Insights on the physician media consumption landscape Association of Medical Media November 2010

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Insights on the physician media consumption landscape Association of Medical Media November 21 Dave Emery Vice President, Sales & Client Services Kantar Media Professional Health

3 take-aways Physicians still matter An evolving multimedia information landscape, with new information sources supplementing existing ones, creates opportunities Journals remain the best option for delivering reach, frequency and importance as an information source

Doctors still matter

Consumer segmentation Self Managers 14% Solution Seekers 1% Healthy Half 44% MARS OTC/DTC Study 21, consumer respondents projected to be representative of total US population Study measures their media consumption habits Attitudinal/behavioral questions allow for segmentation into 4 broad classifications Doctor- Led 32% Source: Kantar Media, MARS Consumer Health MARS OTC/DTC Study

Among all consumers, doctor-leds and solution seekers rely heavily on doctors (and healthy half don t need to) 1 Doctor-Led Solution Seekers Self Managers Healthy Half 5 Use doctorrecommended drug brands only Often discuss new Rx meds with doctor Always do what doc tells me Treatments prescribed work Ask doctor for Rx that I have seen advertised Source: Kantar Media, MARS Consumer Health MARS OTC/DTC Study

Among those with medical conditions, doctors increase in importance 1 Average Hi Cholest Diabetes Kidney Dis 5 Use doctorrecommended drug brands only Often discuss new Rx meds with doctor Always do what doc tells me Treatments prescribed work Ask doctor for Rx that I have seen advertised Source: Kantar Media, MARS Consumer Health MARS OTC/DTC Study

Multimedia Market

Kantar Media s Sources & Interactions 21 study Examines doctors online and mobile activities, e-detailing experience, and exposure to (and evaluation of) 4 information sources/promotional tactics Annual study of over 3, physicians across 2 specialties, exploring their media preferences and habits Study conducted Q1-Q2 21, by mail and online, with a representative sample covering both hospital and office-based US doctors (The following slides summarize key findings from this study)

Doctors are digital 95% use the Internet for professional purposes 53% use a smartphone for professional purposes 45% use social networking sites 29% communicate with their clients using email 3% use Twitter Source: Kantar Media, Professional Health Source & Interactions 21

Tasks performed: desktop/laptop computer Primary tasks performed Access Internet email Research General Medical Topics/Issues Research Specific Clinical Situations Complete CME Reference Drug Data Read Abstracts Interactive Learning Read Articles from Medical Publications Professional News Updates Source: Kantar Media, Professional Health Source & Interactions 21

Internet use for professional purposes 1% 8% 6% 4% 2% % Total FM IM CARD AL AN DERM DIA/ENDO EM GASTRO GEN SURG HE ID NEUR OBG ONC ORTHO PED PSYCH RHEUM UROL Source: Kantar Media, Professional Health Source & Interactions 21

Internet use for professional purposes Internet used 1.8 times per week Range 8.45 14.14 depending on specialty Younger doctors more active users (8.52 13.31 range) Time spent per session: 18.54 minutes Range: 15.22 22.64 minutes depending on specialty Older doctors spend more time (17.83-19.72 range) Source: Kantar Media, Professional Health Source & Interactions 21

Social media is emerging, especially among younger doctors Use of Social Networking Sites Yes No Use of Social Networking Sites 1% % Total <35 35-45 46-6 6+ Age Source: Kantar Media, Professional Health Source & Interactions 21

Individual social media sites: small user base, frequent use Site A 29 % Who Use Annual Uses Site B 14 Site C 11 Site D 9 5 1 15 2 25 Source: Kantar Media Preliminary Data on the 4 leading social media sites for doctors, 211 NonJournal Media Study

Smartphone use for professional purposes 72% say their smartphone use has increased in the past year Use smartphone for professional purposes No Yes 1% % Total <35 35-45 46-6 6+ Age Source: Kantar Media, Professional Health Source & Interactions 21

Tasks performed: smartphone Primary tasks performed Access Internet email Find/Perform Clinical Calculations Reference Drug Data Make Prescribing Decisions Check Formulary Status Peer to Peer Social Networking Professional News Updates Research General Medical Issues/Topics Research Specific Clinical Situations Source: Kantar Media, Professional Health Source & Interactions 21

