Direct Marketing Report: Something old, something new

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In today's world of pharmaceutical direct marketing, it has become clear that the emergence of the Internet has changed the way direct campaigns are executed. But, has the web zapped offline response rates or merely forced brand managers to come up with even more creative ways to reach target audiences?

According to Jay Bolling, president of Roska Healthcare Advertising, the idea that offline direct marketing is being squeezed is very much a misnomer. Sure the online space is growing, he says, but direct mail remains king among doctors. And Bolling says he has the numbers to prove it.

When it comes to consumers, “there are just times when people like to sit and have something tangible,” Bolling says. “In the past, the whole thing was about patients raising their hand. It was about how marketers were going to segment them. But now there has been an evolution of direct techniques. The whole paradigm is shifting forward in the consumer marketing cycle.”

Bolling says pharmaceutical direct marketing should never be simply thought of as “direct mail.” “With direct mail, in isolation, you are not going to get tremendous response rates,” Bolling says. “Instead direct mail should complement other media. You really have to look at a ‘surround sound' approach.”

As the Lunestas and Rozerems of the space continue to spend large amounts of money on DTC advertising, there are a number of brands that want and need to reach consumers but cannot afford the budget required by building an awareness approach. What marketers find is that using direct techniques up front as a core consumer marketing strategy can be a successful alternative.

“Let's face it, we are not only asking patients to be aware of a potential disease state,” he says. “We are asking them to do a tremendous amount, and the idea that we are going to use 60-second spots to take someone all the way through that filter is a bit naïve.”

Case study: Tracleer

Pablo Przygoda, product manager, patient initiatives at Actelion Pharmaceuticals, had five goals in mind 15 months ago when his firm and Roska Healthcare Advertising jointly embarked on the “Sure Steps” program behind Tracleer, an oral therapy for the treatment of pulmonary arterial hypertension (PAH).

Przygoda needed to increase patient persistency, set realistic expectations for success, help patients manage their disease, maximize success with therapy and build trust.

Tracleer is an effective medication for PAH but it poses certain challenges, according to Przygoda. Tracleer use requires monthly testing and can cause side effects, and the drug's positive effect on the patient can be slow and gradual. High drop-off rates occur as a result of these challenges, Przygoda notes.

Bolling adds, “We needed to develop the messages to engage the users. We couldn't just throw out messages and educational material. We identified the barriers and addressed those barriers so that patients were ready and interested in being educated.”

The Tracleer campaign started as an integrated effort of in-office material, multi-wave direct mail, phone calls from nurse counselors and some Internet and computer resources. A team of registered nurses trained by Actelion on PAH and therapy were made available to patients on weekdays from 8 am to 11 pm EST.

The English and Spanish-speaking RNs offered one-on-one phone support to patients. RNs handled day-to-day issues and basic questions such as frequently asked questions, treatment questions, expectations about therapy, insurance and financial issues, monthly shipments and monitoring/testing questions.

Actelion and Roska's use of the “surround sound” approach helped the marketers of Tracleer increase persistency among 16% of all patients, increasing Actelion's revenue by 23%.

According to Przygoda, patient adherence must be addressed to maximize the full potential of your brand.

There are several factors that make the Tracleer unique and successful, Bolling adds. “This campaign is fully integrated with the sales force and the in-office element is also a very big part of it. Especially with this type of therapy, where there is high-involvement from both the patient and physician,” he says.

Bolling notes that the Tracleer campaign also integrates nurses and the physcians into it by surrounding patients on the phone, in the office and at home.

“All those things work hand in hand. We have been able to collect a database and when someone is enrolled we immediately reach out to them and start to set expectations. We have a nurse counselor who will call them and we even have the ability where a nurse counselor can work with an office to establish continuity of care.”

Direct marketing firm Harte-Hanks was recently tasked by Teva to build a non-branded hypermarketing program to build a database of potential patients and caregivers during the pre-launch stage for Azilect, a new therapy for Parkinson's disease.

Patients and caregivers were engaged via surveys and a specially designed newsletter Life in Balance to communicate important information about the disease state and how to live with the disease.

The newsletter was made available both online and offline.

“The database continued to build during the pre-launch stage through self-reported survey information,” David Zaritsky, managing director, pharmaceutical markets, explains.

