Archive | August, 2010

Pharmacy Factoids From Old SWOT Analysis

I found this on the Internet while looking for something else.  It’s a SWOT analysis (from about 2007) about Walgreens.  You can tell it was written by someone who doesn’t understand all the industry dynamics.  There’s no mention of mail order as a threat.  There’s no discussion of PBMs.  There’s no discussion of the value of specialty pharmacy.  It’s pretty focused on the pure play retail strategy.  Frankly, I’m pretty disappointed…BUT

What I did find interesting were some facts about the industry:

  • Walgreens fills an average of 256 Rxs / day per store (in 2006) versus 100 Rxs / day per independent and 180 Rxs per day per chain.
  • Walgreens (at the time) had drive-thru pharmacies at 80% of their stores and 30% of stores were open 24-hours per day.
  • Free-standing stores generate 30% more in sales than pharmacies located in strip malls.
  • 64% of Walgreen’s sales are generated by Rx (2005 analysis).
  • A customer spends 10 minutes in the store if including an Rx purchase; 8 minutes if no Rx purchase.
  • Only 30% of shoppers make impulse purchases.
  • The average non-pharmacy store purchase in 2001 was $19.38. 
  • The average American visits a grocery store 2.2x per week but a drugstore once a month.

In case you don’t know what a SWOT analysis is…

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Fastest Growing Healthcare Companies

Fortune just published their 100 Fastest-Growing Companies (must be public with market cap of greater than $250M).  Here are the healthcare companies from that list:

How Seniors Use Social Media (Pew)

Not a big surprise…the Baby Boomers use technology.  Many of us have had their parents, uncles, grandparents, etc., send them a “friend invite” or talk to them about technology.  This will obviously continue as it’s more the norm and you have people that have been using technology for years age into retirement and look to connect with disparate friends and family.

Here are two charts from the recent report from Pew – Older Adults and Social Media.  Very interesting to watch the trends.

Texting And Driving – Message From Church

A friend posted this on Facebook.  I thought it was worthwhile to share given all the dialogue about texting while driving (which too many people do).

Seven Myths Of Social Media

I’m just finishing up a book on social media (book review to come shortly). As I was reading it and based on my experience, I came up with a few myths:

  1. You have to be everywhere.  It’s impossible.  There are so many sites out there.  You have to know your audience and determine where to spend your effort.  You MIGHT have to stake your claim to avoid someone else using it and provide information for consumers to reach you, but you can’t actively contribute and add value across the social media spectrum.
  2. Set it and forget it.  Social media is about dialogues and continuous information.  You can’t put up static content like a website and come back every week, month, year and update it.  The best companies respond (for example) to a Twitter comment about them in 24-hours while some never respond. 
  3. Build it and they will come.  There is a constant dialogue about whether you have to “own” the community or simply participate in it.  There is certainly reason to create content (i.e., blog posts, tweets), but you have to find a non-marketing environment to interact with your customers and influencers and understand their needs.  In many cases, that environment might already exist and you need to join it.  Additionally, you can’t simply launch something or join something without pushing out information about it.  For example, if you have a Facebook page, you need to have a link on your website, put it in your LinkedIn profile, include it in your press releases, etc.
  4. Marketing should own social media.  Traditional marketing has been about the controlled message.  Social media is about participatory messages.  There’s a big difference.  Additionally, social media can be and needs to include any employees who are actively engaged in social media.  We’ve seen numerous examples of employees who comment inappropriately only to jeopardize their job.  (I’ll agree that there are issues here to still be defined regarding privacy versus freedom of speech.)  Marketing can’t reply real-time about operational issues.  Ownership is a collective effort.
  5. You can outsource your social media.  This is a big mistake.  There are lots of consultants who will tell you what you want to hear.  They will talk about some channel or channels that work (e.g., Twitter experts, Facebook experts).  They’ll talk about search engine optimization (SEO) and what to do.  They’ll tell you that you need an iPhone app or a YouTube channel.  The reality is for your solution to be genuine and timely that it needs to be someone(s) who understands the company, feels passionate, and is empowered to do something quickly.
  6. Tell me..tell me…tell me.  This works great for presentations.  But, you’re now a part of the audience (although an informed member with an agenda).  You need to tailor your objectives to what the audience wants / needs.  In a community, they’re there for a reason.  They are discussing a topic and sharing their thoughts.  They want you to add value not sell your products or agenda.  They want to be valued.
  7. You can avoid it.  This is an obvious one.  With 500M users on Facebook and YouTube being the second most popular search engine, you have to understand how people find you on the Internet.  Google is a verb.  Current generations will grow up with theses modes, smart phones, and be uninhibited by our sense of privacy.  Technology is and will continue to be more ubiquitous.  The way people learn about companies is changing.  The way people learn about people is changing.  Relationships between people are changed based on technology.  Companies have to understand what’s being said about them and embrace it not run from it. 

