August 2007
	Looking at People Looking for Medical Information As I have discussed in numerous articles and presentations in recent years, it is increasingly necessary for the pharmaceutical industry to bring genuine value to physicians and other prescribers in order to gain what Seth Godin would refer to as their permission to market to them. Since state and federal government regulations, public relations and other forces make it more difficult to deliver value to practitioners in the form of goodies, i.e., elaborate dinners, trips, etc., we are increasingly, and rightfully, being returned to providing information as our sole means of being able to provide value. But what is information? For far too many pharmaceutical marketers, information is “stuff you can say.” Little thought is given to the fact that there are actually various kinds of information, and that they are used differently by different doctors in different situations. Certain key general principles apply, however. Among them: Prescribers need information couched in terms of treatment situations and patient types, while pharmaceutical marketers want to talk in terms of products, and Prescribers need their information presented in an easy-to-use format, so they can pull the information they need, when they need it, without expending large amounts of time or energy. But how do those of us in the pharmaceutical industry learn to understand and deal with physician information needs? In an industry so fixated on physician prescribing behavior and market share, watching such Rx data sources at the individual prescriber level on virtually a daily basis, it is astounding and unfortunate that we pay so little attention to other readily available behavioral data sources. Take, for example, Epocrates, one of the most popular and frequently used services provided to the practitioner. For purposes of brevity, we might describe it as the Physicians’ Desk Reference mounted on a Palm PDA. Such a description would be too simplistic, however, since physicians also complete CME courses, receive drug alerts, etc., using this service. Given that one of every three physicians (admittedly slightly younger than average, but otherwise likely representative) has this service and uses it several times a day, consider the treasure trove of valuable information that could be obtained by learning what screens (indications, dosage, etc.) for what drugs in what categories (e.g., CNS, CV, etc.) in what stages of their life cycle get the most hits. If we knew, for example, information about the 10 screens hit most frequently in descending order, pharmaceutical companies would have a much better feeling about what information to provide doctors. Admittedly, some thought would be required to go from the number of hits received to actionability. The most frequently hit screen, for example, might be the biggest target of traffic because: It is a new product, and physicians are accessing this screen as one way to bring themselves up to speed. Representatives for the product have done an especially good job of raising a specific issue about the product, and physicians are going to this screen to collect further information on the topic. A journal article has recently noted a high incidence of a particular side effect with the product, and physicians want to learn more about this side effect as it applies to patients they are treating. In other words, as is not unusual in marketing research involving observation, once we have seen that a particular screen was hit last month more than any other, we must then hypothesize and/or research the reason the screen was hit so frequently and then decide what action steps, if any, are required. Without the why, however, we might be confused as to whether our sales representatives had done an especially good job of emphasizing a potential side effect for a specific group of patients and congratulate them; whether they confused physicians on this topic, thereby requiring remedial training to better explain the issue; or whether the page is being hit so often because of counter-detailing presented by one of our competitors, in which case we may need to redouble, or modify, or both, our own Pharmaceutical Sales Representatives’ (PSR) commentary on this issue. In brief, I strongly believe that companies like Epocrates should begin to offer such analytics at the national, district or territory level, and examine them up against the backdrop of physician age, specialty and other relevant demographic information. I should also strongly emphasize that I am not suggesting this information be offered at the individual doctor level, since the public relations and regulatory climates are far from appropriate for applying this level of granularity and being pounced upon by a PSR for accessing a particular page would likely discourage use of the service, which is the last thing we want to do if our goal is to provide physicians with information. Other online services, available to physicians and those targeted to patients, could also generate a wealth of information about providing information if they were scrupulously analyzed. The online properties of WebMD, for example, could provide us with considerable information in this regard. Focusing on patients and consumers, for example, it is mind-boggling to realize that some 40 million patients/consumers a month access WebMD. Lay people are obviously hungry for medical information, and their needs are not being met by speaking with their physicians. This makes it especially important for the pharmaceutical industry to provide information to these information-hungry consumers and do so in a well thought out and organized manner. A patient who awakens in the middle of the night with frequency, urgency and burning while urinating doesn’t want to know all there is to know about urinary tract infections; she simply wants to know whether she has one or not and what to do about it. Although requiring no trivial amount of effort, great insights about patients’ utilization of such resources as WebMD can be garnered by analyzing, on a de-identified basis, patients’ “footprints” through the medical information on the Internet. Did they come to a particular site through a search engine, or did they access the site directly? What words did they use to conduct their search within the site, and what site pages did they use and for how long? In brief, we believe that the future of pharmaceutical marketing will involve substantially less providing “commercials” to physicians and patients and far more applying our resources to aid the various stakeholders in the health care delivery and consumption process. Directly observing the health care information consumption patterns of these stakeholders within the resources currently available can provide us with important guidance not only as to points of clarity and confusion about current products, but also direction as to how to improve information resources and their user interfaces to provide better access, and therefore enhanced product prescribing, better patient compliance, etc., in the future. Richard B. Vanderveer, Ph.D. Group Chief Executive Officer GfK U.S. Healthcare Companies