At launch the campaign morphed into an Azilect-branded program, letting patients and caregivers know that Azilect was available through physician specialists.

Combining acquisition, conversion and retention tactics, the results saw a significant database of potential patients and caregivers built over time during the pre-launch stage and at launch.

“The product messaging went out to all those who opted into the program,” Zaritsky said. “The database continues to build to ensure that new caregivers and patients become aware of Teva's new therapy for Parkinsons.”

According to Harte-Hanks' Zaritsky, “The whole essence of direct marketing is to find out what information is important to consumers or patients.”

Marketers have to ask how their audience prefers to receive information and how often? It is for this reason that integrated marketing is the most effective way to maximize desired results, namely, driving TRx's and maximizing patients'/consumers' lifetime value.

‘Persona' marketing

Offline pushes such as direct mail pieces allow pharma marketers to provide an audience with a feeling of control and motivation similar to which they experience online. And, of course, there does remain a segment of patients and healthcare providers who continue to prefer the offline channel and have made that choice known to the marketer. “For example, it makes no sense to communicate with elderly patients using e-mail if they are not comfortable with the Internet,” says Zaritsky. One true innovation in the offline direct marketing space lies around what Zaritsky has termed “personas.”

“The tech markets and retailers have had this right for years,” he says. “Essentially these personas are built around individuals— depending on who they are—and several of their characteristics.

In this way we can formulate ‘buckets' of varying ways to communicate offline, as well as different deliverables to the different personas, based on who they are. This gives the patient and healthcare provider the opportunity to receive the materials they want with the information they need…not just a shotgun blast of information coming from a faceless manufacturer. Today when you walk into Best Buy they know that you fall into one of seven buckets or ‘personas' and they interact with you accordingly. The trend in pharma is that to become more ‘client-centric,' we need to speak to these same rules.”

Zaritsky says offline direct marketing can be used as a relationship builder in pharma as effectively, or even better, than online methods. “Again, if the consumer indicates their preference for offline materials and information, this is the way marketers need to provide it.…Some consumers might opt to receive information both online and offline, which ensures that this segment gets the information via two different channels,” he says. “For example, product information can be provided offline and persistency reminders can be sent via the digital channel.  Recipients of medical information still prefer something they can hold and interact with, and the value behind a physical piece is still clear.”

Don't expect new media to replace old media any time soon or vice versa says Nick Moore, chief creative officer, Wunderman.

“The fact that you've got something new means that consumers are using it to enhance their experiences, their expectations and their contact with brands but not necessarily replace them,” Moore says. “Just in the same way television did not replace radio, the relationship between different media certainly alters media but those media don't go away.”

In with the old and in with the new

According to Moore, the Internet is not the only place where technology is changing. Computerization has also revolutionized the digital print arena in the past five years.

“We can do things now which are well beyond what we could do just a few years ago,” he says. “Just as importantly, you can do them at high volume and you can do them at a reasonable cost, which was not necessarily true a few years ago.”

“Another thing that is extraordinary,” Moore adds, “we also work with (electronics firm) HP and they will tell you that the advent of the Internet means that people are using more paper than they ever have in the history of the world. People like paper. When things are important and they like to keep them, they print them out. When we send people things on paper that they find useful and relevant, they keep them. I think irrelevant material, whatever medium it comes in, is going to be ditched.”

Moore notes that most people say they don't respond to so-called junk mail but points out that when you listen to the language people use, whether they are physicians or airline pilots, the language changes from ‘I never read that stuff' to ‘I got sent some information.' The materials are essentially the same stuff, Moore says. “It's direct marketing material but there are times people find it useful and informative and they do respond and they are very willing to engage in some sort of dialogue or exchange.”

And when it come to physicians who get a lot of e-mail every day, it can be a very cluttered environment to work within.

“They spend an enormous amount of time on the web, visiting particular places. So, there's not a huge opportunity to reach them with relevant online messaging. That's why mail still has an important role in the physician space,” he says. 

Moore adds that the trends he sees growing  in the pharmaceutical space are about blending media together. “That's when you get your optimal results,” he says. “It's about being able to follow where the consumer leads. This has been going on for quite some time. It's a mix of media that is giving you your best results and your maximum adherence.”
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