Budget reductions in healthcare marketing

A recent survey of pharmaceutical executives conducted by FirstWord Pharma suggests that lower budgets will be the biggest change in healthcare marketing and communications over the coming year.

Of the 539 people surveyed across 64 countries, 62% expected reduced financial resources. In fact, more than two-thirds of respondents saw this as the largest challenge to be faced in 2011.

Globally, more than half of those surveyed indicated that stricter rules on product advertising would be a key factor during the coming year.

Other changes identified by the respondents included:

• an increased focus on digital channels for marketing communications
• the rise of the informed patient
• a decrease in the use of traditional advertising and detailing aids

What are your biggest challenges for 2011?  Word on Health would love to hear from you.

Asthma in the Naughty Chair?

Celebrity Supernanny and parenting expert Jo Frost, this week kicked off a campaign to raise awareness about asthma.  The modern-day Mary Poppins, was herself diagnosed with asthma and exercise-induced bronchospasm, or EIB, at 5 years old.

The national campaign EIB Active™ is supported by TEVA Respiratory, and stands for Educate, Inspire, Be Active.

EIB Active’s mission is to educate people about EIB, to encourage people to talk to their doctor if they think they have EIB symptoms, and to get the proper diagnosis and treatment for their condition. a national movement to empower those with exercise-induced bronchospasm (EIB) to achieve more and lead healthier, more active lifestyles.

According to Frost, the campaign “is my way of sharing what I’ve learned and inspiring others to be active.”

EIB affects an estimated 80 to 90% of those living with asthma, and about 30 million Americans, according to the Asthma and Allergy Foundation of America.  Those with the condition may experience shortness of breath, wheezing, coughing and chest tightness during or just after exercising. As a result, both adults and children with EIB often avoid physical activity. Lack of exercise can lead to weight gain and even obesity, which can ultimately cause heart disease, high blood pressure, diabetes and trouble sleeping.

Time to take asthma out of the naughty chair and onto the playing fields!?!

Hot Trends in Primary Care

Traditional primary care is changing.  Today, there are roughly 400,000 primary care doctors working in the United States . But this number is plummeting each year. According to the American Academy of Family Physicians, by 2020, we’ll be 40,000 doctors shy of what the population needs.

And while there are far fewer docs there are far more customers.  With waiting to schedule and actually see the doctor taking more and more time, Americans are being forced to look for other options.

SRxA’s Word on Health is pleased to bring you a list of the top trending alternatives:

Drive-Thru Clinics
Retail clinics such as Wal-Mart, Target and CVS and walk-in urgent care chains including MD Now and Patient First. While some researchers purport that retail medical outlets only complement traditional primary care, other studies show that only 25% of those who patronize these locations have a primary care physician and an estimated 16 to 27% are uninsured.

Concierge Doctors
There are now more than 5,000 concierge physicians in the United States, charging on average $1,500 to $2,000 for an annual membership fee on top of insurance co-pays . You pay for access and time,  same-day appointments, email and cell phone privileges and longer visits.

Nurse Practitioners
Remember when the nurse was the warm-up act for your annual physical? Not any more.  Nurse practitioners are headlining the healthcare 2.0 revolution. Several states are already looking to increase the functions and procedures nurse practitioners may oversee.

Virtual Docs
It’s one thing to access your medical records with your mouse cursor and schedule a flu shot online, but it’s another to virtually visit one-on-one with your doc while he’s blowing off steam at the 19th hole. But imagine being able to get diagnosed in your robe and bunny slippers via webcam. The future of 24/7 WiFi house calls is now, and even the recently enacted healthcare legislation has promoted wider proliferation of the high tech, low-personal-touch approach.

Holistic Medicine
Such as acupuncture, herbalism and massage are being increasingly used as patients shy away from pharmaceuticals and invasive operations.

Jet-Set & Suture
Medical tourism is booming. It’s no secret that you can travel to Costa Rica, Brazil, Thailand or South Africa for much cheaper procedures than down the road at your local Regional Hospital. It’s also no secret that serious due diligence and research is important to ensure you don’t get ensnared in a “60 Minutes” black market surgery sting in some godforsaken banana republic. According to Deloitte Consulting, the number of Americans traveling for medical care is around 800,000 / year.

