KidCARE TV Promotional Evaluation

KidCARE TV Promotional Evaluation NINE MONTH TEST/POST-TEST ASSESSMENT

Presentation by: IMS Health Consulting & CARE Media Holdings Corp.

Agenda

• Objective

• Research Methodology

• Methodology Assumptions

• Study Results

• Conclusions

Promo.Return CARE Media Holdings KidCARE TV Final Report • February 20112

Objective

• To assess the impact of CARE Media Holding’s KidCARE TV program that is being evaluated on Product X on prescribing behavior of participating physicians using a nine month test/post-test period

• This analysis is limited to participants who began exposure during April 2010


KidCARE TVfor

Product XIncremental

NRx?

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Agenda

• Objective



• Study Results

• Conclusions


Research Methodology

• Impact of KidCARE TV programming for Product X is assessed using IMS Consulting’s Promotion EvaluationSM methodology

− Paired comparison analysis to measure changes in the product of new prescription writing behavior of a Test group relative to a similar group of Control physicians

− Utilizes physician-level new prescription data* that is “raw,” or not projected, which removes any potential bias that might be introduced by projection


*Data source: IMS Health’s prescriber prescription database

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Agenda

• Objectives



• Study Results

• Conclusions


Research Methodology

• Impact of CARE Media’s KidCARE TV for Product X is assessed

using IMS Consulting’s Promotion EvaluationSM methodology

– Paired comparison analysis to measure changes in Product X new

prescription writing behavior of a Test group relative to a similar group

of Control physicians

– Utilizes physician-level new prescription data* that is “raw,” or not

projected, which removes any potential bias that might be introduced

by projection

*Data source: IMS Health’s prescriber prescription database


Study Time Periods

• Test physicians were initially exposed to the KidCARE TV promotion during April 2010

• NRx data for the same nine months during the previous year (as compared to the post-test period during the current year) is used as the pre-test period

• NRx data for the test month and following eight months of exposure (test/post-test period) reflects prescribing behavior influenced by the KidCARE TV promotion


Pre-Test Period9 Months

Test/Post-Test Period9 Months

Apr – Dec 2009 Apr – Dec 2010

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Test Group


2,264 Physicians participated in the KidCARE TV program for

1,888 Physicians qualified as potential Test physicians (successfully matched to the IMS

Health prescriber universe)

1,831 Physicians had a matched Control

1,548 Physicians were Specialists

283 Physicians were All Other

Specialties

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Promo.Return Client Product Study Name • Month 201010

Statistical Approaches

•ANCOVA was used to measure statistical significance of the difference between the post-test NRx volume generated by the Test and Control physicians

– Adjustments were made in the post-test period to eliminate any pre-test period differences between the Test and Control groups

– Program success was determined by looking for an Index of Adjusted Means (IAM) above “1” with a p-value <0.10, i.e., a confidence level >90% showing that the result is not due to chance

•Z-tests were performed to determine the effectiveness of the program on

– Product X NRx share, defined as the ratio of Product X NRx over market NRx, and

– Product X physician penetration, defined as the number of physicians writing at least one prescription for Product X

Control Group Selection

• 1,888 potential Test physicians were matched to the IMS Health prescriber universe to identify potential Control physicians based on the following criteria:

− Product X NRx during the pre-test period;

− Product X’s competitors NRx in the pre-test period;

− Sales force promotion;

− MD geography; and

− MD specialty

• 1,831 Test physicians were successfully matched to a Control physician


Methodology Assumptions

• Test and Control group physicians are assumed to have similar levels of exposure to promotional activity for the duration of the study time period

− Cannot control for disproportionate changes in promotional levels in the post-program exposure time period

• Managed care influences are also assumed to be similar between the Test and Control physicians

− Cannot control for disproportionate changes in patient flow or patient health care plans at any time of the study time period


Quality Control Procedures

• Two different quality control procedures were utilized as necessary to ensure that sporadic reporters do not bias the results

− Constant Store Panel – a pharmacy must report prescription activity in each study period month to be included in the analysis

− Active Writers – a physician must generate at least one prescription during the most current three months to be included in the analysis


Agenda

• Objective



• Study Results

• Conclusions


Product X NRx Comparison


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Test Product X Control Product X

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During the nine month post period, Test physicians prescribed 3.0% more Product X NRx compared to Control physicians. This change in prescribing behavior is statistically significant (cl=89.96%).

Note: cl = Confidence level; if cl >= 90% the program impact is significant, cl=80-90% is directional, else it is non-significant. Analysis conducted : ANCOVA.

Competitor NRx Comparison


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Test physicians prescribed 1.1% more Competitor NRx compared to Control physicians. This change in prescribing behavior is not statistically significant (cl=58.37%).


Market NRx Comparison


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Test physicians prescribed 1.5% more Market NRx compared to Control physicians. This change in prescribing behavior is directional (cl=79.59%).


Product X NRx Share Comparison


During the nine month test/post-test period, Product X NRx share decreased to a greater extent among Control physicians than Test physicians, resulting in a statistically significant difference in share change of +0.4 share points (cl=97.71%).

25.2% 25.2%

24.9%

24.5%

24.2%

24.3%

24.4%

24.5%

24.6%

24.7%

24.8%

24.9%

25.0%

25.1%

25.2%

25.3%

Test Group Control Group

Pro

du

ct

X

NR

x S

hare

Pre-Test Test/Post-Test

0.3 pointdecrease

0.6 point decrease

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Note: Analysis conducted : Z-test.

