Exploring Future Multichannel Strategies What are the information channels that meet digital native doctors needs?

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1 Exploring Future Multichannel Strategies What are the information channels that meet digital native doctors needs? February 14, 2018, 3:00 p.m. - 6:00 p.m. Venue: Tokyo Conference Center Shinagawa Sponsor: CMIC Ashfield Co., Ltd. Partnership: CareNet, Inc CMIC Ashfield Co., Ltd. is having a series of new open seminars on Channel Innovation starting with this first one. We will continue to sponsor various programs addressing keywords that are receiving attention from the healthcare and life science industries. For this first seminar themed on multichannel strategies, we invited three experts as lecturers and they gave us lectures on how the future multichannel strategies should be in the life science industry based on their unique perspectives. <Summary of Lectures> Introduction I would like to introduce the current quantitative status of pharmaceutical industry s multichannel in Japan prior to the lectures given by the three lecturers. The number of medical representatives (MRs) as a real channel is one MR every 4.8 doctors *1 and in terms of frequency of their detailing services, one doctor receives 2.1 details a day *2. In addition, in terms of the general practitioner market, the number of marketing specialists (MSs) is one every six doctors *3. As for explanatory meeting provided by pharmaceutical companies, a doctor attend 24.8 meetings a year *4 ; and as for lectures including those on the Web, one doctors attend 5.5 lectures a year *5. The number of medical science liaisons (MSLs) who don t conduct promotional activities has been increasing rapidly in recent years. Also, each pharmaceutical company strives to strengthen and enhance owned media as a digital marketing channel. The number of e-details per doctor delivered by medical portal sites can add to several dozen a day *6 sometimes. It is estimated that the number of remote MRs, a combination of digital marketing channel and human marketing channel, is less than 50 FTEs *7 in the pharmaceutical industry as a whole; and therefore it is still an evolving channel. Under this circumstance where various channels exist, what has the most impact on doctors today is still MRs. Taking a look at other industries in recent years, however, there are many cases where the communication channels and digital tools had rapidly spread. I think there is a big potential for those new tools including SNS to spread throughout the medical industry as well. Hironori Komaki New Channel Business Department CMIC Ashfield Co., Ltd. 情報ソース 1 医師数 : 厚生労働省平成 28 年医師 歯科医師 薬剤師調査 P4 1,2 MR 数 : 公益財団法人 MR 認定センター 2017 年版 MR 白書 P2 3 MS 数 : 平成 29 年 6 月 1 日現在 日本医薬品卸売業連合会調べ ( 4,5, 説明会数 講演会数 : 新薬系製薬会社 65 社 長期収載品後発品系製薬会社 11 社の 2016 年度公開情報より CMAS が独自集計 2,6,7 ディテール回数 e ディテール本数 MSL 数 リモート MR 数 :CMAS 推定値

2 Lecture 1 Perspectives of Multichannel Strategy in the HCV Market Mr. Kenji Obama Senior Manager, HCV Strategy & Marketing Hepatitis Business Unit AbbVie GK In the hepatitis C virus (HCV) market, direct-acting antivirals (DAAs) have tremendously improved the treatment outcome, and in recent years an interferon-free treatment enables to shorten the period of treatment. I would say HCV patients in Japan are in a favorable environment compared to other countries, since we have a decent public subsidy system although medication cost is high. Having said that, it is estimated that there are still hundreds of thousands of patients without any treatment, and approaches to several stakeholders such as hepatologists, primary care doctors, other healthcare providers, and patients are required. We have been taking various approaches so far, although there were some concerns that it would be difficult to introduce multichannel or digital strategies to the clinical sites since the patients were at relatively advanced age and leading hepatologists were also in their 60s and 70s. Speaking of multichannel, what comes to my mind first is to provide information through a best channel for each client based on the client information integrated by CRM. Today, combining several channels with a focus on MRs is required rather than using a single channel, when providing medical information. According to an external survey, AbbVie s owned media is admired for its usefulness; however, it is necessary to increase the number of users. In terms of channel strategy, AbbVie puts a priority on lectures and explanatory meetings, let alone detailing by MRs, for specialists and high prescribers; and as for other doctors whose specialty is different from the hepatology, we provide them information using digital tools. We focus on staying in touch with doctors as often as possible whichever channel we choose, since the more contact we make with them the more potential we get to influence them. There is much to learn from other industries in terms of marketing strategy, and we can foresee that the pharmaceutical industry may experience some sort of paradigm shift. Meanwhile although the number has decreased, approximately 230,000 sales people for life insurance, or 60 percent of its peak, are registered even today, when signing an insurance contract on Internet is available. Considering this aspect, we can expect that MRs will play a key role in the knowledge-based pharmaceutical industry for the time being. AbbVie has been promoting improvements of tools, such as contents of ipad MRs carry and approved s, that help MRs give a distinct impression. In addition, we have been working on raising awareness of diseases and providing support to patients through DTC advertising on TV and newspaper, launching a website for patients, establishing a dedicated call center, etc. This is because a broader approach to primary care doctors, ophthalmology and orthopedics (where HCV infection is often detected in patients), other healthcare providers, patients and their family is necessary. In terms of strategy in the HCV field, the following are three core elements: helping undiagnosed patients visit their primary care doctors, ensuring referring patients from their primary care doctors to hepatologists, and patients visiting a hepatologist and receiving treatment. To this end, raising awareness of disease in each local region is more effective, and we have been working on it. We hold the opinion that for the time being multichannel and digital channel are the tools to back up MRs

