In order to gain a better understanding of the benefits of a relatively new and increasingly popular digital promotion medium, we analyzed over two dozen e-detailing programs conducted by Group DCA, a leading provider of digital promotional services to the pharmaceutical industry. The results were unequivocal: - E-detailing is very successful in persuading physicians to prescribe. -It is effective both for physicians who are heavily committed and for those who are relatively indifferent to the promoted product. - It can convert non-prescribers of a product into prescribers. - It generates a very high return on investment (ROI). - There is a direct relationship between the magnitude of the investment in e-detailing and the magnitude of the resultant profits, allowing marketers to manage to profit targets.

1.
A
NEW
MEDIUM
COMES
OF
AGE:
An
Analysis
Of
The
Impact
Of
E-­‐Detailing
On
Physician
Prescribing
by
Patrick
J.
Miller,
Ph.D.
Executive
Vice
President
Clinical
Information
Network
pat.miller@clinicalinfonet.com
480-­‐320-­‐1009

2. Executive
Summary
In
order
to
gain
a
better
understanding
of
the
benefits
of
a
relatively
new
and
increasingly
popular
digital
promotion
medium,
we
analyzed
over
two
dozen
e-­‐detailing
programs
conducted
by
Group
DCA,
a
leading
provider
of
digital
promotional
services
to
the
pharmaceutical
industry.
The
results
were
unequivocal:
E-­‐detailing
is
very
successful
in
persuading
physicians
to
prescribe.
It
is
effective
both
for
physicians
who
are
heavily
committed
and
for
those
who
are
relatively
indifferent
to
the
promoted
product.
It
can
convert
non-­‐prescribers
of
a
product
into
prescribers.
It
generates
a
very
high
return
on
investment
(ROI).
There
is
a
direct
relationship
between
the
magnitude
of
the
investment
in
e-­‐
detailing
and
the
magnitude
of
the
resultant
profits,
allowing
marketers
to
manage
to
profit
targets.
Background
The
past
few
years
have
been
unsettling
years
for
marketers
in
the
pharmaceutical
industry.
The
sales
resource
upon
which
they
have
relied
most
heavily,
the
outside
field
sales
representative,
has
dwindled
in
numbers
and
its
effectiveness
has
waned.
At
the
same
time,
advancing
information
technology
has
spawned
a
host
of
exciting,
but
relatively
untested,
new
alternatives.
While
the
industry
has
slowly
been
building
an
experience
base
with
the
new
media,
the
intuitive
sense
of
expected
return
that
marketers
have
long
enjoyed
with
their
older
sales
resources
is
still
lacking.
One
of
the
most
popular
of
the
new
selling
alternatives
is
e-­‐detailing.
In
a
typical
e-­‐detail,
a
physician
or
other
health
care
professional
is
invited,
using
any
of
the
bewildering
array
of
communication
channels
that
link
pharmaceutical
companies
and
their
targeted
customers,
to
visit
a
web
site
whereon
is
located
an
automated
presentation,
often
interactive,
on
a
topic
of
interest
to
the
customer.
Because
the
experience
can
take
place
at
a
time
and
place
of
the
physician’s
own
choosing
and
is
still
relatively
novel,
the
physician
is
likely
to
devote
substantially
more
time
and
pay
closer
attention
to
the
promotional
or
educational
message
provided
by
the
e-­‐detail
than
he
would
to
a
traditional
in-­‐office
visit
from
a
field
sales
representative.

