Verilogue Study: Does Higher DTC Spend Result in Positive Patient-Physician Conversations?

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Top Spenders Advair and Plavix Not Among Brands Most Mentioned by Patients;

Analysis of In-office Dialogue of More than 40 Brands Reveals How Pharmas Can
Maximize DTC Investment
HORSHAM, Pa.--(Business Wire)--
With Plavix`s gurney on the golf course, Cialis` twin bath tubs and Ambien`s
rooster in the office, many drug commercials make for great water cooler
conversations but do they translate into more conversations in the physician`s
office? And if so, are those conversations positive or negative - improving
disease awareness and brand requests, or raising concerns around fair balance
statements and side effects?

As pharmas continue to make significant investment in DTC, a recent study from
Verilogue revealed that the biggest DTC budgets don`t always result in positive
pull-through - or pull-through at all - in the physician`s office. From this
analysis, Verilogue derived three key recommendations for how pharmas can
convert DTC investment into positive patient-physician interactions.

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Verilogue`s analysis tracked brand requests coupled with a reference to specific
promotional campaigns across 12,500 doctor-patient conversations from 2008 and
covered 20 disease states and 46 different branded prescription medications.
Overall, DTC pull-through in conversations in the doctor`s office is low - 3%
(n=392) - and specific patient requests for advertised medications are even
lower - .002% (n=23). Most significantly, the most frequently pulled-through
brands from Verilogue`s database fail to align with the brands with the biggest
DTC ad spend:

Top DTC 2008 Ad Most Referenced
Spenders 2008 Spend DTC brands
Advair $186,445 Boniva
Plavix $180,646 Enbrel
Cymbalta $171,591 Humira
Lyrica $150,911 Reclast
Ambien $146,852 Detrol LA/Gardasil
Source: TNS Media Intelligence (2009);
Figures do not include Internet spending

Brand analysis: How does DTC come up in patient-physician conversations?

Most of the time, DTC is referenced by the physician to try to increase patient
acceptance for already-chosen medicines. Unaided (spontaneous) patient mentions
or actual patient requests for medication are rarer. Regarding five of the top
DTC brand spenders of 2008, here is how their DTC campaigns influenced the
doctor-patient conversation:

1)Advair
Patients most often brought up side effect concerns arising from fair balance
statements in Advair TV commercials; for instance: "I saw on TV that Advair can
cause pneumonia in some patients."

2)Plavix
Although frequently mentioned and discussed by physicians, Plavix`s DTC campaign
was not mentioned by patients in Verilogue`s database.

3)Cymbalta
This is the most mentioned DTC campaign out of the five top spenders.
Approximately half of the patients expressed positive sentiment about the ad
(e.g. they reflected on other depression symptoms, for instance: "That
commercial they have out showing depression and how it affects everything else.
It's not just that person that feels that way. Your whole family that's around
you."), while the other half expressed negative sentiments (e.g. "No, I don't
want to take Cymbalta. And I don't like the commercials, and plus I'm on Zoloft
and that's it. I don't want any more of those drugs.")

4)Lyrica
The main outcome of the campaign was increased awareness about fibromyalgia in
addition to the brand. (e.g. "Do you do a lot of patients with
fibromyalgia?That's how I found about a neurologist when I seen it on TV for
that Lyrica. And they sent me some stuff in the mail.")

5)Ambien
This is the most likely to be requested out of the top five spenders. However,
like Advair, patients commonly expressed side effect concerns arising from fair
balance statements in Ambien TV commercials, both positive (e.g. "But I saw
where it is Ambien that helps you get to sleep and stay asleep. I saw the
commercial for it. You think that's a good one for me?") and negative (e.g.
"Yeah, I saw the commercial. I think it's, uh, Ambien that says you might go out
and eat and not remember. I thought great all I need.")

DTC Recommendations: How can pharmas get the most bang for their buck?

Verilogue`s study revealed three key recommendations for every pharma in
creating effective DTC ads:

1)Validate patient experiences
In order to drive greater patient awareness and more robust, meaningful
discussions about a disease, akin to Cymbalta DTC pull-through, pharmas should
structure DTC to validate patient experiences with health conditions. Use DTC as
a tool to engage patients in constructing the meaning of - rather than simply
mirroring experiences with - a health condition. Tactics to support such a
strategy might go beyond traditional TV spot advertising to include embedded
marketing where health conditions and treatments are woven into the lives of
television/film characters, among other relevant tactics.

2)Better prepare physicians for the fair balance fight
While there`s no way around the regulatory mandate for fair balance statements,
pharmas can better prepare physicians to address patient side effect concerns
arising from DTC promotion. This might include providing physicians with tools
(visual aids, stories/narratives, etc.) to put side effects into perspective by
couching potential side effects in incidence scales/descriptions or in
risk-benefit scenarios.

3)Connect meaningfully with patients
The most frequently pulled-through DTC campaign was Boniva`s "Rally with Sally,"
which employed a well-known and trusted "friend" to deliver messages to the
targeted middle-aged woman audience. This tactic was markedly different from
tactics in other campaigns where messages are delivered by physicians and actors
portraying patient family members, for example,"I know [Boniva]. Yes. Sally's on
the commercial."

For more information about this study, visit www.verilogue.com.

About Verilogue

Verilogue (www.verilogue.com) is the first health care market research company
to uncover, analyze and deliver nationwide insights derived from
naturally-occurring dialogue between patients and physicians. With its
patent-pending Point-of-Practice database and technology system, which digitally
records real-time conversations between patients and physicians, Verilogue is
able to capture critical information at the point of care, while maintaining
patient and physician confidentiality. The insights gathered from these
conversations, analyzed by Verilogue`s team of linguists, statisticians and
marketing experts, enable pharmaceutical and health care companies to gain a
deeper understanding of patient and physician perspectives, help shape
conversations that affect health care decisions, identify the most effective
methods and tools to reach patients and drive the development and improvement of
new and existing treatments to ultimately improve patient care.

More than 25 pharmaceutical companies have partnered with Verilogue to gain
actionable insights from its database containing 35,000+ unique
physician-patient conversations and corresponding patient charts across 50+
therapeutic categories. Founded in 2006, Verilogue is a privately-held company
headquartered in Horsham, PA.

Lois Paul & Partners
Susan McCarron, 781-782-5767
susan_mccarron@lpp.com

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