The company brought in IMC2 to work on the project. "We learned from their research that one of the big barriers to compliance was children who weren't
aware of how to manage their conditions," says Wolfman. IMC2 developed a Web site with multimedia educational materials and used Serono's sales force to promote it to physicians. With
a hip name (
http://www.coollearnings.com/) and youth-oriented content, the site taught kids how to take Saizen properly, rewarding them with MP3 music downloads when
they answered a quiz correctly.
Barriers to Adherence
Merck took a similar tack with its human papilloma virus vaccine, Gardasil. Ads featuring young "tweens" caught on with the
audience, and Merck built upon them by dabbling in a technology almost all of today's youth know—text messaging.
"We knew from other vaccines that compliance with the second and third dose historically wasn't terrific," says Dave Schechter,
US marketing leader for Gardasil. "With Hepatitis B, it took years for them to get to a point where 75 percent of the people
who got their first dose got their second, and 56 percent of the total got their third."
Merck surveyed physicians to find out what they needed to ensure Gardasil compliance. Using the slogan "Three is key," the
company offered an opt-in reminder system on the branded Gardasil Web site. The system sends mailings, emails, or text messages
to patients remind them to get their second and third doses. To encourage enrollment, Merck sent kits to doctors to get patients
to sign up in the office immediately after receiving the first dose.
"We target two main groups, 18- to 26-year-olds and moms of 10- to 26-year-olds," Schechter says. "Moms were more interested
in email and snail mail, but young adult females were more apt to be reached by text messaging."
Because Merck does not collect patient data, it has no way of knowing if or when patients in the program receive their doses.
Nonetheless, it seems to be working.
"Seventy-five percent of the people who got the first dose got the second, and 50 percent have completed all three," Schechter
confirms. "Those are numbers that took years to achieve with other vaccines. We were able to achieve them at launch, and we've
continued to achieve them."
Disease Management, Not Drug Management
Companies contemplating a patient compliance program have many options: ad campaigns, health information programs, and online
patient tools, to name just a few. One attractive alternative is to work with an outside content provider to establish a health-management
program. "Pharma compliance programs are a fantastic use of technology for the small group of patients who are willing to
provide data directly to a pharma company," explains Rich Benci, president of the health-oriented Web site RealAge. "However,
I have yet to see a pharma company with more than 5 percent of its patients in its CRM [customer relationship management]
RealAge has 20 million users, and compliance is built into its basic business strategy. Consumers come to the site to learn
their "real age" by completing an online questionnaire of 150 lifestyle and health questions. RealAge, in turn, creates a
health management plan for them. The site accepts advertising, and users can opt to receive information from pharmaceutical
companies, tailored to their health issues and the treatments they already receive. So far, nine million customers have opted