Product X Physician Penetration Report

89.8% 89.8%

89.1%

88.4%

87.5%

88.0%

88.5%

89.0%

89.5%

90.0%

Test Group Control Group

MD

Pen

etr

ati

on



Physician penetration decreased to a lesser extent among Test than Control, resulting in a net increase of 0.7 points. The results are not statistically significant (cl=34.98%).

0.8 pointdecrease

1.4 point decrease

Note: Physician Penetration is defined as the ratio of MDs writing / MDs in program. Analysis conducted : Z-test

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Comparison of the Impact of KidCARE TV on Physicians by Specialty

Specialists n = 1,548All Other Specialties n = 283


Participants Breakout by Specialty


SpecialtyPhysician

Count% of Total

Specialists 1,548 85%

All Others 283 15%

Total 1,831 100%

All Other SpecialtiesPhysician

Count% of Total Physicians with Patients Enrolled

Specialty C 117 41%

Specialty D 39 14%

Specialty E 14 5%

All Others (individual specialties comprising of less than 7%)

113 40%

Total 283 100%

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Product X NRx Volume Comparison by Specialty


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Specialists Test Product X Specialists Control Product X

All Others Test Product X All Others Control Product X

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Test Specialists prescribed 2.5% (cl=80.80%) more Product X NRx compared to Control physicians, as All Other Test physicians prescribed 8.7% (cl=87.00%) more NRx. These changes in prescribing behavior are directional.


Competitor NRx Volume Comparison by Specialty


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Specialists Test Competitor Specialtists Control Competitor Competitor

All Others Test Competitor All Others Control Competitor

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Test Specialists prescribed 1.5% (cl=72.70%) more Competitor NRx compared to Control physicians, as All Other Test physicians prescribed 2.2% (cl=49.33%) fewer Competitor NRx. However, these changes in prescribing behavior are not statistically significant.

Market NRx Volume Comparison by Specialty


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Specialists Test Market Specialists Control Market

All Others Test Market All Others Control Market

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Test Specialists prescribed 1.8% (cl=83.25%) more Market NRx compared to Control physicians, as All Other Test physicians prescribed 0.3% (cl=6.98%) fewer Market NRx. Specialist changes in prescribing behavior are directional, All Others are not statistically significant.

Product X NRx Share Comparison by Specialty

25.7% 25.9%

20.3%19.0%

25.4% 25.3%

20.7%

17.7%

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15%

20%

25%

30%

Test Group Control Group Test Group Control Group

Sp

ecia

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NR

x S

hare



The program increased Product X NRx share among All Others with statistical significance. Specialists increased share to a lesser extent, and without statistical significance.

A non-significant net increase among Test of 0.2 share points (cl=75.75%)

A significant net increase among Test of 1.6 share points (cl=99.97%)

Specialists All Others

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Note: Analysis conducted : Z-test.

Physician Penetration Comparison by Specialty

94.9% 94.9%

62.2% 62.2%

94.4% 94.0%

60.1% 58.0%

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100%

Test Group Control Group Test Group Control Group

% P

hysic

ian

Pen

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Physician penetration increased among All Others to a greater extent than among Specialists. However, results are not statistically significant.

A non-significant net increase of 0.4points (cl=26.29%)

A non-significant net increase of 2.1 points (cl=28.49%)

Specialists All Others

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Note: Physician Penetration is defined as the ratio of MDs writing / MDs in program. Analysis conducted : Z-test

ROI Analysis – Methodology

Step I

Step II

• Calculate Average Product TRx (average retail price for a prescription) = TRx sales/ 9 month study period (for ) is $148.30 (source: IMS NPA Plus – TRx retail price)

Step III

• Calculate Revenue Associated with Test Physicians = Projected Product X TRx x Average Product Price

350,703 x $148.30 = $52,008,378

Step IV

• Calculate Revenue Associated with Control Physicians = Projected Product X TRx for Control Physicians* x Average Product Price

340,488 x $148.30 = $50,493,519

Note: Projected Product TRx for Control physicians calculated using Index of Adjusted Means (1.03) from ANCOVA, which means Test physicians wrote 3.0% more NRx than Control physicians during a 9 month post-test period.

• Incremental Revenue due to the program = Revenue Associated with Test Physicians – Revenue Associated with Control Physicians

$52,008,378 - $50,493,519 = $1,514,859

Step V• Return on Investment = Incremental Revenue from program/

Cost of the program

$1,514,859/$236,460 = 6.4:1 or $1,278,399


Agenda

• Objective



• Study Results

• Conclusions


Conclusions

• The KidCARE TV promotion for Product X was successful at increasing Product X NRx volume and share with statistical significance. During the latter months of the post-test period, Test group appears to be outperforming the Control group as evidenced by the separation in trend lines. The program also retained writers as indicated by the positive result for physician penetration, however results are not statistically significant.

− Among the specialties, Specialists increased Product X NRx directionally, with a non-significant increase in share. All Others showed a directional increase in NRx volume, with a significant increase in share.

− Both specialty groups showed non-significant increases in physician penetration.


Conclusions

• The KidCARE TV promotion for was successful at increasing Product X NRx volume and share with statistical significance. During the latter months of the post-test period, Test group appears to be outperforming the Control group as evidenced by the separation in trend lines. The program also retained writers as indicated by the positive result for physician penetration, however results are not statistically significant.

− Among the specialties, Specialists increased NRx directionally, with a non-significant increase in share. All Others showed a directional increase in NRx volume, with a significant increase in share.

− Both specialty groups showed non-significant increases in physician penetration.


Business

KidCARE TV Promotional Evaluation