There are tons of infographics out there that symbolize some of this.  I pulled a few of my favorites together here, but you can find more.

NCPDP Nov 2010 Event: The New Economy And …

On November 2nd, NCPDP is hosting an educational event called “The New Economy and It’s Impact on Healthcare, Pharmacy, and the Patient.” Sounds pretty cool! It’s a topic we all talk about.

What does the new sense of frugality mean? What will new forms of insurance mean? How will pharmacy evolve? Will MTM work? Will MTM become a product for commercial? How is the consumer’s behavior changing relative to information and compliance?

The agenda includes yours truly along with people from:
* Kaiser
* Walgreens
* AARP
* Sanofi-Aventis
* North Carolina Association of Pharmacists
* Eaton Apothecary
* American Society of Consultant Pharmacists
* RegenceRx

Growth In Prescription Claims

The growth in prescription claims for 2010 (per IMS) continues to be slow (but positive). The data portrays a pretty typical cycle so I guess the big question is whether we’ve hit bottom and are ready to bounce.

Obama and PRI (Parody) on Healthcare.gov

I found these two videos explaining the new Healthcare.gov websites.  One is the official Obama video and the other is a parody of that video from the Pacific Research Institute. [PRI is a free-market think tank.]

Complexity of Decision Making

In today’s world, the amount of information is overwhelming.  At the same time, we are constantly striving to practice DIY (do it yourself) medicine where we are reaching out to experts to help us sort thru information (especially when data is conflicting).  But, a lot of that assumes we know what we need or we know when to ask for help.

A study published recently in the Annals of Family Medicine looked a small group of diabetics and how they received information about their condition. 

They collected a nice long list of different sources used for information:

  • People
  • Physician
  • Nurse, nurse practitioner
  • Dietitian
  • Diabetes educator
  • Pharmacist
  • Dentist
  • Eye doctor, eye laser surgeon
  • Health care professional(s), specific role not indicated
  • Self, have had training as health professional or worked in medical field
  • Hospital-based diabetes center
  • Insurance company nurse, nurse, dietician, educator, wellness program personnel
  • Workplace nurse, health professional or wellness program
  • Family, including family members with diabetes
  • Friends, neighbors, coworkers, acquaintances, other patients, personal interaction, “word of mouth”
  • Classes or seminars
  • Support groups
  • Participation in research study
  • Comprehensive weight loss program
  • Health fair or similar event
  • Media
  • Internet (Web sites, search engines)
  • Information from organizations (eg, American Diabetes Association, American Kidney Foundation), other than from their Web sites
  • Books
  • Magazines (eg, Diabetes Forecast, Diabetes Self-Management, popular magazines—especially health/diet, cooking, women’s, African-American interest)
  • Television (eg, “D-Life,” news programs, talk shows, food-oriented shows)
  • Newspaper/newsmagazine articles
  • Booklets, brochures, etc, from clinic or health professionals
  • Booklets, brochures, newsletters, e-mail newsletters, etc, from miscellaneous sources (“in the mail”)
  • Information from pharmaceutical company, drugstore, medication supplier
  • Information from insurance company
  • Library
  • Bookstore
  • “Reading” or “studying” (type of material not specified)
  • “Media” or “articles” (not further specified)
  • Nutrition labels on food packages
  • Nutritional information pamphlet, fast foods
  • Product information (eg, Glucerna, information in insulin kit)
  • Atkins, South Beach diets
  • Reader’s Digest “Change One” program
  • Exercise videos
  • Printed reports of laboratory results