Kantar Media s Sources & Interactions 21 study A key component of the Sources & Interactions 21 study is the analysis of 4 information sources/promotional tactics to which physicians are exposed in their practice. In this study, we examine categories of information sources as opposed to specific sources (so Pharma Sales Reps not Company X Sales Reps; Medical Journals: Accessed Online not TheJournalOfXYZ.com) Doctors are asked to: Rate each Source in helping them stay abreast of new medical developments Indicate how frequently, if at all, they re exposed to each source The total percentage of doctors exposed to a source is the Reach for that source Exposures is an annualized number for exposures to that type of information source (note: this is not the same as ad exposures or ad impressions, metrics dependent on number and type of ads run in a specific media property or properties, and the readership or site activity for that particular property) Importance can be viewed in several ways; typically top 2 on a 5 point scale is considered Important

Promotional tactics/sources of information studied CME: Attendance at Meetings CME: Audio/Video via CD or DVD or TV CME: Printed Courses CME: Webcasts/Podcasts Colleagues Conferences/Symposia on a Product or Therapy: Attendance at Meetings Conferences/Symposia on a Product or Therapy: e-conferences Convention Attendance Dinner Meetings Grand Rounds/Speaker Programs Pharma Medical Liaisons Pharma Sales Representatives e-detailing Faxed Information Government Bulletins/Literature: Printed Government Bulletins/Literature: Online Medical Center/University Newsletters: Printed Medical Center/University Newsletters: Online Other Medical Newsletters: Printed Other Medical Newsletters: Online Pharma Company Mailings: Printed Pharma Company Mailings: Online Consumer News Sites: Online Medical Webcasts/Podcasts (non-cme) Physician-Requested Television Network Physician-Targeted Radio Programming Websites: Company/Product Site Websites: Medical Society Site - Local Websites: Medical Society Site - National Websites: Disease Site - Focused on Medical Professionals Websites: Disease Site - Focused on Consumers/Sufferers Medical Journals: Accessed Online Medical Journals: Accessed via Print Medical Journals: Reprints - Printed Medical Journals: Reprints - Online Reference Publications: Printed Reference Publications: Online Physician-Targeted Poster Patient Record Forms Prescription Pads

Among 4 print, digital and in-person information sources: Reach 18 sources reach over ¾ of the market 7 reach < ½ Frequency 9 deliver weekly or more frequent exposure 5 offer < monthly exposure Importance 9 are rated important (top 2 on a 5 point scale) for keeping physicians abreast of new medical developments 16 receive high importance ratings from less than a quarter of all doctors Source: Kantar Media, Professional Health Source & Interactions 21

Top online sources: reach Medical Journals: Accessed Online Reference Publications: Online Medical Society Sites - National Disease Sites - Focused on Medical Professionals Medical Journal Reprints: Online Government Bulletins/Lit Online Company/Product Sites % 5% 1% Source: Kantar Media, Professional Health Source & Interactions 21

Top offline sources: reach Medical Journals: Accessed via Print CME: Attendance at Meetings Conference/Symposia on a product/therapy Reference Publications: printed Convention Attendance Grand Rounds/Speaker Programs Medical Journal Reprints: printed CME: Printed Courses % 5% 1% Source: Kantar Media, Professional Health Source & Interactions 21

Medical journal brands offer more annual exposures Colleagues Medical Journals: Printed + Online Prescription Pads Websites (excluding journal sites) Reference Publications: Printed + Online Patient Record Forms Medical Journal Reprints Pharma Sales Reps Medical Newsletters: e and print CME (all types) Among 4 tactics available to marketers for promotional messaging and education, physicians are exposed to print and online medical journals more frequently than any other tactic Conferences Source: Kantar Media, Professional Health Source & Interactions 21 1 2 number of annual exposures

Physicians rate medical journal brands among their most important sources of information CME: Meeting Attendance Colleagues Medical Journals: Accessed via Print Medical Journals: Accessed Online Convention Attendance Conf/Symposia on a Product/Therapy: Meeting Attendance Grand Rounds/Speaker Programs Reference Publications: Printed Reference Publications: Electronic CME: Printed Courses Medical Journal Reprints - Online Medical Journal Reprints - Printed % 25% 5% 75% Source: Kantar Media, Professional Health Source & Interactions 21 Percent of physicians rating source a 4 or 5 on 5 point importance scale for keeping them abreast of new medical developments

Which sources are the best? In practice, it depends on communication goals and cost In general, we can compare sources across all three metrics by calculating a composite score: Metrics Reach, Exposures, Importance (Top 2) Reach Exposures Importance Ranked from highest to lowest Highest third for each metric get a value of 3 Middle third get a value of 2 Lowest third get a value of 1 High Medium 3 2 3 2 3 2 Highest theoretical composite score is 9, lowest is 3 Low 1 1 1

