 20 questions should be avoided because respondents could naturally become demotivated.

One questioner suggested that it would be ethical to stop doctors at the point when you know they can no longer qualify, and that this will remove a lot of these problems. Another said: “We shouldn’t need to ask the panel these basic demographic questions every time - age, gender, how long they’ve been working. We need to think seriously about the damage we are doing with long screeners. As an industry we have to collaborate.” Mo said that an often-heard excuse for badly-worded questions continuing to be included is “because legal signed it off so it can’t be changed”. Certainly, among the challenges to addressing this issue is that screeners are approved by the client and are often standardised so they can

work across numerous markets. Data collection suppliers often suggest changes in order to adapt to different markets or to reflect market variations. The agency might refer this to their client, but often no changes can be made because approval has already been given or because fieldwork is already underway. As a result, respondents can be asked inappropriate questions, creating a feeling of disappointment and the strong impression that they are wasting their time.

One suggestion from the floor was that EphMRA could establish recommended screening wording - perhaps giving doctor seniority guidelines across countries - and to recommend the acceptable amount of questions to ask a doctor unpaid. One delegate said that certain clients would not work with you again if you say they have to pay for certain questions. But it was generally agreed that to have a document which is backed by EphMRA would make a difference.

KEY TAKEAWAYS

• Long screeners mean demotivated respondents: check basic demographic information

• Critical questions should be frontloaded in shorter screeners

• To continue collecting information from a doctor who won’t qualify is counter-productive

• Clients should pay for questions which are there for profiling purposes

• EphMRA to produce guidelines on putting together successful screeners

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A WHOLE LOT OF DIFFERENCE BETWEEN LISTENING AND HEARINGSpeakers: John Coulthard & Andrew Formar, Branding Science

The importance of listening to respondent feedback cannot be underestimated - but so is stimulating discussion about how best to respond to that feedback.

The importance of listening to respondent feedback, and deciding how best to respond to it, are crucial areas for market researchers. But, John Coulthard of Branding Science insisted, coming up with innovative ways of doing this does not require reinventing the wheel. He started his presentation by asking whether there are sources of information which we’re not hearing - or perhaps we are hearing them but not responding to them. “We spend a lot of time listening to doctors, payers talking about our clients,” he pointed out. “But do we ask them about methodology?” Branding Science asked itself where it actively listens for feedback and came up with the three following areas: clients we work with, clients we don’t work with, and internal reviews. That being the case, the agency thought about the feedback it was missing and decided to ask actual UK respondents, after face-to-face fieldwork, some simple quality control questions to understand why they took part and what the agency could be doing better. It also followed up on no-shows who did they not take part even though they had been recruited. Doctors said the main reason

they took part is to find out about new products, initiatives, services; patients and caregivers, on the other hand, wanted to have their voice heard because they rarely got the chance to talk.

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So, John said, the agency thought about what it can do to engage respondents right from the start and questioned whether it was losing respondents because they don’t realise this was an opportunity to learn. It was also apparent that doctors don’t want to appear ignorant. The agency realised that they could be doing more to explain what a project is about and that respondents needed to be kept engaged if they were to be receptive to further contact. Feedback forms to respondents included the idea that they might be contacted again and explained, where possible, the purpose of the study.

“We often find that the mention of what the research feeds into is useful,” John explained. “That’s a great way of getting them to stay involved.” He admitted that it was early days but that simple changes could make a big difference. For instance, some respondents said they found the pre-task difficult, and would have preferred different materials to look at or less ‘blue sky’ thinking and more ‘rational’ exercises to do.

This means it is important to think about where you’re doing these exercises - and to consider not putting difficult exercises up front if you want respondents to then commit to an hour’s face-to-face. The final complaint to the agency was that respondents wanted better directions to research venues. Branding Science launched an internal competition to provide new directions for respondent on the basis that not everyone will have a smartphone. New directions included advice on what respondents should not do (e.g. don’t go to this similarly-named station by mistake) and an acknowledgement that they were ‘not on the Tube’ rather than ignoring this is an issue. Finally, John advised that agencies check that their location is accurate on mapping applications - since it is not helpful if it is off by 50 metres.

KEY TAKEAWAYS

• Ask respondents why they took part and what could improve their experience

• Follow-up on no-shows and target people who were not interested or couldn’t take part

• If possible, give respondents information on how the research might be used

• Ensure that even basic information for respondents - such as directions - is accurate

15Chapter Meeting - Germany

15www.ephmra.org

CONTACT USEphMRA, Streicher & Brotschin Treuhand AGGartenstrasse 101, 4052 Basel, Switzerlandgeneralsecretary@ephmra.org