A Medikly White Paper

June 12th, 2013

The Physician Value Index™

A Framework for Optimizing Marketing Performance
and Spend in the Digital Age

By Venkat Gullapalli, MD, Mark Goldstone, and Nita Nehru

Intended Audience: Pharmaceutical Marketing Professionals
Intended Audience: Pharmaceutical Marketing Professionals A Medikly White
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Executive Summary
The “Age of the Empowered Physician” represents a contradiction of sorts for pharmaceutical companies—
there have never been more ways to reach healthcare providers (HCPs)—yet it’s never been so challenging to
effectively engage them. Driven by the decline in face-to-face interactions and the increasing availability of on-
demand access to digital channels, HCPs now choose when, where, how, and if they interact with
pharmaceutical companies.

With more than $60 billion being spent annually on marketing and communications to HCPs, pharmaceutical
marketers need to reinvent how they allocate, optimize, and justify spend through real-time, data-based
insights and intelligence.

We propose a new model, the Physician Value Index™ or PV Index™, which integrates four key aspects of how
a physician interacts with a pharmaceutical brand—presence, participation, influence and sentiment. Using the
PV Index™, pharmaceutical marketers can now incorporate a new capability model of measuring marketing
performance, and its contribution to driving business value.

Target Audience
This white paper is intended for pharmaceutical marketers to discuss and agree on an appropriate set of
metrics that will demonstrate marketing performance while driving business value within their individual
organizations.

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Does Pharma Need to Change How It Values Physicians?

The traditional view of the HCP has been—for the last two decades—based primarily on face-to-face
interactions by sales reps, by mail, and in call centers. Fast-forward to today, when 95 percent of HCPs get
necessary and relevant information online through various digital touch points on their desktops or laptops,
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and 87 percent use a smartphone or tablet. These two systems (old and new) often exist in parallel silos
without exchanging information, giving marketers an incomplete view of the HCP. In the past five years this
view has fragmented even further due to multiple new mobile, social, and other communications platforms
and channels. Connecting these disparate channels is crucial for not only understanding, but also predicting
HCP behavior.

This digital evolution has changed the fundamental skills and technologies required for pharmaceutical
marketing. Excelling at one marketing capability or channel is no longer acceptable. As Accenture points out in
its recent survey of over 200 pharmaceutical sales and marketing executives, “…[A] customer engagement
revolution in the ‘new normal’ demands entirely new capabilities from pharmaceutical companies’ sales and
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marketing organizations.”

Figure 1: Trends and Challenges

30+ CHANNELS !!!!!!!!!!! BIG DATA INSIGHTS

Brands must better !!!!!!!! !!!!!!!! Need faster way to sort,
understand how to manage analyze, target and segment
and integrate new channels the HCP digital footprint

NO HCP ACCESS SPECIALTY MARKETS

Decline in sales rep access !!!!!! !!!!! Sophisticated Rx criteria and niche
force brands to rethink how segments create need for
they approach marketing personalized and targeted content

MARKETER!
Source: Medikly, Inc

New Trends and Challenges

The Pharmaceutical Sales Force is Evolving. One of the biggest changes facing pharmaceutical marketers is
the evolving role of the sales force in the marketing mix. Powered by the decline in face-to-face interactions,
pharmaceutical organizations are now looking for other ways to determine who their target HCPs are, where
they active, what conversations they’re having and with whom.

Traditional Marketing Tactics are Producing Less and Less ROI. A decade ago, sales reps, print mailers, brand
reminders, and banner ads were the norm. And they were incredibly successful. But we’re in a fundamentally
different environment today: Restrictions on rep activity are increasingly stringent, and due to their declining
numbers, it is increasingly difficult to generate as much frequency as is optimal. As a result, the sales force is
becoming increasingly expensive for a much smaller ROI.