RESULTS Five themes emerged: (1) passive receipt of health information about diabetes is an important aspect of health information behavior; (2) patients weave their own information web depending on their disease trajectory; (3) patients’ personal relationships help them understand and use this information; (4) a relationship with a health care professional is needed to cope with complicated and sometimes conflicting information; and (5) health literacy makes a difference in patients’ ability to understand and use information.

CONCLUSIONS Patients make decisions about diabetes self-management depending on their current needs, seeking and incorporating diverse information sources not traditionally viewed as providing health information. Based on our findings, we have developed a new health information model that reflects both the nonlinear nature of health information-seeking behavior and the interplay of both active information seeking and passive receipt of information.

The Sandwich Generation

One of the things that I am surprised that we don’t hear more about is the sandwich generation.  These are people who are caring both for children along with their older parents.  According to Pew, 1 in every 8 people aged 40 to 60 fit into this category.

There are obvious implications in terms of managing health.

  1. Information challenges for these caregivers that have to manage information on their health, their kid’s health, and their parent’s health.
  2. Challenges in acting and coordinating this caregiver role while managing typical stresses of work, financial planning, and other things.

And, all of this puts a new requirement on health plans and health entities.  How do you engage the caregiver?  How do you track approval to send information to the caregiver instead of the patient? 

What about when the caregiver is remote and there is a surrogate?  How are decisions delegated?  How do you create information and send it to multiple parties?  Should the information be personalized to the individual knowing that perhaps my parents need certain information which I might need presented to me differently? 

Other resources on this topic include:

Blog Content Via E-mail

Just a friendly reminder that if you’re like me and you don’t get out to check blogs you follow regularly, you can have new posts e-mailed directly to you.  A few hundred of your peers have signed up for this service for Enabling Healthy Decisions.  The list is not used for anything else.  If interested, simply go to http://feedburner.google.com/fb/a/mailverify?uri=EnablingHealthyDecisions.

Every morning, Feedburner looks for any new posts in the past 24 hours, aggregates them, and e-mails them to you.  Thanks for following.

Express Scripts Drug Trend Highest Among Trend Reports

I am sure there is a project at Express Scripts right now to figure out how to position this in the industry. I personally would go for claiming better adherence drives up drug trend (see prior post).

With five major drug trend reports out (Express Scripts, CVS Caremark, Medco, Walgreens, and Prime Therapeutics), there is only one more that I expect – SXC. I’m sure someone else could come into the market with a report, but it’s a lot of work.

The trend numbers so far are:

  • 3.2% for Walgreens
  • 3.4% for Prime Therapeutics and CVS Caremark
  • 3.7% for Medco
  • 6.4% for Express Scripts

Does anyone really care? Should they?

On the one hand, it’s a good marker, but the companies each have different mixes of clients (Medicare, Medicaid, Employer, Managed Care, Government). They also have different mixes of clients by geography. All of these things matter.

I would personally argue that we need a different key metric for the industry. The one challenge Express Scripts faces is that they really drove this metric for years and were able to set the standard. Now, they may be caught up in that legacy.

Some of the metrics that are used to compare PBMs:

  • Generic fill rate – this is meaningful in that traditional PBMs make more money on generics but definitely subject to client mix
  • Mail order penetration – this is meaningful in that it drives several other metrics and is where PBMs make money
  • Drug trend – this is relevant in a traditional PBM sense that lower trend is better
  • Cost share – this has held pretty flat for years while the absolute value has gone up
  • Mail order satisfaction – this is generally a measure that everyone has as high and touts
  • Client retention – it seems like everyone has high marks here while clients obviously move around
  • Mail order fill accuracy – everyone’s at 99% plus so you get to differentiate at the six sigma versus two sigma level (which in scale matters)

I personally think average client cost per claim processed is a better measure. It takes into account drug mix (brand / generic). It takes into account rebates and rebates provided to clients. It takes into account retail mix (30 / 90 day) and mail order. It takes into account plan design.

