Direct Marketing Report: The Digitization of Direct

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Whether or not paper is passé as a direct marketing channel for engaging patients or physicians, depends on who you ask. “I literally have seen people wince when you start talking about packaging and direct mail,” says David Zaritsky, group managing director at Harte-Hanks, a direct marketing shop. “They look at direct marketing as something archaic.”

“They,” in this case, refers to a younger generation of marketers ascending the ranks within big pharmas' multichannel marketing groups. Some of these marketers have been signing onto the web since high school, and their backgrounds, unsurprisingly, are online. Perhaps that's as it should be. No one would dispute the fact that the web has become a predominant avenue for one-to-one discourse with patients.

But is a search-optimized website with an opt-in patient program, plus a Facebook page and Twitter account, enough to drive medication adherence? Don't stop the fulfillment presses just yet, says Lynn Benzing, CEO at the Patient Marketing Group. “Individual patients frequently behave in ways that defy categorization,” says Benzing. “Patients may sign up for an engagement program online, but then prefer to receive follow-up communications and incentives by mail, while still periodically using a particular online tool offered through the program at their convenience.”

Not convinced? Take the “experiment” Zaritsky conducted with an unnamed Merck brand. “Merck decided to go heavily into the online space a few years ago,” says Zaritsky. “We added a little bit of direct mail to the online marketing effort”—with respect to one patient group—“and communicated with another group exclusively online. And we found that the group that received information in multichannels had double-digit increases over the purely online group.”
Inundation vs. retention
Online and offline, striking the right content balance with patients and doctors is of the utmost importance. Opting-out must be kept to a minimum, considering the work (and expense) of acquiring targeted groups.
Nick Moore, EVP and chief creative officer at Wunderman, says his agency uses a “curriculum” approach. “We find that it's much better to break information into packets, and educate people over time, because if you tell them everything at once, it's too much information to absorb, and none of it registers,” he says.

Zaritsky agrees, but prefers military metaphors. “Just a few years ago, pharma was in what I call the ‘shotgun approach,'” he says. “You obliterate [patients] with every bit of information you have about the drug, whether they need it or not, and you just hope that one of those shotgun pellets sticks.”

“Now, it's more like a sniper's approach. It's very targeted,” and that helps with retention, adds Zaritsky.
Both Zaritsky and Moore say mobile technology represents the next big platform for direct marketers, but Zaritsky says it's still a couple of years away.

Benjamin McCabe, director of marketing at Healthcare Data Solutions, a database provider for direct-to-physician marketing, says it's wise to limit the number of emails sent to any one address. “We only send four messages per email address per month, averaging maybe one a week,” says McCabe. “As a result, opt-out rates remain very low.” McCabe also endorses the use of direct mail as a component of an integrated campaign, but says email simply works better in some instances, like physician surveys. For surveys, small honorariums—as little as $20 to $25 for a shorter questionnaire—drive physician response rates through the roof, says McCabe.
Case Study: Direct as a vaccine life-expander
MedImmune's Flumist had a disappointing launch in 2003, and never reached the sales its manufacturers had hoped for—its best year was 2009, with total sales at $145 million, according to AstraZeneca's annual report (AZ acquired MedImmune in 2007).

In 2008, the Advisory Committee on Immunization Practices expanded flu vaccination guidelines to include school-age children up to 18 years old, which meant general practitioners (GPs) and family practitioners (FPs) that treat children presented a new opportunity for the vaccine. Harte-Hanks was tasked with creating a direct-marketing campaign targeting these physicians, without the benefit of additional sales-rep coverage.

Zaritsky and his colleagues started with 100,000 FP/GPs, and honed that number to 38,000 using unbranded surveys and prescriber-level information. From there, direct mail was sent to everyone, and half the targets received email. Direct calls were made, and co-branded materials were developed for the distributor, according to the Harte-Hanks case study. As a result, the program reached all 38,000 FP/GPs in two months, four times each on average. Cost per contact was less than $10, and the effort generated 53% of all Flumist doses sold to FP/GPs during that time period. The pilot phase delivered a 1.24 to 1 return on investment (ROI), and the full roll out delivered a 12 to 1 ROI, according to the case study.

Direct to patients, digitally
Does 3,000 fans on Facebook indicate a successful direct-to-patient campaign? “It seems like a good number to me,” says Nicole Athanas, corporate marketing communications manager at Hologic, a medical equipment and supplies company. Hologic is focused on women's health and launched the Promise To Me campaign last October. The site encourages women to make a promise to take care of themselves, and that means getting annual mammograms, gynecological exams and bone density screenings—areas that speak to the products Hologic sells.
Hologic promoted the site initially by tapping its customer base with an opt-in list, followed by an e-blast asking participants to “get the message out to women,” says Athanas. The campaign's Facebook page has garnered 3,000 fans, and 215 followers on Twitter. According to Athanas, the company uses Google analytics to monitor, and says that people in 95 different countries have visited the site. She concedes that it's difficult to tie these statistics back to actual sales dollars, but says new elements are in the works for the campaign, and marketing toolkits Hologic provides to doctors' offices and other clients may soon include a text messaging reminder service. The campaign may also add traditional direct mail, says Athanas.
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