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Explosion of Digital Channels. In the “Age of the Empowered Physician,” over 95 percent of physicians are
digitally savvy and connected with each other through numerous new channels and touch points. With this
hyper-connectivity come new behaviors and expectations on how they access and consume content from
pharma. This evolution is challenging marketers to integrate these channels into their marketing mix while
providing personalized and coordinated brand experiences to physicians and other HCPs.

“Big Data” Brings New Opportunities. With the explosion of new channels and touch points, there is a
tremendous increase in the volume, velocity, and variety of data being generated. This data, generated in real-
time, needs to be captured, sorted, and analyzed to enable marketers to make informed, real-time decisions
on optimizing their audience, channels, and content. This data provides insights into the needs, interests,
behaviors, and preferences of HCPs, helping marketers better understand the specific triggers that influence
prescribing decisions.

The Era of the Blockbuster Drug is Over. With the business model that drove the pharma’s “blockbuster era”
no longer viable, marketers must now market drugs geared toward specialized patient populations, where the
HCPs that prescribe these drugs have very specific information needs. And when combining fewer addressable
markets with dwindling budgets, generic competition, reduced R&D budgets, lower revenues, and reduced
profitability, marketers are ultimately put in a position to do more with a lot less.

Physician Value: A Whole New Dimension

While the above trends and challenges may seem insurmountable at first, they give pharmaceutical marketers
the opportunity to think and act in entirely new ways. In fact, the evolution of digital now allows them to better
understand the behaviors and preferences of their physician audiences and take appropriate action.

All Physicians Are Not Created Equal. Given that technology and social media are playing such an integral role
in how HCPs interact, it is important to note that from a marketing perspective, each individual HCP does not
hold the same weight. In the old world, a disgruntled physician or nurse practitioner simply did not prescribe
the offending product. In today’s digital world however, a disgruntled HCP has the ability to tell 2,000 of their
friends via social media how unhappy they are, which can be very detrimental to a brand and its sales.
Alternately, even a low prescriber can be tremendously valuable to a brand, as they may positively encourage
their networks to consider prescribing as well. In this model, positive
influencers are valuable and should be seen as brand assets, whereas
detractors must be managed and neutralized. “…even a low prescriber can be
tremendously valuable to a
Managing a Pharma Brand Now Means Managing an Audience.
Social media has opened the door to a brand new marketing brand, as they may positively
channel—the HCP audience. Traditionally, a brand manager’s role was encourage their networks to
to ensure that all messaging, advertising and media was uniform,
consider prescribing as well.”
consistent, and “on brand.” In the new digital world, branding is
frequently outside of the brand’s control and must be shared with
multiple audiences. In fact, a report by McKinsey & Company states that “…marketing management…has
become more complex through the emergence of online tools—especially social media—that are shifting the
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balance of power to [customers].”

Once branded messaging or content is on the web, users can comment, add their opinions, and republish.
Goodbye months of careful brand planning! Thus the pharmaceutical marketer’s role now must include
understanding and managing their audience as another brand media channel.

Current Systems and Databases Exist in Silos. Pharmaceutical organizations today utilize different platforms,
systems, and databases, each with their own set of analytics and metrics, to gain insights into HCP behaviors
and preferences. These systems are rarely integrated nor automated, and to gather any real insights,
pharmaceutical marketers must manually aggregate and analyze the data generated—a prohibitively costly
and time-consuming task—in a market that requires real-time decision making.

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Existing metrics and models do not capture these new realities. While technologies have advanced
tremendously, metrics and application of insights have remained largely unchanged. Mark Goldstone, co-CEO
of Medikly, explains “the metrics of yesterday just don’t do a good job of capturing the insights necessary in
our new digital world. The more digital channels there are and the more transactions physicians perform in
them, the higher our expectations should be of what we can measure.”

If traditional marketing methods and systems are losing their utility and the audience has become another
media channel to be managed, what must pharmaceutical marketers now do to handle this shift? We propose
a new metric for pharmaceutical marketers to measure marketing performance by—the Physician Value
Index™.