Composite score example An information source/promotional tactic that fell in the middle third of scores in both reach and exposure, and the top tier in importance, would earn a composite score of 7 Composite Score = 7 Reach Exposures Importance High 3 3 3 Medium 2 2 2 Low 1 1 1

Journals & reference publications, in print and online, dominate the most effective information sources list Medical Journals: Accessed Via Print Medical Journals: Accessed Online Reference Publications: Online Reference Publications: Printed Medical Journals: Reprints - Printed Websites: Disease Site Focused on Medical Professionals Medical Journals: Reprints - Online Websites: Medical Society Site National Grand Rounds/Speaker Programs Prescription Pads Pharma Sales Representatives Other Medical Newsletters: Online Other Medical Newsletters: Printed Conferences/Symposia on a Product or Therapy: Attendance at Convention Attendance Patient Record Forms Consumer News Sites: Online Pharma Company Mailings: Printed Websites: Company/Product Site Medical Center/University Newsletters: Printed Dinner Meetings Faxed Information Pharma Medical Liaisons Pharma Company Mailings: Online Physician-Targeted Poster Medical Center/University Newsletters: Online e-detailing Websites: Medical Society Site Local Conferences/Symposia on a Product or Therapy: e-conferences Websites: Disease Site Focused on Consumers/Sufferers Medical Webcasts/Podcasts (non-cme) Physician-Requested Television Network Physician-Targeted Radio Programming Source: Kantar Media, Professional Health Source & Interactions 21 Composite Score Distribution (Sponsorable) 1 2 3 4 5 6 7 8 9

Journals still matter

Journal trends Sources & Interactions 21 Print journal penetration remains largely unsurpassed Reach and exposure levels for online journal content continues to grow 75% 5% How Medical Journal Content Gets Read, When Available in Both Formats Print and online readership have more or less reached parity 25% % Hard Copy Online Printed from online Source: Kantar Media, Professional Health Source & Interactions 21

Journal trends Syndicated readership studies document journal readership stability Readership levels do not show a declining trend, even with the proliferation of other information sources An examination of Average Issue Readers (a measure of reading frequency) and Average Page Exposure (a measure of reading frequency and thoroughness) data from the past 11 study periods shows relatively constant reading patterns across multiple specialties. (Examples follow) Detailed data on readership of specific journals are available in Kantar Media s syndicated readership studies covering the medical/surgical, pharmacy, managed healthcare, hospital management, eyecare, NP/PA, radiology, dental, and veterinary markets.

Average Issue Readers P e rc en t o f S p e c ia lty 8 7 6 5 4 3 2 Cardiology 6.7 61.3 6.3 62.3 6. 59.7 62.3 63.3 63.3 63.3 59. 31.2 3.6 29.5 3.9 28.6 28.6 28.5 3.3 31.3 28.8 27.1 Percent of Specialty 8 7 6 5 4 3 2 62.7 38.4 Gastroenterology 67.7 69. 69.3 69.7 7.3 67. 67.3 45.4 42. 43.8 41.5 4.8 42.7 41.7 68.3 69.7 69.3 42.2 43.9 39.4 Top 3 Average Top 5 Average Top 1 Average All Average 1 1 J5 D5 J6 D6 J7 D7 J8 D8 J9 D9 J1 J5 D5 J6 D6 J7 D7 J8 D8 J9 D9 J1 Dermatology Obstetrics/Gynecology 1 1 9 8 83.3 83.7 82.3 8.3 79.3 81.3 83. 83. 8.3 8. 8. 9 8 78. 77.3 74.3 76.3 77.3 76.3 75. 77.7 76.7 77. 79.7 Percent of Specialty 7 6 5 4 3 2 61.5 6.8 55.2 51.9 49.5 5.2 51.1 52.1 49.7 5.3 5.7 Percent of Specialty 7 6 5 4 3 2 47.9 48.3 48.1 49.8 52.6 53.8 54. 56.8 54.2 54.1 55.2 1 1 J5 D5 J6 D6 J7 D7 J8 D8 J9 D9 J1 J5 D5 J6 D6 J7 D7 J8 D8 J9 D9 J1 Source: Kantar Media Medical/Surgical Readership 25-21