3 activities rather than the replacements of MRs based on the perspective how far the company can enhance its corporate strength. I would think that multichannel strategy is like an art we are able to get the point by taking a panoramic view, although how to approach differs depending on disease or competitive situation; and I hope that it will be even faster with AI automation or digital technologies in the future. When it comes to multichannel, I think it would be more important to discuss it based on the perspective of how a company can enhance its corporate strength rather than discussing it only as an alternative to MRs.

4 Lecture 2 Digital Channel Strategies for 2020 Mr. Motoyasu Ohno Chairman, CareNet, Inc. I would like to take a look at how the pharmaceutical industry would change for the Tokyo Olympic Games. In recent years, patents for many blockbuster drugs in the field of high blood pressure and others have expired, and this trend will continue for the next five years. The review of NHI price system has a significant impact as well. In my opinion the following figures are not necessarily convincing. However, according to the European Federation of Pharmaceutical Industries and Associations (EFPIA), it is expected that the ethical drug market will remain in an annual average negative growth rate of 1.5 percent, and the 10.5 trillion yen market in 2017 will shrink to the 9.2 trillion yen market in The Pharmaceutical Research and Manufacturers of America (PhRMA) makes a similar forecast. Focusing exclusively on pharmaceutical companies manufacturing new molecules, it will not be easy to make up for the drop in sales even if the selling, general and administrative expenses (excluding the cost for MRs) and investment expenses were reduced by 10 percent. Companies executives will be forced to decide to reduce either operating income or the number of MRs, since the amount of 1.8 trillion yen totaling the operating income at 1 trillion yen in 2017 and the cost for MRs at 0.8 trillion will shrink to 0.8 trillion yen in CareNet develops a life cycle map based on our own patients count database in order to provide solutions to pharmaceutical companies in difficult environments. More specifically we have classified major products into three groups: a group of internal medicine such as diabetes and hyperlipidemia; a group of specialized medicine such as lung cancer, prostate cancer, and rheumatism; and a group of mixture of internal and specialized medicines such as non-cardiogenic atrial fibrillation, osteoporosis, and chronic pain; and then we have analyzed that which stage of the product life cycle-introduction stage (product launch between 2019 and 2020), growth stage (product launch between 2016 and 2018), or maturity stage (product launch between 2008 and 2015)-each product will be in as of Since strategy can differ according to product group and its life cycle, a formulation of strategy based on a product life cycle map is required. For example, in a case of a product in a group of internal medicine and in a maturity stage, it would be necessary to increase the number of target doctors for each MR in order to improve MRs productivity. In order to maintain sales revenue, the frequency of MR s visit to each client can be reduced according to the doctors preferences, and instead, MS, assistant MRs, remote MRs, or e-visit can substitute. In a case of a product in a group of mixture of internal and specialized medicines and in a growth stage or in a maturity stage, the product can be segmented further such as a developing disease awareness group, a specialist dependent group, and a rare diseases group. And a solution can be developed with a channel strategy mixing MRs activities, e-detailing services, e-questionnaire, websites that raise awareness of disease, etc. In terms of the strategy with the specialized medicine, it is necessary to put aside the preconceived notions, that is, digital channels are not effective for specialists. It is possible to get specialists highly interested if an appropriate speaker would provide information with an appropriate topic at the right time. In fact, CareNet original Web seminar in the field of oncology was successful and it will be developed further in the future.