The Physician Value Index: Pharma’s New Marketing Metric

The PV Index™ is a weighted aggregate measure of the presence, participation, influence, and sentiment a physician
or other HCP generates as they interact with content, a brand, or
messaging over time.
“The PV Index™ is a weighted
The PV Index™ does more than just gauge reach and frequency;
aggregate measure of the presence,
it gives marketers real-time insight into the impact an individual
HCP can have on their brand. This value in turn, enables participation, influence, and
marketers to understand who is worth talking to and who is not, sentiment a physician or other HCP
who must be neutralized and who can be a brand asset.
generates as they interact with
Once understood, physician value can then be used to define content, brand, or messaging over
the ROI metrics relevant to one’s own brand and organizational time.”
goals. Ultimately, the objective is to help pharmaceutical
marketers better allocate their time, money, and effort in the
most efficient and effective ways possible, and to generate ROI.

What is Physician Value?

The PV Index™ covers four broad aspects of how an HCP interacts with a brand, with each of these aspects
broken down into various aggregate measures combining online and offline data, eg, information gathered
from sales calls, live meetings, and sample requests.

By combining these measures, pharmaceutical marketers can now identify the various elements of physician
value that drive marketing performance and ultimately demonstrate business value. The four aspects of the PV
Index™ are below.

• Presence – Presence is a measure of one-way activity that an HCP has with a brand at various touch
points. Metrics to track include unique visits, average number of page views, average duration of visit,
downloads, logins, time spent per page or per web property, the number of different assets touched,
frequency—the number of times each HCP sees branded content—and other similar quantitative
metrics. While only providing a partial indication of content, message or brand reach, these metrics
are crucial to track and understand, as they provide insight into the initial interaction and growing
awareness the audience has with a brand at a specific touch point.

• Participation – As the word implies, Participation is the intensity of interaction an audience has with the
content, brand, or message at specific touch points. Participation is a two-way street and includes metrics
such as the frequency and quantity of reading and writing of content on a branded digital property.
Metrics to track include scroll depth and speed for text-based content, and quality and quantity of user-
generated content (UGC). This is a much stronger measure of how engaged an audience is with a brand
than the transactional metrics of Presence. We can equate Presence with the breadth of interaction

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an audience has with the brand at multiple touch points, whereas Participation is akin to the depth of
each interaction.

• Influence – The metric of Influence is binary, tracking both the influence of the brand’s content on the
degree of change in an HCP’s knowledge, skills or behaviors pre- and post-content, and the degree of
influence a particular HCP has on the brand through sharing, suggesting, or recommending that content
to their network. To understand Influence, key metrics include shares, likes, recommendations,
suggestions of brand content or messaging to other physicians, and how those metrics are attributed
back to the original HCP. When measuring influence, marketers need to also capture the type of
influence an HCP has on a brand. For example, influence can be either positive or negative, allowing
an influencer to be either an advocate or a detractor.

• Sentiment – Sentiment is the final yet crucial component in building the PV Index™, as it enables us to
discern affinity, assigning separate values to HCPs who hold positive or negative perceptions about the
brand. Sentiment can be tracked by analyzing words and context in user-generated content. Tracking
sentiment in real-time can be critical in acknowledging and addressing any potential problems, or
better yet, opportunities facing the brand. Measuring sentiment can also be an ideal way to assess
brand equity or affinity among HCP audiences.

Dr. Jim Golden, Managing Director, Accenture Analytics, adds that “By leveraging a PV Index™, pharmaceutical
organizations can segment and manage their audience and make strategic decisions regarding where to spend
their time, money, and marketing resources.”

“By leveraging a PV Index™,

pharmaceutical organizations can
segment and manage their
audience and make strategic
decisions regarding where to spend
their time, money, and marketing
resources.”

