Statistical modeling for medication adherence

Patients not adhering to their medication regimens has been shown in multiple studies to yield sub-optimal health outcomes as well as decreased sales opportunities for pharmaceutical companies. Various CRM efforts over the years have tried to address this. Now a new tool may be avaialable.

There was a fascinating article in the NY Times Health Blog recently about Fair Isaac (FICO)creating a logistic regression style "medication adherence score" much like their credit score, that predicts likelihood to adhere based on demographic, financial, and transactional variables. For example: Are sixty-something
middle class Midwestern grandparents with low net worth particularly non-adherent?

If a score comes up as such, would a pharmaceutical company target them with a an extra adherence mailer, kit, or a premium adherence pill bottle? Or call center support? Since these are expensive resources, targeting using a validated model score seems attractive.

Of course, these resources could be offered to anyone, but could be promoted selectively.

I think likely the modeling score was validated on historical data. It will be fascinating to see how accuracy is tracked moving forward. Also, whether pharmaceutical firms or communications agencies will adopt it.

List purchasing and direct mail

One of the ways healthcare companies perform acquisition is via direct mail. It can be a targeted approach to acquire lists and then send patients information. Of course, direct mail can be expensive depending on the piece, and you might expect to get a 1% to 2% response rate on actions like website registrations or calls. Definitely this is an acquisition channel where you can create a basic pro-forma spreadsheet model to gauge potential ROI.

I would recommend Email as an more cost effective alternative for consumer acquisition. These also can be list purchased.

Where do the sources of the lists come from? They are opted in at various sources by the consumers who note that they have a particular condition. The sources of a pharmaceutical direct mail piece to patients is illuminating; see this blog entry and article.

I recommend a test and learn approach when it comes to pharma lists for direct mail or email. Rent a random fraction of the list and see the response rate. Or better yet, use a quantitiy you can afford. Also, consult an agency you trust to find the right list suppliers.

Invest a Bit to Measure

When investing millions in a new major promotional campaign, or a new selling technology, think about this: how will you be accountable for that investment? How will you know if that investment in advertising, communications, and technology is actually paying off? In today's corporate environment, answering those questions is paramount.

The Dutch physicist Heike Kamerlingh Onnes (1853-1926) cleverly remarked in rhyme: "Door Meten tot Weten:" Through Measurement is Knoweldge.

Yet I often see clients, and agencies, omit the small proportion of the budget required to measure, which insures understanding of success, and the ability to optimize and improve. I would say 8% to 10% is a good minimal requirement benchmark for a measurement budget -- others would go much higher -- see this ClickZ point of view.

What does measurement look like? Especially with new technologies like multichannel, closed loop marketing, RM, iPads, QR codes, etc?

Ultimately, you want linkage between your promotional investments and incremental sales.

However, there are other critical evaluations that should be performed, on how the marketplace is behaving and how perceptions are being changed. Some call this "engagement." I like to think of it as: "are my stakeholders behaving the way I intended?"

Measurement is in large part the comparison of actual behaviors to what you expected when you set up your mutli-channel program, or your sales force automation system. Are the sales reps detailing as you intended? Are the physicians or consumers interacting with the media you have placed? Is navigation on websites achieving to goals that move your brand?

Therefore, when investing in promotional platforms, give some thought as to the expected marketplace experiences. And save some funds for measurment to confirm or optimize your plans.

Healthcare is Digital and Pervasive

This Tuesday our firm The CementBloc hosted an event during New York's Internet Week demonstrating multi-channel solutions in the Health and Wellness Sector. We received an impressive response of over 100 registrants, and we showed four waves of attendees through our offices. The context was a patient journey for a prospective traveler to the Far East, and how that consumer learned about all of the required vaccinations from web, mobile, office materials, EMail, and so on. Furthermore, healthcare professionals, be they primary care physicians or travel clinic specialists, hear about vaccine updates via professional portals, Epocrates, and ipad tablets from their pharmaceutical sales representatives.

For some first hand accounts of this exhibit, please see Yahoo and also Mediapost. For an impact on how this affected TheBloc and beyond, see My Life as a Focus Group.

Communications in healthcare can only be impactful when they can reach the target audiences where they gathering informations and making decisions. By necessity, that means placing portable information assets at various places: online, within communities, in office, (E)mail, out of doors, and in various media: print, digital, and video. The days of building monolithic websites with many bells and whistles is drawing to a close. Instead, one must design an interconnected distributed system that collectively accomplishes CRM or PRM.

Furthermore, that means working in medical communications is an exciting place to be.