Traditional promotion efforts, including details and sampling, can only affect about 10% of prescriptions, an IMS study found, suggesting that the bulk of promotion dollars is misplaced.

The data firm’s Brand Excellence Study looked at prescriptions for 50 brands across 10 categories and found a small “dynamic market” comprised of patients who are making changes to their therapeutic regimens. There’s some slight variation between categories — for diabetes, new starts, add-ons and switches comprise around 5% of prescriptions, and for overactive bladder medications, at the other extreme, it’s about 15% — but on average, only a tenth of prescriptions are capable of being influenced. That sliver, says IMS, is the make-or-break segment for product launches.

Around 60% of that dynamic market — or 6% of all scripts — is “new-to-therapy” starts, which IMS defines as patients not on any drug in that class for the past year. Another 30% is switches, with the remaining 10% made up of add-on therapies.

“Down at the patient level, these patients are entering the dynamic market for different reasons,” said Rob Harold, senior principal at IMS. “Depending on whether it’s an asymptomatic or symptomatic disease, it could be the intensity of symptoms, it could be the number of symptoms, it could be a diagnostic test or screening that prompts the new start.” Switches indicate dissatisfaction with current therapy, whether for reasons of efficacy, adverse events, dosing, delivery mechanism or sticker shock, said Harold, noting: “We found that a strong reason for people entering the dynamic market is seeking a lower copay.”

The study found similar disparities in physicians’ prescribing habits. Around 4% of physicians — some 24,000 dubbed “market drivers” by the study — wrote 44% of all new-to-brand prescriptions tracked. Another 409,000 “non-drivers,” around 90% of physicians to whom roughly 60% of field force contacts and samples are allocated, generated less than 40% of new-to-brand scripts.  

“There’s that classic adage that says, ‘We know 50% of our budget is ineffective, we just don’t know which 50%,’” said Harold. “We see over-allocation in that group, and the true market driver quadrant still receives some of the contacts but it’s not proportionate. We know that prescribers in that 4% see more patients, they’re making more changes, and as a result, they’re more engaged with the field force.”