Nursing a Wounded Campaign
While many companies are reaching to the Internet to boost compliance, others are going back to an old standby—nurse-delivered
patient education. Take, for example, Diabetes Interactive Network (DIN), established early in the decade to educate patients
about its new insulin pens. "We thought it was our obligation that patients knew how to use the pens, and we wanted to offer
general diabetes tips and education," says Lilly spokesperson Scott MacGregor.
Now in its eighth year, DIN employs approximately 500 diabetes educators across the US who teach classes on how to manage
the disease, how to use the pen, and on the importance of nutrition, exercise, and taking the medication—Humalog and Byetta.
"There's a lot more that goes into taking insulin drugs than just taking the prescription to the pharmacist and taking one
pill a day," MacGregor says. "Particularly with insulin and the complexity around dose penetration and carbohydrate intake,
it's a complex regimen.
"In terms of compliance, insulin is an interesting medicine because if someone needs it and doesn't take it, you'll notice,"
MacGregor continues. "There is a huge opportunity to help these patients because healthcare providers are limited in what
they can do to provide this kind of education. It's a service luxury that an office can't always offer."
So far, more than 44,000 patients have completed DIN program. In a survey, 90 percent reported that they felt confident that
they knew how to take their medication, while 85 percent said they would continue the therapy post-training.
Lilly is now working on a pilot program with the Joslin Diabetes Center in Harvard to help primary-care physicians and staff
better understand diabetes. The goal: to show meaningful clinical differences in diabetes management. Results are not in yet,
but Lilly is hopeful.
"With consumer advertising being less than what it once was, pharma companies are looking for new ways to reach patients and
affect patient compliance," explains Abby Mallon, vice president VMS Medical, which serves as an outsource for the DIN program.
"In the last few years, we've seen nurse programs double. There's nothing better than having a live healthcare professional
walking you through your questions."
Connecting at the Pharmacy
One place where pharma is still trying to reach patients is at the pharmacy, either through staggered couponing or through
informational inserts included with prescriptions. "It really frustrates me as a pharmacist to see patients not realize the
implication of not taking their medication or not understanding how to take it properly," says Reen Nouh, director of client
services at the marketing firm Koroberi. "It's low-hanging fruit. Patients who are already diagnosed and prescribed the medication
are easier to keep and maintain on therapy, which translates to faster dollars than trying to get a patient diagnosed."
Package inserts offer an opportunity for customization for the needs of the individual customer. Catalina Marketing, for example,
develops custom inserts that are printed out at the point of sale. The inserts vary by what stage of therapy the patient is
at. And the company will work with pharmaceutical companies to create sponsored messages.
"The messaging can't be a simple reminder," explains Joe Meadows, vice president of marketing and creative services at Catalina.
"It has to be a message continuum—a patient starting a therapy is in a very different place, with very different needs than
a patient two to three months in, and that patient is in a different place than someone who has been on therapy for 18 months
and is thinking about jumping off."