Dr. Jim Golden, Managing Director,

Accenture Analytics

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Understanding Physician Value Index™

Utilizing the PV Index™ as a Key Performance Indicator (KPI) can demonstrate tremendous value to
pharmaceutical companies looking to assess the effectiveness of their marketing campaigns. Understanding
and leveraging physician value enables a marketer to make distinct and specific real-time marketing decisions
around optimizing content, channels, and audiences.

Now, pharmaceutical marketers can spend their marketing dollars on the HCPs who provide the most long-
term value for the organization’s goals. Furthermore, the PV Index™ allows for more granular and real-time
audience segmentation and the effective targeting of HCPs based on specific brand goals, whether to raise
awareness, drive prescriptions, or promote brand advocacy.

Let’s take a look at a few ways a marketer can apply the PV Index™:

PV INDEXTM! PRESENCE! PARTICIPATION! INFLUENCE! SENTIMENT!

86 82% 94% 78% 88%

Intensity Intensity Intensity Intensity

Sarah Chin, MD (HIGH VALUE): Dr. Chin, a much-respected physician with a PV Index™ of 86 is an advocate of
your brand and frequently prescribes your product, as many of her patients have the appropriate disease
state. Moreover, many of her patients take the product and have seen great results, so she is a big fan and is
fiercely loyal. Since she is very actively followed on Twitter, her love of the brand spreads via word of mouth to
her 4,500 followers, many of whom are HCPs in her hospital and are members of the same associations.

PV INDEXTM! PRESENCE! PARTICIPATION! INFLUENCE! SENTIMENT!

48 51% 56% 53% 32%

Intensity Intensity Intensity Intensity

Maria Gonzales, MD (MODERATE VALUE): Dr. Gonzales, with a PV Index™ of 48, is neutral regarding your
brand. She sometimes prescribes your product but also prescribes your competitor’s with similar frequency.
She rarely discusses brand opinions online, though does frequently comment in open forums on the effects of
obesity on Type II diabetes, a relevant topic to your brand. With appropriate and relevant promotional
messages, Dr. Gonzales could be converted into a brand advocate.

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PV INDEXTM! PRESENCE! PARTICIPATION! INFLUENCE! SENTIMENT!

37 37% 54% 42% 16%

Intensity Intensity Intensity Intensity

DAVID CLAIRE, MD, MPH (LOW VALUE): Dr. Claire is highly engaged with your brand but has a PV Index™ of 37.
He visits your e-detailing portal frequently, has downloaded prescribing information, and follows your latest
updates. Despite this level of engagement, Dr. Claire is not an advocate. In fact, many of his patients have
complained about adverse events and therefore he does not particularly like your brand. Moreover, he shares
this sentiment via social media to his 1,200 followers and, given his moderate level of influence, is negatively
swaying others.

PV Index: What It Can Mean For Pharmaceutical Marketing

The real benefit of creating a PV Index™ is in its application. As previously mentioned, healthcare organizations
can leverage the Index to make strategic marketing decisions, appropriately target their audience(s), and
optimize spend for a brand’s objective or stage in its lifecycle.

The PV Index™ provides a way to match an HCP’s interactions with the business goals and objectives of a
brand. For example:

Increasing Awareness. To achieve this goal, the initial objective for pharma marketers will be to understand
the best methods to build awareness of their brand among their target audience. To accomplish this, they
must focus on a particular set of KPIs across all of their channels and touch points. Sample KPIs that provide
an assessment into brand health include, but are not limited to, digital share of voice, brand recall,
amplification, and brand equity.

A great example is assessing the effectiveness of a pre-launch, multichannel campaign in a therapeutic

category where there are multiple “me-too” drugs. The effectiveness of these efforts can be gauged by
monitoring the pre- and post-campaign reach, velocity, volume, and amplification of digital share of voice over
time, and also the overall sentiment of those conversations.

Increasing Brand Preference. A marketer tasked with building and measuring brand preference must track
how HCPs are engaging with their brand, content, or message across multiple channels and touch points. This
requires utilizing attitudinal-based KPIs that capture metrics such as the percentage of HCPs willing to consider
or prescribe their brand, and utilizing surveys to capture preference or the number of likes, shares, and
recommendations combined with sentiment of comments and posts on social media.