I also think creating an average MPR (medication possession ratio) would be a relevant metric that more closely mapped to health outcomes and would still be within the PBMs sphere of influence. They can drive awareness and help with adherence programs thru the consumer, the pharmacy, and the prescriber.

I’m also a big fan of key metrics like:

  • 1st call resolution
  • Average inbound calls per claim processed (mail versus retail)
  • Web utilization – # of registrants AND average visits per registered member per year

PBM Data – Apples and Oranges

When I first saw the data below from AIS’s quarterly pharmacy benefits survey (2Q 2010), I was excited. I hadn’t ever seen a breakdown of claims filled by tier across multiple PBMs. But, I was disappointed as I dug in.

Percentage of Claims Processed per Tier, per PBM, as of 2nd Quarter 2010 
           
  

% of Claims Processed

Company

1st Tier

2nd Tier

3rd Tier

4D Pharmacy Management Systems

78

16

7

ACS, Inc.

36

50

14

Aetna Pharmacy Management

64

20

16

BioScrip

50

39

11

Burman’s Specialty Pharmacy

90

8

2

CIGNA Pharmacy Management

67

26

7

Envision Pharmaceutical Services, Inc.

70

25

5

Factor Support Network Pharmacy

95

5

First Health Services Corporation

48

37

15

FutureScripts

66

18

16

HealthSmart RX

48

41

11

HealthTrans

69

16

16

Maxor National

40

55

5

National Pharmaceutical Services

78

17

5

Navitus Health Solutions

68

28

2

Northwest Pharmacy Services

54

37

9

OncoMed The Oncology Pharmacy

90

10

Partners Rx Management

72

19

9

PBM Plus, Inc.

60

35

5

Prescription Solutions

55

25

20

Prime Therapeutics

68

20

12

RegenceRx

73

15

12

RESTAT

71

17

12

SXC Health Solutions/informedRx

70

24

6

United Drugs

64

29

7

Walgreens Health Services Division

55

30

15

 

Where is the data from Express Scripts, Medco Health Solutions, and CVS Caremark? I’m sure someone chose not to participate, but I don’t think they would be hurt by these numbers.

Why are the numbers so different across companies?

  • 1st tier ranges from 36% to 95%
  • 2nd tier ranges from 5% to 55%
  • 3rd tier ranges from 0% to 20%

What do I do with this? Do they all define tiers the traditional way (i.e., 1st tier = generics, 2nd tier = brand formulary, 3rd tier = non-formulary brands)?

Are they all even in the same business (i.e., a specialty only company might not have any generics)?

Do they serve similar populations (i.e., Medicaid is very different than commercial)?

Now, I could certainly drill in one by one. For example, if I pull out the companies that I believe have similar diversified clients, I get a few more focused questions:

 

1st Tier

2nd Tier

3rd Tier

Aetna Pharmacy Management

64

20

16

CIGNA Pharmacy Management

67

26

7

Envision Pharmaceutical Services, Inc.

70

25

5

FutureScripts

66

18

16

Navitus Health Solutions

68

28

2

Prime Therapeutics

68

20

12

RegenceRx

73

15

12

SXC Health Solutions/informedRx

70

24

6

Walgreens Health Services Division

55

30

15

 

Now, I see some distinct clustering that maps closer to what I would expect. I would expect a PBM to have 65-70% generic (1st tier) utilization); 25-30% brand formulary (2nd tier) utilization; and 5-10% non-formulary brand (3rd tier) utilization.

