E Detailing

Presented by: Dr.
Andre Bates
Traditional Detailing Is Getting Harder As Physicians Become Busier
Pharmaceutical rep waits whilst doctor sees patients 10 - 40% Appointments cancelled or rescheduled Typical call <5 minutes Impact on Prescriptions (ROI) per rep not usually measured
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Copyright 2009 Eularis
Conventional Pharma Selling Is Rep Based...And Failing To Deliver ROI
Reps are the foot soldiers of selling to doctors. Methods changed very little in 20 years o Mud-at-the-wall approach o Has worked in the past Average 3 - 8 visits per day. 43% Of calls, rep fails to speak to doctor.
Decreasing Impact of Sales Force
Source: Eli Lilly

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e Solutions Emerged To Address Detailing Challenges

Video/Web Conferencing Phone PDA eDetailing eDetailing simply means using digital technology, in the detailing process, e.g. internet, videoconferencing and Interactive Voice Response (IVR) for enabling the interaction with the physician.
Health Warnings: e Does not simply equal use of the Internet Not all the benefits apply equally to all the models 5 of eDetailing
Potential Benefits Giving more control to the physicians Reducing sales force expenses without losing sales Allowing trackable interaction with physicians Allows sales rep to be more productive & effective Allows method to change product positioning Rep can make greater number of sales calls Increase strength of relationship between Rep/Dr Increases number of prescriptions written
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There Are Many Different eDetailing Models And Suppliers

Many forms of eDetailing are emerging and being used today, including: Virtual Live eDetailing Scripted eDetailing Physician Portal eDetailing Pharmaceutical companies own solutions e.g. installation of Pharmaceutical company system (live or scripted) with a physician popular approach is telephone co-browsing which is an adaptation of virtual live and scripted
We will start by defining each of the current models before comparing the options.
Virtual Live eDetailing Offers Remote Real-Time Access To A Rep

In the original version of this approach, participating doctors are provided with equipment that allow real-time video and data connections with a live rep via a personal computer. The physician initiates the eDetailing session and has control over the timing of the call. During the call, the physician and sales representative view and listen to a multi-media presentation about the promoted product and have the opportunity to discuss any points from this or anything else the physician has questions about. This type of system was pioneered by iPhysicianNet in the US. A variance on this approach is a system where only the sales representative is viewed, or only audio and data slides are shown, or the sales rep is on the telephone while they view an online presentation together, depending on the wishes of the physician.
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Telephonic Co-Browsing
The physician initiates the eDetailing session and has control over the timing of the call. The physician calls the sales rep or clicks a button on their computer or a Web site and this prompts the sales rep to call them. During the call, the physician and sales representative view a scripted online eDetail about the promoted product and have the opportunity to discuss any points from this or anything else the physician has questions about. This type of system grew out of virtual live (but became telephone rather than video based) and scripted and combines the best of both in a more cost-effective manner It can be delivered via a physician portal in some cases
Scripted eDetailing Offers Automated Interactive Product Conversation

Physician uses a personal computer to launch an automated sponsored learning program which is usually delivered online via a web site. This is often a series of interactive, multimedia screens with information about the promoted product, including: o Research evidence o Clinical practice guidelines o Prescribing information o Patient advice Doctor usually rewarded with an honorarium for completing the walkthrough of the information designed to last ca. 10 - 15 minutes.
NovoNorm Scripted eDetail
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Physician Portals Offer eDetailing Via Sponsorship, Surveys & Targeted Mails
Online physician communities via physician portals offer an opportunity to deliver pharmaceutical company messages to a specific audience of physicians. Such portals also provide a means for gathering physician views (e.g. via surveys). Was often used for delivering soft general marketing messages (e.g. via sponsorship of a disease area forum or an online CME module and/or sending targeted emails to selected physicians). Now being used to provide hard product specific messages (like traditional detailing) via incorporating Scripted eDetailing models
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Pharmaceutical DIY eDetailing Solutions Can Be Custom-Built
Companies can design and build their own eDetailing solutions e.g. 3M, Lilly both of which were telephonic co-browsing models Such a system would be installed with pre-selected physicians who would be invited to use it by pharmaceutical sales forces. The format can be any of the models already discussed from Virtual Live to Scripted to added modules to existing physician Web sites Other variants could include Call Me buttons installed on physicians desktop or appropriate physicians Web sites.
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PLANNING AN eDETAILING STRATEGY
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There Are Some Key Factors That Underpin eDetailing