Average Issue Readers Oncology and Hem/Onc Pediatrics Top 3 Average Percent of Specialty 9 8 7 6 5 4 3 2 71.3 68.7 69.3 69.3 68.3 69.7 7.3 69.7 33. 32.9 33.4 35.2 34.8 32.6 32.1 34.3 66.7 66.7 66. 32.4 31.2 28.3 Percent of Specialty 9 8 7 6 5 4 3 2 77.3 76. 73. 74.7 75. 76. 76.7 73.7 75.3 72.3 69.3 52.1 5.7 5.1 49. 48.3 47.4 49.1 49.5 48.7 47.4 48.5 Top 5 Average Top 1 Average All Average 1 1 J5 D5 J6 D6 J7 D7 J8 D8 J9 D9 J1 J5 D5 J6 D6 J7 D7 J8 D8 J9 D9 J1 Orthopedic Surgery Psychiatry 1 8 Percent of Specialty 9 8 7 6 5 4 3 2 1 76.3 78. 79. 8. 79.7 79.7 8.3 8. 79.7 79.3 79.3 36.9 36.4 34.4 33.8 35.5 37.8 38.2 37.9 39.4 36.1 36.6 Percent of Specialty 7 6 5 4 3 2 1 65.7 65.7 66. 65.7 66. 65.3 63.7 64. 64.7 65.7 66. 44. 43.1 44.9 46.1 46.9 45.9 44.9 45.8 43.6 42.8 43.2 J5 D5 J6 D6 J7 D7 J8 D8 J9 D9 J1 J5 D5 J6 D6 J7 D7 J8 D8 J9 D9 J1 Source: Kantar Media Medical/Surgical Readership 25-21

Average Issue Readers Internal Medicine Primary Care Top 3 Average Percent of Specialty 6 5 4 3 2 42. 45. 29.6 29.7 48. 47.3 32. 29.6 45.3 44.3 24.1 23.2 47. 48.7 48.3 25. 25.3 24. 53. 27.5 48.7 23.6 Percent of Specialty 6 5 4 3 2 5.7 5.7 48.3 48. 47.3 47.7 48. 48.3 49.7 5.3 49.3 2.1 19.9 2.2 2.4 2.8 18.7 18.5 18.4 18.7 18.2 18.5 Top 5 Average Top 1 Average All Average 1 1 J5 D5 J6 D6 J7 D7 J8 D8 J9 D9 J1 J5 D5 J6 D6 J7 D7 J8 D8 J9 D9 J1 Small variations (up and down) from study period to study period are common, and statistically irrelevant Average readership for the leading publications, in particular, shows flat and in some cases even slight upward trend Source: Kantar Media Medical/Surgical Readership 25-21

Average Page Exposures Cardiology Gastroenterology Top 3 Average Percent of Specialty 45 4 35 3 25 2 15 1 5 38.7 38.7 38.3 37. 35.3 35. 35.7 35. 35. 35.3 33.7 15.9 16.8 16.4 15.1 15.3 14.6 15.1 15.9 16.9 16.2 14.8 J5 D5 J6 D6 J7 D7 J8 D8 J9 D9 J1 Percent of Specialty 5 45 4 35 3 25 2 15 1 5 43.3 43. 42.3 42.3 42. 42.3 43. 42. 43. 43. 38. 25.2 25.6 26.8 25.8 26.3 24.9 23.4 24.1 24.9 22.7 21.4 J5 D5 J6 D6 J7 D7 J8 D8 J9 D9 J1 Top 5 Average Top 1 Average All Average Dermatology Obstetrics/Gynecology Percent of Specialty 7 6 5 4 3 2 56.3 55.7 55. 53.7 53.7 36.6 35.8 33.1 31.1 29.5 56.7 58.3 55.7 53.7 53.3 51.3 31.1 31. 3.1 29.7 29.2 28.6 Percent of Specialty 6 5 4 3 2 52.7 52.7 48.7 49.3 28.3 29.3 28.5 28.8 51.7 52. 5.3 31.7 32.6 31.7 52.7 52.3 51.7 53. 34.1 33.6 32.7 32.1 1 1 J5 D5 J6 D6 J7 D7 J8 D8 J9 D9 J1 J5 D5 J6 D6 J7 D7 J8 D8 J9 D9 J1 Source: Kantar Media Medical/Surgical Readership 25-21