The two things that jump out for me here are then:

  • Why does Walgreens have such low 1st tier utilization? My general perception is that they do a good job at driving generic utilization and have incentives in place for their pharmacists to do that.
  • Why does Navitus have only 2% third tier utilization? Do they have a closed formulary (i.e., no 3rd tier drugs are covered without some medical exception)?

In the same issue of Drug Benefit News (DBN 8/13/10) and the same survey, there were a few other data points:

  • The total number of claims processed by PBMs increased by 9.97% over the past year to 2.56B.
    • Does that mean that the remaining ~600M claims are cash?
    • Does that equate to a 9.97% increase in utilization or is that just more covered lives or more concentration of business among the PBMs that respond to the survey?
  • Average copays were:
    • $9.98 for the 1st tier
    • $23.69 for the 2nd tier
    • $36.93 for the 3rd tier

IMHO (in my humble opinion), I think these copays show a problem…not with the data but with plan design. Generics should definitely be below $10 so we’re alright here although I would probably shoot for $8. A difference of $14 between tiers 1 and 2 is too low. $15 should be the minimum and $20 is probably better. The same goes for the $13 difference between tiers 2 and 3.

My ideal plan design would be $8, $25, and $45 (or the equivalent average using percentage copays).

Diabetes Mock PSA – Direct And To The Point

Much like the soda PSAs being used in NY, a friend at work suggested this as a pointed message around diabetes.  A little extreme perhaps, but I thought it was good.

The Power Of A Name

Believe it or not…Cows with names produce 68 more gallons of milk a year (according to Newcastle University in the UK).

So what does that mean for you?  Imagine how important it is to treat your customers as people…or your employees.  Think about that personal experience when you interact with a member.  If you’re the consumer, think about how it makes you feel when you get a general message from your healthcare provider.  Isn’t it better when it’s personalized to you?

10% Discount On DMAA Registration

As a speaker at the upcoming conference, they sent me a discount code…

Register Now for The Forum 10

DMAA: The Care Continuum Alliance, the leading trade association for wellness, prevention, disease management and other services across the continuum of care for chronic conditions, invites you to its 2010 annual meeting, The Forum 10, Oct. 13-15, in Washington, D.C. Join leading health plans, wellness and care management organizations, physician groups, health IT companies, state and federal programs and other stakeholders as they discuss health care reform, share best practices and network. Keynote speakers include best-selling author and motivation and engagement expert Dan Pink; and a panel presentation by nationally recognized consultants on workplace wellness strategies. View complete programming details

Special Registration Offer: Viewers of this notice can receive 10 percent off standard Forum pricing by using discount code “FRIENDS-FORUM” during the registration process. Go to online registration

Choices: Grande Skim Mocha With Whip @ 140 Degrees

Choices.  We can all become overwhelmed with them.  As several studies have shown, more choices are not better…they paralyze us and limit our ability to make a decision. 

So what do we do with this.  Choice is a double-edged sword.  On the one hand, you want to offer choice to everyone.  On the other hand, this can make implementation very difficult. 

Like my Starbucks example.  I can customize almost everything off a pretty basic menu…even the temperature.  (BTW – they suggested using 140 degrees rather than saying kiddy temperature)  But that makes it more difficult to standardize and should increase the risk of error.  Imagine doing this efficiently and in scale.

Mass customization has been a challenge for years. 

People can have the Model T in any color – as long as it’s black.  (Henry Ford)

While technology allows this to a certain degree, it all has to be moderated.  Let’s take communications.  I could let every consumer tell me their preferences and other facts about them.

I want you to send me automated calls unless the information is clinical in which case I want a letter than I can share with my physician.  I’d like the calls made to my home number between 5-7 pm or on Saturday’s between 10-4.  I’d like you to leave a message and don’t call back unless I don’t act for seven days.  If I interact with the call, please text me the URL or phone number for follow-up.  I like to be addressed by my first name.  I’m an INTJ so please use that as for framing the message. 