5 Lecture 3 Evolution of Multichannel Approach by Pfizer Mr. Masao Okazaki Sr. Director, Business Technology Pfizer Holdings We developed a digital channel strategy 10 years ago at the request of the global organization. We got to it on a trial and error basis, since many things like substitutability with MRs activities, advisability of ROI measurement, connection to SFE, correlation with SOV, etc. were unclear. Originally, a digital channel spread rapidly in Europe and the U.S. as an alternative channel of sales representatives that was reduced in the 2000s. Face-to-face productivity declined, due to a significant drop in new product launches and a patent cliff, and yet tightening of regulations and guidelines pressured by payers. Therefore, it was deemed necessary to invest in a digital channel. In contrast, in Japan, MRs play a key role in medical practice and they are important information source for healthcare providers. And for pharmaceutical companies, MRs are an important channel to help their clients solve problems and to conclude business negotiation. And in terms of SOV, putting the highest priority on a constant best practice is coming to an end; instead, providing information through a channel according to each doctor s preference by combining face-to-face as a part of multichannel is required. With these backgrounds, Pfizer has been developing digital channels at four phases. As a first phase, we launched our owned media Pfizer PRO in 2009 to develop a multichannel for MRs and we have been enhancing it. We introduced a membership system to it by integrating the websites of previous products and about diseases, and provided medical science information. We promoted to expand the number of member by putting together all communications including entry to Web seminars and by investing in killer contents such as an exclusive distribution of medical journal. At the second phase, we worked to visualize the clients 360-degree interactions, which had been developed at the first stage, for MRs. A digital channel functions not only as an information service but also as an information source to understand clients needs. In 2013, we created a visualization tool; and MRs began taking a look at their doctors preferences over drug information, doctors behavior, etc. from various perspectives. In addition, we have developed a mobile application that enables us to provide client information to MRs in real time. At the third phase, a function that enables us to recommend MRs an optimum approach based on all available information was added. The information that became available at the second phase was vast and beyond the physical limit that MRs could handle. Therefore, we created an environment that let artificial intelligence work on prioritizing where to visit based on the vast information and allowed MRs to focus on understanding clients needs and their detailing activities. The fourth phase was about an optimization of a mixture of channels, in other words, a mixture of a personalized channel. We are working on developing a system that will enable us to recommend (or automatically run) a necessary channel by identifying the best channel, the best time, and the best message for each client based on the internal and external information accumulated. I talked about a Pfizer s digital strategy, but there is a need to consider some specific problems in the Japanese market. In the pharmaceutical market where negative growth is predicted, pharmaceutical companies promotion and how information should be distributed has been discussed, and the market is at the turning point. It is becoming difficult for MRs to deliver drug information to busy doctors year by year. On the other hand, advanced information transfer will be required, such as providing explanations about new mechanism of action and complicated usage, and deliver information about real world evidence. Although there seems to be many doctors who feel there is too much digital information provided by pharmaceutical companies, I wonder if

6 sufficient information reaches them. It is true that the number of digital native doctors has increased, but at the same time, the average age of doctors at primary care clinics is 59.6 years old. There are many doctors who are just busy and have no other choice but to rely on MRs visit. Information is vital to ethical medicines. It is pharmaceutical companies responsibility to keep healthcare providers accessible to medicines all the time and to develop ways to deliver the necessary information to the necessary people when needed. I would say that new channels should be developed from information receivers perspectives. Contact info for inquiries CMIC Ashfield Co., Ltd. Channel Innovation Seminar Tel: Mail:cmas.seminar@cmic.co.jp 本書の全部又は一部を複写 複製 改変 引用 転載 私的目的外での使用はできません 本書の内容は予告なく変更されることがあります 2018 CMIC Ashfield Co ltd. All Rights Reserved. Content may not be reproduced, downloaded, disseminated, published, or transferred in any form or by any means, except with the prior written permission of CMIC Ashfield.