Emergency Room
When the line for the doctor is too long, where can people turn for honest medical care? The E.R.! Patients are showing up more frequently with routine ailments because they feel they have nowhere else to turn, especially in poor, urban areas. In a case study of Massachusetts, E.R. visits were up 10% between 2004 and 2008. Considering the current trending of primary care accessibility, expect even longer waits at your neighborhood E.R.

What do you think about these trends?  Are you aware of any others?  We look forward to hearing from you.

The changing co-morbidities of COPD

It seems that people suffering from chronic obstructive pulmonary disease (COPD) who are on long-term oxygen therapy (LTOT) have more to worry about than breathing difficulties.

According to a new study from Sweden, COPD patients on LTOT face an increased risk of death from cardiovascular disease and other non-respiratory ailments. The findings were published in the online version of the American Journal of Respiratory and Critical Care Medicine.

“In recent decades the demography of patients starting LTOT for COPD has changed markedly,” said principal researcher Magnus P. Ekström.

The mean age of patients starting LTOT increased from approximately 66 to 73 years between 1987 and 2000.  In parallel there has also been a significant increase in the proportion of women receiving LTOT for COPD.

The researchers enrolled 7,628 adult patients who started LTOT for COPD between January 1987 and December 2004. Patients remained in the study until LTOT was suspended or until death. Study participants were followed for a median of 1.7 years.

5,497 patients died during the course of the study. Although the risk of death decreased annually for both respiratory disease (2.7%) and lung cancer (3.4%), it increased for circulatory disease (2.8%) and digestive organ disease (7.8%). The overall risk of death increased by 1.6% per year during the study period.

In total, the risk of death for cardiovascular disease increased by 61.5% between 1987 and 2004, the authors noted.  According to the authors, the shift in mortality is partly attributable to an increase in the age of patients starting LTOT, which in turn may be related to decreases in tobacco use.

“In our view, the mechanism that underlies the increases in both overall mortality and mortality due to non-respiratory causes is that the patients have a progressively higher burden of coexisting diseases and conditions, and become more vulnerable with increasing age,” Dr. Ekström said. “Physicians who treat COPD with LTOT need to be aware of these shifts and to monitor for other conditions that may influence the risk of death in these patients.”

SRxA’s Pulmonology and Health Outcomes Advisors can help pharmaceutical companies develop programs to educate physicians about COPD. To find out more, contact us today.

Clinical Research under scrutiny?

If you watched the news at all over the past week you probably saw CNN‘s Sanjay Gupta‘s confrontation with disgraced doctor Andrew Wakefield.  He, as you may recall was the author of the 1998 study that linked autism to some childhood vaccines and set off a worldwide scare for parents.

In the intervening years there have been countless lawsuits against vaccine manufacturers and millions of children who, perhaps needlessly, have gone unvaccinated.  Recently,  an investigative report published in the British Medical Journal called the original study an elaborate fraud.

So, is Dr Wakefield alone in manipulating clinical trial data?  Can we rely on other clinical studies to provide us with the truth?

No, not according to researchers at Johns Hopkins.  In a report published January 4th in the Annals of Internal Medicine the authors concluded that the vast majority of published clinical trials of a given drug, device or procedure are routinely ignored by scientists conducting new research on the same topic.

Trials being done may not be justified, because researchers are not looking at or at least not reporting what is already known.  In some cases, patients who volunteer for clinical trials may be getting a placebo for a medication that a previous researcher has already determined works or may be getting a treatment that another researcher has shown is of no value. In rare instances, patients have suffered severe side effects and even died in studies because researchers were not aware of previous studies documenting a treatment’s dangers.

Not surprising then that they go on to say, “the failure to consider existing evidence is both unscientific and unethical.”

The report argues that these omissions potentially skew scientific results, waste taxpayer money on redundant studies and involve patients in unnecessary research.

Conducting an analysis of published studies, the Johns Hopkins team concludes that researchers, on average, cited less than 21% of previously published, relevant studies in their papers. For papers with at least five prior publications available for citation, one-quarter cited only one previous trial, while another quarter cited no other previous trials on the topic. Those statistics stayed roughly the same even as the number of papers available for citation increased. Larger studies were no more likely to be cited than smaller ones.

“The extent of the discrepancy between the existing evidence and what was cited is pretty large and pretty striking,” said Karen Robinson, Ph.D., co-director of the Evidence Based Practice Center (EPIC) at the Johns Hopkins University School of Medicine and co-author of the research.  “It’s like listening to one witness as opposed to the other 12 witnesses in a criminal trial and making a decision without all the evidence. Clinical trials should not be started — and cannot be interpreted — without a full accounting of the existing evidence.”

