Like many forms of domestic labor,  the work of in-home caregivers has long been overlooked and undervalued. But there are signs that this is starting to change: Look no further than the White House, which included funding to expand access to home healthcare as part of President Biden’s $2 trillion American Jobs Plan.

In doing so, the Biden administration is adopting a broader definition of “infrastructure” that includes essential care work provided by humans. The underlying truth there isn’t hard to find, either: Chances are you know someone who attends appointments with a loved one, helps them adhere to a treatment regimen or advocates on their behalf. You may be that person yourself. Just like roads and bridges, caregivers are vital components of a functioning society.

The medical marketing world understands that, having long since abandoned the idea that you “get” caregivers with the same campaigns that get patients. But that still leaves unanswered the question: How do you get caregivers? That remains a conundrum, for three main reasons: First, the caregiver role differs wildly depending on category and disease state; second, the specific needs of caregivers are not always well understood; and third, well, money.

“Caregiver marketing is an important part of the brand experience and works to ensure patients are supported properly. But depending on the category and budget, it may not be a high priority in the marketing mix,” acknowledges H4B Chelsea president Violet Aldaia.

But as the industry has continued to refine its behavioral-insight capabilities, the role of the caregiver has come into sharper focus. At the same time, science has made progress in understanding how targeted interventions can help alleviate some of the strains associated with care-giving. For example, a study presented at the 2020 ASCO Virtual Scientific 

Program found that oncology caregivers who participated in videoconferenced coaching sessions were less anxious and more effective.

“It starts with market research — you can’t just assume ‘here are five truths about caregivers,’” explains Hill Holliday Health EVP, managing director Linda Bennett. “I may care for somebody with a temporary injury, which is very different from a chronic condition or cancer. There are different needs, different physical responsibilities, different emotional responsibilities. Understanding what those are — that is what a company trying to support caregivers should be doing.”

Here are three campaigns that did just that, achieving better outcomes by targeting caregivers at different points along the continuum of care.

BioMarin Pharmaceutical and Havas San Francisco created MyPKUFamily, a multichannel effort to create content and materials specifically for caregivers of patients with phenylketonuria.

BioMarin Pharmaceutical/Havas San Francisco

MyPKUFamily

Caregivers play a particularly important and multifaceted role with rare disease patients. To that point, a 2018 study by the National Alliance for Caregiving, in partnership with Global Genes, looked at the effect of rare disease on caregivers. Of the respondents, 67% said providing care is emotionally stressful, 89% said they had had to educate their HCP about their loved one’s rare disease and more than half reported feeling alone.

That insight influenced a campaign Havas San Francisco did for caregivers of patients with phenylketonuria. Better known as PKU, it’s a rare genetic disorder caused by a deficiency of the enzyme that breaks down phenylalanine, an amino acid found in protein-containing foods and artificial sweeteners. It can be managed with a proper diet, but left unchecked phenylalanine can accumulate in toxic levels and cause serious health problems, including brain damage.

Because PKU is inherited, babies born to mothers with the mutation are screened in the U.S. But that practice has only been in place for a couple of decades; there are older patients who never received a diagnosis at birth and may never have gotten one later in life, given the rarity of the disease.

What’s more, the symptoms of PKU can wane if the patient maintains a proper diet or if their enzyme retains some function, slowing the buildup of the amino acid. Over time, this can cause some patients to lose discipline, if not outright forget how to manage the condition.

“We had the insight that there were patients who were ‘lost to follow-up,’ meaning they were lost to the system,” explains Havas San Francisco president Monette Hagopian. “They had PKU but had not seen a specialist in at least two years. That pretty much means you’re off therapy, so there’s a good chance you’re experiencing cognitive impairment at that point.”

Individuals experiencing cognitive impairment are not ideal targets for a media outreach campaign. But Havas, in partnership with BioMarin Pharmaceutical, realized a patient’s loved ones likely would be able to tell a difference in their mood and function. They just might not know what to do about it.

Thus was born MyPKUFamily, a multichannel effort to create content and materials specifically for caregivers, including a website, social, print brochures, video assets and virtual patient programs. “The idea was we would equip the caregivers to help notice changes in cognitive behavior in their loved one and encourage them to get back into therapy,” Hagopian says.

One key component of the effort was a PKU family tree. Havas and BioMarin found that, in many cases, the genetic nature of PKU was not understood as well as the lifelong management of the disease. So they created a sub-campaign on MyPKUFamily.com that educated visitors on how PKU is inherited.

Hagopian says the campaign’s success demonstrates that a caregiver not only can be a conduit to adherence, but also to getting onto therapy in the first place. The results were immediately apparent: Within two hours of launching the campaign, seven lost-to-follow-up PKU patients reached out to BioMarin to ask about next steps.

Novartis/Hill Holliday Health

Hope the Giraffe

One Hill Holliday Health campaign in the rare-disease realm targeted a different kind of caregiver: Parents of young children suffering from a class of autoinflammatory disease called Cryopyrin-Associated Periodic Syndromes (CAPS). The agency’s portfolio included the pediatric indication of Ilaris, a drug made by Novartis to treat CAPS.

Bennett says the physician community, not surprisingly, has focused on children with the condition. But given how infrequently the condition occurs, the parents of patients often feel isolated, with nowhere to turn.

“What we were looking at was creating a community for parents of children with this rare disease, to provide some relevant support for them that was not about selling the brand,” Bennett recalls.

Launched in August 2017, the unbranded Hope the Giraffe campaign featured a Facebook page for a character named Hope, a giraffe with different colored spots. The page served as a social community for caregivers and children, with Hope as its goodwill emissary. Hill Holliday also created an augmented reality “world effect” that let parents and children watch Hope come to life as she encouraged them with messages of support.

Given that Ilaris is among the very few treatment options for CAPS patients, the initiative “was less about selling the brand than showing leadership,” Bennett says, adding the page garnered significantly higher engagement compared to the usual Facebook brand page.

Anecdotally, she reports that caregivers responded enthusiastically. “They were appreciative to have a community where they could tap into other people who understood specifically what they were dealing with.”

Janssen/Hill Holliday Health

Stay Connected

For a campaign touting Janssen’s blood-clot preventative Xarelto, Hill Holliday went with a more typical creative mix. But it was unique in one regard: a recognition that the caregiver’s role would evolve throughout the care process. To that point, the campaign identified different points along that continuum to adjust the deliverables, so as to better support caregivers wherever they happened to be at that particular moment.

During the “early awareness” stage, when caregivers were conducting initial research alongside the patient, campaign messaging didn’t differ from the bigger-picture branding. 

“You want a common understanding of what the brand is offering from a benefit standpoint,” Bennett explains.

The messaging took a turn toward the personal in what Bennett dubs the “consideration” stage. There, the goal was to help caregivers retain a level head as they helped patients navigate a complicated decision process. “Our concern was, ‘What kinds of things might a care-giver be tuned into, versus a patient?’” she notes.

Finally, once patients entered long-term care, the focus shifted to providing adherence materials designed to help caregivers keep the patient on therapy. To most effectively reach caregivers at that point, Hill Holliday found that it helped to empathize with their circumstances.

“You’re caring for somebody who most likely just came off having a heart attack or a stroke or some other sort of coronary event,” Bennett says. “It’s high-risk and high-concern, and understanding those emotions the caregiver is going through is important.”

To that end, Hill Holliday built a separate microsite, featuring videos and informational materials, specifically dedicated to caregivers. “The video was much more focused on what you’re going to be doing as a caregiver,” Bennett continues. “It wasn’t a video about the drug — it was acknowledging your role and how we as a brand are supporting you in that role.”