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Don’t Forget the Payer in Your Digital Strategy · Pharma-Payer Partnership Trends: Then vs. Now Traditional Partnerships No Financial Drivers Attached Good Ole Days Utilization-Based

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  • Don’t Forget the Payer in Your Digital Strategy:WHAT PAYERS NEED AND WANT FROM PHARMA

    mailto:[email protected]://

  • AgendaChallenge the status quo – does a digital strategy for payers make sense?

    Do YOU have a

    seat at the

    table inside

    your company

    re digital


  • The Stakeholders - WHO?2/3 Total Rxs Covered by Private Payers1










  • Industry Trends - WHY Payers?

    When Pharma overpays incentive dollars to those territories with favorable MCO environment, then

    company is paying more with getting less;

    Conversely there are territories where individuals are

    underpaid, causing incentive plan to lose

    motivational value

  • Pharma-Payer Partnership Trends:

    Then vs. Now

    Traditional Partnerships

    No Financial Drivers Attached

    Good Ole DaysUtilization-Based


    “Light” Financial Drivers Attached

    Value-Based Partnerships

    Price, Reimbursement, Access Negotiations


    Performance Guarantees

    Rebates for not meeting criteria



    • FROM Access-based contracting to Value-based contracting

    • TOWARD flexible risk-sharing and cost management mechanisms

  • Payer + Pharma = “Frenemies”?

    The 1st 6 months of product intro are crucial. Missteps

    along the way are the difference between commercial success

    and failure.

    Payer and Market Access strategy are


  • When the Gap Isn’t Filled…

    "[I]f you are organized around the physician, you are

    missing the key influencer,"

    ~Joe Jiminez, chief of Novartis' pharma division,

    to The Wall Street Journal.

    Merck has been running pilot programs in which reps are

    assigned to spend more time with third-party payers.

    "We think the focus should be on the Medcos of the world,"

    ~Ken Frazier, chief of Merck's global pharma

  • Payer Involvement – WHEN?


    What does this mean

    for a digital strategy?

  • Poll Question:

  • The Long View

  • Inflection Point in Pharma Marketing

  • Pharma e-Promotion: Far from “Digitally









    2010 2011 2012

    USA e-Promotion Investment Trends, 4Q MAT

    e-Detailing e-Mailing e-Meeting

    $353 M

    $534 M

    $879 M

    + 14 %

    + 68 %

    + 74 %

    2012 vs. 2011 % Change

  • Pharma are “Beginners” in Digital

  • Do Pharma Execs“Get” Payers or

    Digital Marketing?


    Access –

    Biggest Pain

    Point to

    Pharma Execs


  • Why are CEOs Reticent?



  • Poll Question:

  • Virtually No Digital Spend on Payers2%



    All Others

    ~$900M Total Spend, 2012

    2:1 - Physicians would

    rather go online for info

    than see a rep

    Would Payers say this?

    ► ~1 in 4 direct sales force interactions are digital1

  • Digital – WHY? It’s Not About Digital – It’s About Customer

    Engagement, Loyalty, Advocacy

    “It’s all about making the brand

    experience so positive that it drives

    Loyalty and Advocacy.”

    ~Lisa Flaiz, Janssen Digital Marketing,

    June 2013

  • •••••

    Poll Question:

  • With any Promotion – Including

    Digital, remember….

    This is true for


    Doctors, and


  • Payer Promotion – WHAT?

  • Payer Digital Promotion – HOW

    Pharma Marketing

    eMarketingManaged Markets


    Get Internal Stakeholders Together

  • But What About Regulatory Issues?

    Draft Guidance for

    Industry Responding to

    Unsolicited Requests

    for Off-Label

    Information about

    Prescription Drugs and

    Medical Devices;

    Section VI on “Social


    December 2011

    FDAMA Section 114


    AMCP Format


  • Promotion of Health Economics Data

    Physicians &


    “Substantial evidence”

    Not really appropriate for HEOR

    data; preference to RCTs, doesn’t

    allow modeling

    “Competent and

    reliable scientific


    (Section 114)

    Section 114 of the FDAMA states

    ‘‘Health care economic information

    provided to a formulary committee, or

    other similar entity, in the course of

    carrying out its responsibilities for the

    selection of drugs for managed care or

    other similar organizations, shall not be

    considered to be false or misleading if

    the health care economic information

    directly relates to an indication

    approved and is based on competent

    and reliable

    scientific evidence.’’

    How do we deal with CER?

    Cost savings claim – probably ok; cost/QALY – probably not OK (under Section 114)

  • Non-promotional Health Economic


  • FDA Actions and Health

    Economic Info•

    Intense interest on “value” promotion

    FDA concerns – “backdoor” clinical

    claim within economic endpoint

    Section 114 allows promotion of HCEI

    to health plans but has restrictions

    and there has been n guidance

    New legislation extending 114 to CER

    may help

    mailto:[email protected]://

  • FDA Guidance on Digital Media

  • Examples of Payer-Oriented

    Digital Marketing or e-Tools

  • iPad Budget Impact Model & App


  • Genentech-Forum.Com

  • Collaborative Real-World Evidence

    Arrangement, AstraZeneca and WellPoint

    There’s lots of Big Data out there with not a lot of robust insight,” says Marcus Wilson, president, HealthCore. “There’s a limit to what you can get from it without it being effectively integrated.”

  • Social Networks to Assess Treatments and

    Recruit for Clinical Trials, Merck and


    “It’s a surprise to no one that as an industry, we’ve really lagged behind in terms of engaging with end users of our medicines and patients, so social media creates new kinds of opportunities for us to understand, from the patient perspective, what the relative value of our medicines are in the real world,”

    Sachin Jain, MD, chief medical information and innovation officer at Merck.

  • Innovative Web-based Technologies.

    Would it work for Payers? Assets/Documents/SEA sales and marketing.pdf

  • Managed Markets Portal, Biogen-Idec

  • Common: Website section

    describing coverage by various payers

  • Novo Nordisk NovoPayerLink

  • SummaryTips To Remember

  • Poll Question:

  • Payer Digital Promotion

    What are the Needs of


    Payers Interested in:

    • Aligning with Customers and Employers

    • Improving patient outcomes• Budget Impact• Adherence• Cost-effectiveness• CER• Real-world studies (participation,

    recruitment, results)

    • ACOs• Contracting

  • Take Home Messages for Digital

  • Don’t Forget the Payer in Your Digital Strategy:WHAT PAYERS NEED AND WANT FROM PHARMA

    Download slides here

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