The Hopkins researchers could not say why prior trials failed to be cited, but Robinson says one reason for the omissions could be the self-interest of researchers trying to get ahead.

Want to make sure that your clinical trials stay on track and that your publications are evidence-based?

Contact SRxA for more details.

Hard Facts on Hard Drives & Heart Health

If you’re like us and spend much of your day in front of a computer screen, rather than rockin’ it like Lady Gaga or kickin’ it like David Beckham, today’s story may just kick your butt!

How many of us sit in front of a computer for an entire work day, and then go home and park it night after night on the couch watching television or surfing the Web?  But no, we don’t  feel guilty because we religiously squeeze in an hour of cardio at the gym before or after work.  That mitigates all that motionless  sitting, right?  Well, apparently not.  According to  a new study that just makes us “active couch potatoes”.

According to a report published this week in The Journal of the American College of Cardiology,  the amount of leisure time spent sitting in front of  a screen can have an such an overwhelming  impact on our health that the exercise we take doesn’t produce much benefit.

What!?!  All our lives we’ve been told that 30 minutes a of brisk physical activity day will improve our health! Unfortunately, it now seems that the concern isn’t how much exercise we get, but how much of our time is spent in sedentary activity and the harm this does to our body.

Uh-oh.

This particular study followed 4,512 middle-aged Scottish Health Survey respondents from 2003 to 2007. It found that those who admitted to spending two or more leisure hours a day sitting in front of a screen had double the risk of a heart attack and other cardiac events compared with those who watched less.

Those who spent four or more hours of recreational time in front of a screen were 50% more likely to die of any cause. The study noted it didn’t matter whether subjects were physically active for several hours a week. Exercise it seems, doesn’t mitigate the risks associated with the high amount of sedentary screen time.

During the study’s follow-up period, 325 individuals died of various causes, and 215 suffered a heart attack or other cardiac event. Even after adjusting for differences in lifestyle, weight, smoking, occupational physical activity and risk factors such as diabetes, high blood pressure and other longstanding illnesses,  those who spent four hours or more of their leisure time in front of a screen each day were 50% more likely to die.

Recreational screen time has an “independent, deleterious relationship” with cardiovascular events and death of all causes, the paper concluded, possibly because it induces metabolic changes.

The study focused on recreational screen time because it’s the easiest to curtail, said lead author Dr. Emmanuel Stamatakis. However, he encouraged employees who work at computers all day to get up and take breaks and short walks periodically.

That said, SRxA’s Word on Health bloggers will always be here to assist you….when we’re not taking a brisk run around the courtyard!

Happy Birthday…

to…First Lady- Michelle Obama,  boxing legend-Muhammad Ali, Founding Father-Benjamin Franklin, actors-Betty White and Jim Carrey, gangster-Al Capone…and to Us!

Yes, SRxA’s Word on Health is a year old today. Over the past 12 months we have posted 159 blogs on a variety of medical, healthcare and pharmaceutical industry issues. In this time the blog has been viewed  14,697 times.   To put this into perspective, a Boeing 747-400 passenger jet can hold 416 passengers, meaning we have been viewed by the equivalent of all the passengers on 35 full 747s.

We’re happy you like what we’ve been doing and want to take this opportunity to Thank You for your support.

If there are topics you’d like to hear more about, stories you’d like us to cover or opinions you’d like to share, we’d love to hear from you.

Pharmaceutical Marketing – new year, new challenges, new solutions?

As each week passes, regulations governing prescriber-sales rep interactions seem to tighten and as a result fewer and fewer physicians are admitting reps to their offices. In parallel more and more doctors are looking on line for the information they need about the drugs they prescribe and products they use.  It’s not surprising, then, that so many pharmaceutical companies have pared down their field sales force.

Increasingly the pharma rep is being replaced by internet based customer-centric strategies, portable technology and other forms of closed-loop marketing.  This seismic shift in pharmaceutical sales and marketing means there are fewer face-to-face meetings and that doctors have relatively limited opportunities to interact and share knowledge with their peers.

However, a recent survey undertaken by SRxA, shows this is precisely what doctors want.

Because the traditional pharma sponsored dinner is no longer acceptable in today’s heighted era of regulatory scrutiny, SRxA has worked with its team of clinical advisors to develop a number of exciting new and compliant approaches. Healthcare professionals from all specialties who have participated in these events have unanimously rated the programs as “excellent” and our clients are delighted with their return on investment.