Average Page Exposures Oncology and Hem/Onc Pediatrics Top 3 Average Percent of Specialty 5 45 4 35 3 25 2 15 1 5 41.7 41. 41.7 4.3 41.3 38.7 38.3 39. 38. 37.3 36.7 15. 16.1 17.2 17.5 17.2 16.4 16.4 17. 16.1 15.6 14.4 J5 D5 J6 D6 J7 D7 J8 D8 J9 D9 J1 Percent of Specialty 7 6 5 4 3 2 1 54.7 53.3 52.7 52.7 51.7 53.3 54. 53.3 49.3 5. 48.3 32.2 32.5 32.5 31.5 3.5 29.9 31.5 32.2 31.6 3.3 31.2 J5 D5 J6 D6 J7 D7 J8 D8 J9 D9 J1 Top 5 Average Top 1 Average All Average Orthopedic Surgery Psychiatry 6 5 49. 49. 51.3 52.7 5.7 5.3 5.7 5. 51. 5.3 5.7 5 45 4 42.3 42.3 42.7 43. 41.3 4.7 4.3 42.3 43. 42.7 43. Percent of Specialty 4 3 2 21.3 2.9 21.8 23. 22. 22. 22.2 22. 23.3 21.3 21.9 Percent of Specialty 35 3 25 2 15 24.7 24.1 25. 25.9 25.9 25.4 24.6 25.5 24.4 23.8 24.2 1 1 5 J5 D5 J6 D6 J7 D7 J8 D8 J9 D9 J1 J5 D5 J6 D6 J7 D7 J8 D8 J9 D9 J1 Source: Kantar Media Medical/Surgical Readership 25-21

Average Page Exposures Internal Medicine Primary Care Top 3 Average Percent of Specialty 4 35 3 25 2 15 1 22.7 15.1 26. 16.1 28. 27.3 17.8 16.7 26. 25. 27. 13.5 13.4 13.6 28.7 28.7 14.8 13.2 32. 15.5 28.7 13.1 Percent of Specialty 4 35 3 25 2 15 1 3.7 31.3 28.7 29.7 27.7 27.7 28.3 27.7 26.7 1.6 1.9 11. 1.5 1.4 1.1 1.5 1.5 1.7 3.7 3.3 12.1 12.6 Top 5 Average Top 1 Average All Average 5 5 J5 D5 J6 D6 J7 D7 J8 D8 J9 D9 J1 J5 D5 J6 D6 J7 D7 J8 D8 J9 D9 J1 Source: Kantar Media Medical/Surgical Readership 25-21

The inarguable fact is that readership of leading journals has not declined with a handful of explainable exceptions over the last 5 years Physicians and other healthcare professionals read leading journals (in print and increasingly, online) as frequently and thoroughly today as in the past Why? In short: journals have a unique bond with physicians as a most-trusted source of information

Changing incorrect perceptions about medical journals Perception Reality Consumers drive Rx decisions Ink on paper Digital laggards If it works with consumers Increasing physician use of internet and other digital media means journal readership is declining Digital is targeted, print is not

Changing incorrect perceptions about medical journals Consumers drive Rx decisions Ink on paper Digital laggards Perception If it works with consumers Increasing physician use of internet and other digital media means journal readership is declining Digital is targeted, print is not Reality Consumers still rely on their doctors Media neutral utilizing whatever media platforms work best for the content & audience The most widely accessed sites online Doctors aren t consumers. Trust the research, not your gut. Not according to the readership data. E- sources are supplementing, not replacing, print information. Medical journals have always, by and large, been highly targeted and use is opt in. The media platform doesn t matter in this case.

Journals offer the single most effective medium in the current marketplace Journal websites already lead in the digital space Change creates opportunity: for publishers, to leverage their audience and content across multiple existing and emerging media platforms, and in doing so to best meet the market s information needs For marketers and their agencies, to capitalize on the reach, exposure potential and unique bond between doctors and medical journals in both print and digital environments, to cost-effectively build the foundation for any effective promotional campaign

Contact us: www.kantarmediana.com/healthcare Marketers, Media Inquiries Dave Emery 847.375.571 dave,emery@kantarmedia.com Agencies Bernadette Cognac 312.543.778 bernadette.cognac@kantarmedia.com Media Owners (Northeast/Midwest) Jaime Brewster 917.716.3963 jaime.brewster@kantarmedia.com Media Owners (Mid-Atlantic/Southeast/West Coast) Alejandro Alvarez 69.462.9883 alejandro.alvarez@kantarmedia.com