You get the point.  Where do you stop?  And, do you really think that I know what’s best.  I tell almost everyone to e-mail me, but depending on when it comes in, it could be days before I respond or even read the e-mail.  That’s if it passes the spam filter. 

I’m sure if I asked 10 people whether they wanted automated calls then 7 of them would say no, BUT you know what…good calls work (voice recorded, speech recognition, personalized).  The vast majority of people interact with good, automated calls (some for 10+ minutes).  Most people think about those annoying robocalls that use TTS (text to speech) we all get around the elections.  But, good technology with a relevant message from a relevant party get people to care.  It’s all about WIIFM (what’s in it for me).   The other half of the equation is being able to coordinate the multiple modes.  (e.g., I missed you so I’m sending you a letter.  Let me text you the URL.)

So, should I let the consumer pick their preferences?  Sure for certain things.  But, what about a drug recall (for example)?  Do I have to wait a week to get a letter?   What can I personalize versus what should the company own.  I pay for them to “manage” my health.  Why don’t I let them?

There is no perfect system.  You need a series of things to be successful. 

  • A database to track consumers – demographic data, claims data, preferences, interaction history, …
  • A workflow engine with embedded business rules to manage communication programs with rules about what to do when certain situations arise
  • Reporting to track basic metrics
  • Analytics to understand and analyze programs

And, of course all this requires expertise to interpret and leverage the data for continuous improvement.

Are you doing all that?  I doubt it…but you can be.

Racing: Incentive or Extra Cost

I’ve run a handful of races over the past 7 years (marathons, 1/2 marathons, and 5Ks).  I have a lot of friends that us the race as an event to motivate them to train.  And, I agree.  It’s helpful to have a goal and be timeboxed to deliver against that goal. 

On the flipside, I always struggle with paying to run in a race with all the added headaches (parking, crowds) if I don’t see any chance to beat my PR (personal record).  I have decent PRs in my 5K (20:55) and my 1/2 marathon (1:42)…we won’t talk about my full marathons.  I’ve finished, but all around 4:30. 

Why is this relevant?  For several reasons:

  1. Incentives are important in healthcare.  Motivating people to change is critical.
  2. This is an example of how an incentive is viewed differently by different people.
  3. This is an example of how the view of an incentive (or motivating event) changes over time or based on a particular framework.

I know this is an opinion of one, but I’ve seen this numerous times.  Healthcare is different.  People are different.  People’s perceptions of their disease change over time.  People’s understanding of healthcare changes over time.  The macro economic factors change. 

You have to be aware of this as you design programs to drive health behaviors.  While you need to understand and respect the past programs, you have to be willing to try things again as the environment might have changed.  You also can’t segment people broadly or put people into one segmentation across time and across different programs (even if their demographic segmentation – income, geography – hasn’t changed).

Doctor – Patient: Relationship or Transaction…and Therefore

Don’t jump the gun too quick here. I assume most of you are going to say that there is an implicit (or explicit) relationship between the physician and the patient. They have some interest in your outcome and your care.

But, before you go there, I want to put forth a hypothesis. If this is true, is it okay for the physician to monitor your activities on your social network? (original question posted by The Side Note blog) Can they follow your tweets? Can they review your activities on Facebook or MySpace or some future site? Can they reach out to you to ask why you tell them you’re on a diet while you tweet about eating a Big Mac? Can they ask you about side effects that you’re having to a medication?

I’m positive that they don’t have the time to monitor these sites (but someone could do that for them). The question is whether it’s ethically okay for them to do that and use that information to provide you with care.

It seems like everyone else is using that information (which is public domain). Lawyers are using it. Tax collectors are using it. HR managers are using it. I would assume insurance adjusters might be using it.

How To Improve Your Presentations

I’ve been asked many times how to improve your presentation skills. I don’t have any hints about visualizing the audience naked. My perspective has been practice, practice, practice. I think it fits well with the Outliers concept of 10,000 hours.

When I was in high school, I participated in Model United Nations (MUN) which was a great experience and forced you to get up in front of your peers and present on a topic. You had to research a country and understand their perspective. That was good, low pressure experience.