QUESTIONS TO BE ANSWERED Should eDetailing be initiated? Is it appropriate for the drug and situation and target audience? Which form of eDetailing? How can we ensure success? FACTORS AFFECTING IMPLEMENTATION Objectives Which product? Drug stage in drug life cycle, market situation Physicians chosen - based on their prescribing habits Regulatory restrictions Segmentation of roll-out Effective integration with current sales force efforts ROI results of pilot data
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Clear, Measurable Objectives Are Key

SET OBJECTIVES (SMART)
Move product positioning Increasing effectiveness of the detail Decreasing number of rep calls to get the prescriptions Increasing number of prescriptions (with valid measurement criteria) Decreasing sales force costs without losing effectiveness
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How Do You Select a Product?
New product entry Late stage of product life cycle New or innovative treatment option New element of scientific interest Pull from marketplace for information/data (when theres noise
in the market)
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Market Situations Suited To eDetailing

eDetailing Different Marketing Situations
Label Changes Product Launch
Competitive Threat Response
Accessing Hard To Reach Physician Segment Extending the Product Line
eDetailing Differentiated Applications
Rapid Awareness Building for New Indications Products At Last Phase Product Lifecycle
Reinforcing Sales Force Efforts
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Implementation: Through LifeCycle

SALES
Launch
Market & Support
Rational Physician Brand Prescribing Curve Emotional
Patent expiry
Pre-Launch
TIME
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Choose Highest ROI Products
Best for products at beginning of lifecycle or nearing maturity for reasons of: Complexity of message more easily communicated electronically Rational brand prescribing curve data
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Highest ROI Physician Segmentation

High volume/low brand prescribers yield the greatest ROI in the short-term. Medium volume/low brand prescribers next target group. Low volume prescribing has great potential for long term.
Degree of brand loyalty
High brand prescribers

Written Rx volume in therapeutic area
Med brand prescribers
Low brand prescribers
High volume prescribers
Medium volume prescribers
Low volume prescribers

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Segment Market Roll-Out
Plan Roll out Roll out based on areas according to highest ROI Physicians first
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Sales Force Integration
Get sales force buy-in Leverage current relationships so, if using virtual live, or telephonic co-browsing, use same sales reps with current Doctors. Maybe have certain days of the week when they do traditional and other days when they do live virtual eDetailing?
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Implementing a Pilot
Implement pilot first with high volume/low brand prescribers for biggest win. Measure baseline prescribing, cost per call in the physicians targeted prior to beginning as well as a control group of physicians. Re-measure prescribing behaviour in both groups after 2 - 3 months of implementation: prescribing, length of sales calls, cost per call, ROI calculations. Check statistically significant differences in increases in prescribing.
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Summary Of Key Factors For eDetailing Strategy

QUESTIONS TO BE ANSWERED Should eDetailing be initiated? Which form of eDetailing? How can we ensure success? FACTORS AFFECTING IMPLEMENTATION Objectives Which product? Drug stage in drug life cycle Physicians chosen - based on their prescribing habits Regulatory restrictions Segmentation of roll-out Effective integration with current sales force efforts ROI results of pilot data
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MEASURING RETURN ON INVESTMENT

Why ROI is essential to the success of eDetailing What metrics to use and why Expected results from studies
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eDetailing ROI Metrics Are Fairly Easy To Identify

Depends on objectives set Number of rep calls to get a prescription Increase in Rx Profit from number of prescriptions written Cost of program development Cost per eDetail Number of eDetails completed Utilise the measurements into a formula to calculate ROI. Adopt over time, costs reduce significantly.
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ROI: There are many formulae to calculate ROI

ROI = Incremental profits from prescriptions written as a result of eDetailing / (Cost of eDetails + Development of program) OR (a / c) x 100 = %ROI a (profit attributed to eDetailing) = (pRx Rx) b (actual cost per eDetail) = (i / n) + c c (cost of campaign) = b x n pRx = profit from prescriptions written as the result of eDetailing (could use revenue) Rx = baseline profit i = initial investment in eDetailing technologies n = number of eDetails completed c = cost per eDetail excluding initial investment
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ROI: Who Should Calculate What?
Pharmaceutical company should calculate actual ROI. Assisted by independent third-party firm using Rx data. eDetailing vendor company should track interactions, time of day and who they are with, but not calculate ROI.
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eDETAILING ROI UNDER THE MICROSCOPE
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Metrics Building Blocks Measuring Value

Demonstrable eDetailing Value
Rx Increase Share Increase Profit Increase eDetailing Algorithmic Analysis Campaign ROI DFU attitude surveys Rx increase Cost per details Minutes of details Response rates Usability issues Connectivity Access
1996+ 2000 2004 2007 onwards
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Cost Alone Is NOT Justification For eDetailing This Is Not ROI