Undoubtedly, healthcare marketing is a much tougher business than it was just a few years ago. Rising costs, increased regulatory pressure, and shrinking sales forces, mean it’s harder than ever to reach physicians and patients. To succeed, you need to tailor your marketing strategies to the changing times.

Our team of pharmaceutical marketing experts and clinical advisors will work closely with you to:

• Identify gaps and opportunities in your current strategy
• Build enduring relationships with consumers and healthcare professionals through targeted, effective multi-channel programs

To find out more about the SRxA survey, the “for physicians – by physicians” programs, and how SRxA can help you meet your marketing objectives, contact us today.

Infectious Disease Guidelines: A Matter of Opinion!

In recent years, a deluge of publications addressing nearly every aspect of patient care has enhanced clinical decision making, However, some feel it may also have encumbered it, owing to the tremendous volume of new and often conflicting information.

Clinical practice guidelines were developed to aid clinicians in improving patient outcomes and streamlining health care delivery by analyzing and summarizing data from all relevant publications. Lately, these guidelines have also been used as tools for educational purposes, performance measures and policy making. They are also meant to assist in the delivery of patient care. Not surprising then, that both physicians and patients assume that following such guidelines means practicing evidence-based medicine.

However, according to a new study published in the Archives of Internal Medicine, more than half of recommendations included in infectious disease guidelines rely on low-quality evidence.

Researchers examined 41 guidelines published by the Infectious Diseases Society of America (IDSA) since 1994. Of the 4200 recommendations in those guidelines, only 14% were guided by randomized controlled trials (level I evidence) while 55% were supported by expert opinions only (level III evidence).

Five guidelines were updated during the study period. In these updates, the number of recommendations increased between 20% and 400%, but only two updates saw an increase in the number of recommendations based on high-quality evidence.

An accompanying editorial advises physicians to be wary of falling into the trap of ‘cookbook medicine.’ “Guidelines may provide a starting point for searching for information, but they are not the finish line.” said John H. Powers, MD of the National Institute of Allergy and Infectious Diseases.

Ultimately, the existence of guidelines is probably better than no guidelines, but clearly guidelines should never replace critical thinking in patient care and physicians should avoid  using guidelines as their only source when making clinical decisions.

For better critical thinking or to discuss the development of true evidence based guidelines for your brand, contact SRxA today. Learn how our teams of expert Advisors in Allergy, Pulmonology, ENT, Ocular Medicine and Surgery, Aesthetics, Reproductive Medicine and Behavioral Health can help you and your brand.

Time to Reflect?

SRxA’s Word on Health would like to add its heartfelt condolences to the families, friends and loved ones, of all those affected by this weekends seemingly senseless shooting that left six people dead and twelve injured in Arizona.

Although neither the motive nor the full extent of the ripple effects from these events have yet to unfolded, Congress already announced that all legislation scheduled for consideration this week will be postponed. This includes efforts to repeal President Obama‘s healthcare reform law.

Maybe this hiatus will enable people, all sides of the divide to step back and reflect on the real issues. Maybe, they should consider healthcare through the eyes of an impartial observer.

UK physician and medical reporter Dr Karine Nohr recently returned from the States, where she spent one week observing in a cardiology clinic in San Diego and another observing a primary care clinic in New York City.

Among her “observations” Dr Nohr thought it was “wonderful to see” the integrative medicine approach in both specialties. For example, she was impressed that patients undergoing cardiac rehabilitation were offered physical rehabilitation in a gym, vegetarian cooking classes, music classes, yoga, meditation, relaxation, guided imagery, managing anxiety and other modalities such as acupuncture and spiritual healing.

On the other hand, she was shocked to see how much unproductive time and energy in American medical practice, was devoted to financial matters. “A substantial part of the consultation might address what a particular patient’s insurance might, or conversely might not cover. This was completely irrespective of the patient’s needs and I did not witness any discussions with patients as to how important it was for them to undergo a particular investigation” reflected Dr Nohr.  “If a patient was well insured, then the degree of over-investigation or unnecessary investigation or unnecessary follow-up could be shocking. This is partly because doctors are reimbursed for procedures and not for talking with patients. Additionally, American doctors are so litigatious-conscious if a patient requests an investigation, that investigation would be done.”

Maybe, there’s something to be learned from this outsider’s view. What do you think?