In undergraduate school, I studied architecture and you had to constantly stand in front of your peers and judges to present your solution. In business school, I constantly presented our cases and other work (until my teachers said I couldn’t present any more). Then, I think what finally helped me hone my skills was Toastmasters. A friend got me into it in graduate school, and it was great. We dropped pennies in glasses if people used “uhms” in their presentations. We did ad-hoc presentations on topics that we didn’t prepare for. We had to present in different ways using different skills.

Then, at Ernst & Young LLP, we practiced everything and focused on details. What does a white shirt under a dark suit mean versus a grey shirt under a grey suit? Attention to details.

At Express Scripts, Larry Zarin (CMO) introduced me to Presentation Zen before the book was even out. Before our annual Outcomes conference, we would practice our delivery over and over again. We would focus on slide content, fonts, and everything else that made them easy to use.

There are lots of things to think about in driving presentations, but in the end, I think there are some basics that I live by which are only learned and honed by practice. (I also think that presenting is highly correlated with being able to facilitate meetings (see good list here).)

  1. Tell them what you’re going to tell them. Tell them what you want to tell them. Tell them what you told them.
  2. Have a structure to the presentation. Think Minto Pyramid Principle or writing a good letter (intro, body, conclusion).
  3. Know your audience. What’s important to them? What’s their history with the topic?
  4. Manage your environment. How do people sit? Projector or handouts?
  5. Engage people…don’t just lecture to them.
  6. If you’re using slides or handouts, make sure people can read them and understand them.
  7. Slides are NOT handouts. They are props.
  8. Don’t talk to the slides. Make eye contact.
  9. Walk thru the presentation (at least once) out loud before delivering it to your audience.
  10. Have a routine (like golfing). I like to get a good night’s sleep and run in the morning before any big presentation. I also try to manage my caffeine intact before the presentation.

I could go on, but those are some thoughts.

Creators, Critics, Collectors, Joiners, Spectators, and Inactives

Which of these are you?  I’m clearly a creator and a joiner.

Forrester has created 6 overlapping groups of people from a social media perspective (paraphrased):

  1. Creators.  These are people who publish on the web (blog, website, video, podcasts).
  2. Critics.  These are people who post reviews online, comment on blogs, or contribute in other ways to existing content.
  3. Collectors.  These are people who read lots of information and may vote or tag pages or photos.
  4. Joiners.  These are people who have a profile on different social networking sites and visit them with some regularity.
  5. Spectators.  These are people who read online information, list to podcasts, and watch videos but do not participate.
  6. Inactives.  As suspected, these are the people who aren’t engaged in any of these social technologies. 

The other thing that I think is interesting is their breakdown of these groups by percentage (Based on their North American Technographics Interactive Marketing Online Survey (Q2 2009)).  As expected, in all these categories (except inactives), the younger age groups are more likely to represent these categories.  For example, 46% of people 18-24 are creators while only 12% of people over 55 are creators. 

  • 24% of people are creators
  • 37% are critics
  • 21% are collectors
  • 51% are joiners
  • 73% are spectators
  • 18% are inactives

Slideshare: Social Media Primer

I found this and thought I would share it.

Health Loyalty Lessons

Colloquy published a good article on Health Loyalty Lessons.  It pointed out 6 things that were important:

  1. Short-term incentives can mean long-term payoffs.
  2. Understand your objectives if you want to offer the right benefits.
  3. Communicate.  Communicate.  Then communicate some more.
  4. Strike a balance between hard and soft benefits.
  5. Stay relevant if you want consumers to stay motivated.
  6. Raise the bar.

These are good points (and more detail is in the article).  They’re relevant whether you’re doing a full blown loyalty or incentive program or simply focusing on the WIIFM principle (What’s In It For Me).  This is why healthcare communications is such a hot area right now. 