From DataMonitor US average estimate: Cost per traditional detail = $ 70 per min x 2 mins = $140 per traditional detail Cost per eDetail = $125 to $170 per eDetail
From Novartis US IPNI Case Study: Cost per traditional detail = = Cost per eDetail =
$58 per min x 2 mins $116 per traditional detail $ 14 per min x 10+ mins ($80-$150 per eDetail)
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Virtual Live eDetailing

PRIOR TO IMPLEMENTATION

Measured In Number Of Minutes

Prior to eDetailing, benchmark independent research was conducted with individual physicians participating in the trial. This found average detail call was between 2 - 3 minutes using traditional detailing.
FOLLOWING IMPLEMENTATION
Started using virtual live eDetailing via iPNi After implementing the system shown, the calls (all Dr initiated) were tracked. Between 8am and 6pm - average detail 17.4 minutes. Between 6pm and 9pm - average detail 28.6 minutes. Average eDetailing call = 19 minutes. Therefore, this system increased detail length 9 times. In addition, reps were found to have at least 5 times the number of effective calls per day.
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1996+ 2000 2004 2007 onwards
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Scripted eDetailing
Measured In Terms Of Minutes And NRx

PRIOR TO IMPLEMENTATION
Prior to eDetailing, benchmark independent research was conducted with individual physicians participating in the trial. This found average detail call was between 2 - 3 minutes using traditional detailing.
FOLLOWING IMPLEMENTATION
After implementing the system (Physicians Interactive), the calls (all Dr initiated) were tracked. Average eDetailing call = 10 minutes. Therefore, this system increased detail length 5 times. No difference in benefits between Web or IVR phone for eDetailing i.e. type of technology not as relevant as content and incentives. New prescription market share increased from 3.2% to 9.8%.
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1996+ 2000 2004 2007 onwards
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OVERVIEW OF A RECENT UK eDETAILING ROI CASE STUDY
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Case Study: Background

PRODUCT SITUATION
Product early - mid lifecycle Crowded market Declining market New indication to be communicated but no increase in sales force possible
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Case Study: Background (Cont)

PRODUCT STRATEGY New indication However, despite ongoing marketing and detailing activities prior to this eDetailing program, there was only 27% spontaneous awareness of the brand and little to no awareness of the new indication This new indication needed to be conveyed to the target Physicians as effectively, cost-effectively and as fast as possible. The brand team wanted to ensure that reps were fully supported in their detailing by strengthening their messages with an eDetail.
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Case Study: Objectives

PROGRAM OBJECTIVES
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Case Study: Approach
PROGRAM DESIGN An eDetail was created to meet the objectives. Recruitment was via direct email invitation via third party; a doctors portal and a detailing company implemented this A USB phone charger was given as an incentive. Additional recruitment was via Online Banner Advertisements via other targeted third parties; Offline Mailing to 9,000 GPs (~20 % of UK total) and nurses, and Cards were also distributed by contract sales force.
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Case Study:
COST-EFFICIENCY
Physicians in a more cost-effective manner than rep visits (less than 130)
Quantitative Objective 1: Reach
COSTS Design and development ...................... Recruitment ....................................... TOTAL ............................................... Costs per started eDetail ..................... Costs per completed eDetail .................. Cost of a sales reps visit - UK .................. RESULT:
21,000.00 24,000.00 45,000.00 19.70 32.00 130.00
The costs were 75.4% LESS than the cost of a rep per visit. The goal of reaching these Physicians costeffectively compared to rep visits had been met.
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Case Study:
SHARE OF VOICE
increased Share Of Voice (SOV) equivalent to 15 sales reps FTE
Quantitative Objective 2: Achieve
4 Minutes and 5 seconds per eDetail gave a total of 9,200 brand exposure minutes per eDetail. Based on the assumption that each rep produces around 770 visits per annum, with the same length of visit (4.08 minutes) yielding 3144.17 brand exposure minutes. The eDetail generated this result in a time span of 2 weeks. Assuming that there are 44 weeks of detailing in a year, one sales rep is getting 71.5 minutes of brand exposure per week. So, in a 2 week period, 1 sales rep is getting 142.9 minutes brand exposure. Now, in this case study, 9,200 minutes of brand exposure was achieved in 2 weeks, which is the equivalent brand exposure of 64.4 sales reps FTE in that time period. RESULT: The eDetail achieved the equivalent of having an additional 64.4 sales reps FTE for that 2 week period of the eDetail.
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Case Study:
Quantitative Objective 3:
Increase NRx by at least 15% (Cont)
Sales Increase was 23.9% for the brand in the 3 months following the eDetailing
but how do we prove that was from the eDetailing? Match a test and control group prior to starting: List of respondents post-codes matched to IMS practices (Test Group) Matched practices
Groups of control practices identified (Study Group) Close to sample practices at least within same PCO Similar size practices health center/number of GPs
So, we could compare matched practices that had: no eDetail and no rep visits, a rep visit only, an eDetail only, both an eDetail and a rep visit combined with no cross-over for maximum statistical validity.
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Case Study: Incremental Sales Growth Achieved