For example, assume that after the launch of a novel product within a new therapeutic area, it was found that
the efficacy message was not believable or not resonating with the target audience. A way to address this is to
create multiple mechanism of action videos that tie to the brand’s efficacy message, and then track the real-
time change in consumption among their HCP audiences.

Driving Prescriptions. Marketers can leverage the PV Index™ to understand the impact of various channels on
prescribing behavior, as well as how different types of content influence an HCP’s intent to prescribe. With
today’s technology, marketers can now attribute specific channels to particular actions, such as tracking the
impact of social media on prescribing.

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As an example, marketers interested in understanding the effects of social media channels on script lift can
measure the number of prescriptions generated from a specific user in select social channels, as well as the
growth of sales over time and the increase in repeat number of prescriptions from that HCP in that particular
channel.

Creating Brand Advocacy. Creating brand advocacy as a business goal requires the support and dedication of
HCPs that can act as brand ambassadors without having any official affiliation with the brand. Brand advocacy
allows pharmaceutical brands to extend their reach beyond their immediate spheres of influence by taking
advantage of the virility of social networks. Among the many KPIs that indicate the overall health of brand
advocates are active advocates, advocate influence, and advocacy impact.

For example, a mature product that’s facing patent expiration and has no new clinical data or announcements
will need to be seen as a trusted and quality source with significant brand equity. By monitoring conversations
and segmenting influencers into advocates and detractors, a brand can identify what specific key messages set
it apart from competition, while simultaneously building a stable of genuine interest amongst HCPs by tapping
into their respective areas of interest. This will allow the brand to create future marketing programs
incorporating these new messages, in turn creating more loyal users and brand advocates.

Conclusion
Today’s successful marketers realize that we live in the Age of
the Empowered Physician, where there is no “one-size-fits-all”
marketing approach. They understand the value of their HCP “Until the use of the PV Index™
audience as a media channel—whether positive, negative, or becomes widespread, those that
neutral. They know that creating meaningful relationships with
their HCP audiences is the new imperative because those deep
apply first it will most certainly have
connections drive engagement, loyalty, and ultimately an unfair advantage over their
prescription decisions. competitors.”
Marketers and brands that utilize the PV Index™ as a key
corporate asset will be able to leverage it to drive media planning and budget optimization decisions. They will
develop deeper audience relationships with their audiences by offering relevant, personalized, and timely
content in the channels preferred by individual HCPs. They will have the unique ability to understand exactly
where, when, and how to allocate resources to achieve business objectives and improve ROI on marketing
campaigns. Until the use of the PV Index™ becomes widespread, those that apply it first will most certainly
have an unfair advantage over their competitors.

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References

1. Google/Manhattan Research. Screen to Script: The Doctor's Digital Path to Treatment.

http://www.thinkwithgoogle.com/insights/uploads/940659.pdf. Published June 2012. Accessed June
13, 2013.
2. Accenture. Survey Results: Life in the New Normal: The Customer Engagement Revolution.
http://www.accenture.com/SiteCollectionDocuments/PDF/Accenture-Life-Sciences-Life-in-the-New-
Normal-the-Customer-Engagement-Revolution.pdf. Published 2013. Accessed June 13, 2013.
3. Haas S, McGurk M, Mihas L. A new world for brand managers.
http://www.mckinsey.com/insights/organization/a_new_world_ for_brand_managers. Published April
2010. Accessed June 13, 2013.

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About Medikly, Inc

Medikly helps pharmaceutical organizations better reach, engage, and understand HCPs by gaining
insights into the HCP journey through various digital touch points and highlighting how these touch
points impact the behaviors and preferences of HCPs and their intent to prescribe.

Contact Information
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35 East 21 Street, 5 floor
New York, NY 10010
USA
Phone: 212-951-1525
Email: info@medikly.com

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