  • Who do I communicate with? (targeting)
  • When do I communicate with them?
  • How do I communicate with them? (letter, call, e-mail, text)
  • What message will drive them to act?
  • How do I measure success?
  • What’s worked before…for the individual or for people in the same segment as the individual (gender, age, condition, income, plan design)?

No “Pay-to-Delay” For Pharma

The Senate Appropriations Committee approved adding language to restrict this practice to a spending bill.  Will it ultimately pass?  I’m not sure.

What is it?  The way a generic drug comes to market is that generic manufacturers (e.g., Teva) will wait for a patent to expire and/or challenge the patent.  They do this by filing an ANDA (Abbreviated New Drug Application).  Manufacturers obviously want to enjoy the exclusivity of their patent(s) as long as possible.

My understanding is that “pay-to-delay” is when:

  • The brand manufacturer knows that someone is going to challenge their patent and try to get a generic to market before the patent expires.  They pay the generic manufacturer not to do this and in return might allow them to offer an “authorized generic” before the patent expires.

On the one hand, my reaction to this potential legislationis a “finally”.  On the other hand, this is a defeat for creative capitalism.  Does a company have to launch a product?

If Ford wanted to pay Toyota to delay the launch of a new car such that they both made more money, would the government step in and tell them they had to launch it.  Perhaps that’s apples to oranges.

The problem here is that while the brand manufacturer made more money and the generic manufacturer made money for doing nothing (other than getting the right to launch it) the public (i.e., consumers) and payers lost since they had to wait to save money.

Is This The Time To Buy Pharma and Biotech Stocks?

Certainly there’s been lots of press about their P/E ratios being historically low especially at some of the blue chips like Pfizer. There are good reasons like limited pipelines and generic competition. And, generally, my opinion is that if everyone’s talking about it then you’ve missed your window.

That being said, I found this chart very interesting. It came out from Citigroup months ago, but if I interpret it right than it shows a typical uptick in those stocks in the upcoming months. [Note: This should not serve as investment advice but simply presentation of data. Any investments should be made based on your own research and the advice of your advisors.]

If it’s hard to read, the title says “S&P 500 Pharma & Biotech: Average Relative Performance & Frequency of Relative Gains, By Month, Since 1989”. So, in September, these stocks have gained an average of 1.59% with a frequency of 65%.

 

A Collection Of Misc Articles

I’m in a clean-up mode in my e-mail and blog pile. For the first time in almost two years, I’m beginning to feel caught up. I have less than 250 e-mails (combined) in both my personal and work e-mail inboxes. This is a lot since once I open an e-mail I either (a) delete it; (b) respond immediately if possible; (c) file it in a folder on that topic; or (d) leave it in my inbox for future reading (i.e., it’s too much info to digest quickly) or for future response (i.e., it requires more time than I have).

It always begs the question of how late can you respond to something. Yesterday, I stumbled upon a e-mail from someone in Europe that wanted me to add their pharmaceutical site to my blogroll. I clicked on the link, reviewed the site, and added it. It took me less than 5 minutes, but the kicker was that he e-mailed me almost a year ago.

*****

  1. A study by Timothy Monk at the University of Pittsburgh concluded that keeping children on a stable schedule of activities can make them less anxious as they grow up.
  2. People with strong social connections are 50% more likely to live longer.
  3. People who regularly logged in to a weight-management website for 2 years lost 9-pounds (3x those that didn’t log in).
  4. Can a mouthguard make you a better athlete?
  5. A study in the July Health Affairs says that patients that use e-mail with their physicians have healthier outcomes.  (Lots of challenges here, but this should be key in health reform.)
  6. Digital Darwinism…you have to develop relevance, interactivity, and accountability.
  7. MyPressurePoints.com – a survey and website focused on African-Americans with diabetes.
  8. Generic drug videos from Teva.
  9. 9 Leading Trends in Rx Plan Management by Medco.
  10. Two low-cost generics used by Kaiser to reduce heart attacks and strokes.
  11. Managing with the Brain in Mind – neuroscience.
  12. AMA and Medco study about physicians and pharmacogenomic testing

More to come…


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