When Adding Different Multi-channel Events. Greatest
sales growth if we can direct reps to practices receiving e-detail or vice-versa
RESULT: eDetailing produces 43% increase in NRx value per practice above baseline and 71% NRx value per practice when combined with rep activity, when separated out from other activity.
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Case Study: Performance

CONCLUSION All quantitative objectives met: Increased awareness of the new indication as evidenced by increased prescribing. The goal of reaching these Physicians cost-effectively compared to rep visits has also been met as the cost per eDetail was 32 compared to 130 per rep visit. Achieved increased Share Of Voice (SOV) equivalent to 64.4 sales reps FTE. Additional per practice was 9% above baseline in practice (no rep on eDetail) receiving a rep visit, 43% above baseline in practices receiving an eDetail and no rep visit, and 71% above baseline in practices receiving both a rep visit and an eDetail. RESULT: eDetailing proven to grow Rx value and be a costeffective channel for raising awareness and Rx value.
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REMEMBER
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Repeat eDetails Re-Enforces Effectiveness

Repeat eDetails Re-Enforces Effectiveness
10%
2 eDetails
nRx Mkt share
0%
5%
Control
Month
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..But Please Learn.
Refine target audience from previous waves. Customise key messages on each deployment to meets target needs. Tie proxy responses to segmentation.
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eDetailing Requires Crafted Approach Not Just Cookie Cutter

LESSONS LEARNT FROM CASE STUDIES Doctors want to initiate the eDetail on their time terms. Doctors prefer interactivity (can be interactive with scripted). New content and themes crucial (CONTENT IS KING!). The approach is not optimized simply by the fact it is e but it is the interactive structure and the convenience (got same increases in prescribing from using IVR and Internet-based scripted eDetailing compared with controls). Dummy prescriptions very, very useful in scripted formats! Must tailor eDetailing format according to physician preference Can give incentives (carefully) but MUST stay within promotional code. Suppliers are still emerging that can handle multi-country eDetailing
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For More Information
Eularis Removing Uncertainty from Pharma Marketing ROI URL: http://www.eularis.com Email: abates@eularis.com
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Presented by: Dr.

Traditional Detailing Is Getting Harder As Physicians Become Busier

Copyright 2009 Eularis

Conventional Pharma Selling Is Rep Based...And Failing To Deliver ROI

Copyright 2009 Eularis

Decreasing Impact of Sales Force

Source: Eli Lilly

Copyright 2009 Eularis

e Solutions Emerged To Address Detailing Challenges

Copyright 2009 Eularis

There Are Many Different eDetailing Models And Suppliers

Copyright 2009 Eularis

Virtual Live eDetailing Offers Remote Real-Time Access To A Rep

Copyright 2009 Eularis

Copyright 2009 Eularis

Scripted eDetailing Offers Automated Interactive Product Conversation

Copyright 2009 Eularis

NovoNorm Scripted eDetail

Copyright 2009 Eularis

Copyright 2009 Eularis

Pharmaceutical DIY eDetailing Solutions Can Be Custom-Built

Copyright 2009 Eularis

PLANNING AN eDETAILING STRATEGY

Copyright 2009 Eularis

There Are Some Key Factors That Underpin eDetailing

Copyright 2009 Eularis

Clear, Measurable Objectives Are Key

Copyright 2009 Eularis

How Do You Select a Product?

Copyright 2009 Eularis

Market Situations Suited To eDetailing

Competitive Threat Response

Accessing Hard To Reach Physician Segment Extending the Product Line

eDetailing Differentiated Applications

Reinforcing Sales Force Efforts

Copyright 2009 Eularis

Implementation: Through LifeCycle

Market & Support

Rational Physician Brand Prescribing Curve Emotional

Copyright 2009 Eularis

Choose Highest ROI Products

Copyright 2009 Eularis

Highest ROI Physician Segmentation

High brand prescribers

Med brand prescribers

Low brand prescribers

High volume prescribers

Medium volume prescribers

Low volume prescribers

Copyright 2009 Eularis

Segment Market Roll-Out

Copyright 2009 Eularis

Sales Force Integration

Copyright 2009 Eularis

Copyright 2009 Eularis

Summary Of Key Factors For eDetailing Strategy

Copyright 2009 Eularis

MEASURING RETURN ON INVESTMENT

Copyright 2009 Eularis