3. These
customer-­‐centric
attributes
have
made
e-­‐detailing
one
of
the
most
widely
used
of
the
new
media.
As
a
result,
a
fuller
understanding
of
its
impact
on
physician
prescribing
would
be
of
significant
value
to
marketers.
To
this
end,
a
comprehensive
analysis
was
undertaken
of
a
large
sample
of
over
two
dozen
programs
completed
by
Group
DCA,
an
industry
leading
provider
of
digital
media
services.
METHODOLOGY
Each
of
the
studies
included
in
this
analysis
was
examined
using
a
matched-­‐pair
test-­‐control
design.
The
pre-­‐treatment
period
used
to
establish
the
baseline
for
the
physician
matches
was
six
(6)
months.
Once
matching
equivalency
was
established,
any
post-­‐treatment
divergence
in
the
value
of
the
dependent
variable
between
the
test
and
control
physicians
could
be
attributed
to
the
treatment
–
in
this
case
1
exposure
to
the
e-­‐detail.
0.9
Figure
1
shows
the
results
0.8
NRx's per Physician
of
a
typical
program
0.7
0.6 TEST
analysis.
The
dependent
0.5
variable
is
NRx
volume
per
0.4 CONTROL
physician.
Prior
to
the
e-­‐ 0.3
0.2
detailing
experience,
the
0.1
test
and
control
0
MTH MTH MTH MTH MTH MTH MTH MTH MTH MTH MTH MTH MTH
physicians
are
essentially
1 2 3 4 5 6 1 2 3 4 5 6 7
identical.
After
the
e-­‐ 2 3 4 6
CONTROL MONTHS
1 TEST MONTHS
detailing
experience,
they
are
not.
FIGURE 1
Of
course,
all
of
the
e-­‐detailing
programs
were
designed
to
meet
the
needs
of
Group
DCA’s
clients,
not
to
satisfy
the
requirements
of
an
experimental
design.
The
test
and
control
matches,
therefore,
were
established
post
hoc.
In
spite
of
this,
the
results
are
robust
and
the
interpretation
straightforward.
Projection,
the
analytical
attribute
most
sensitive
to
non-­‐
randomness,
is
buffered,
to
some
extent,
by
the
large
sample
of
studies,
with
the
consequent
large
and
diverse
sample
of
physicians,
drawn
for
this
analysis.

4. RESULTS
Rx
Impact
Table
1
displays
the
median
values
for
the
expected
and
observed
NRx
MEDIAN NRx VOLUME
volumes.
The
difference
between
Expected Observed
% Gain
these
values
is
the
NRx
volume
(without e - detail) (with e - detail)
attributable
to
the
e-­‐details.
The
median
rather
than
the
average
was
1,412 2,298 +63%
used
because
one
product
was
so
much
larger
than
any
other
tested
product
that
its
volume
introduced
Table
1
substantial
skew
into
the
calculation
of
the
mean.
Overall,
e-­‐detailing
produced
a
63%
increase
in
new
prescription
volume.
Figure
2
shows
the
average
volume
differences
by
month.
The
critical
message
conveyed
by
Figure
2
is
that
the
effect
of
the
e-­‐detailing
has
diminished
but
not
washed
out
by
the
end
of
the
measurement
period.
Consequently,
the
impact
reported
here
understates
the
actual
volume
return
attendant
upon
the
e-­‐detail.
Although
the
overall
prescription
impact
of
e-­‐detailing
is
quite
substantial,
the
distribution
of
the
impact
across
different
FIGURE 2 classes
of
prescribers
is,
perhaps,
even
more
impressive.
Most
pharmaceutical
companies
use
existing
prescribing
volume
as
a
criterion
in
selecting
promotional
targets.
Because
the
most
expensive
promotional
resources,
such
as
the
field
sales
force,
are
typically
reserved
for
the
highest
prescribing
deciles,
there
is
always
interest
in
the
ability
of
more
affordable
promotional
media
to
affect
the
prescribing
of
a
broader
array
of
prescriber
categories,
including
the
mid
and
lower
level
prescribing
deciles.
Figure
3
shows
the
proportion
of
the
e-­‐detailing
impact
that
is
generated
by
high
prescribers
(deciles
ten
through
eight),
mid
and
low
level
prescribers
(deciles
seven
through
one)
and
non-­‐prescribers.
As

5. Figure
3
reveals,
e-­‐detailing
was
almost
equally
effective
in
generating
incremental
prescribing
regardless
of
the
prior
prescribing
level
of
the
physician.
The
effect
shown
in
Figure
3
is
of
particular
interest
in
the
case
of
physicians
who
had
not,
prior
to
the
e-­‐
detailing
experience,
been
persuaded
to
prescribe
the
product
at
all.
Several
of
the
programs
included
in
FIGURE 3
this
analysis
included
in
their
target
list
physicians
who
had
not
written
a
prescription
for
the
promoted
product
in
the
entire
six
month
pre-­‐test
period.
Figure
4
shows
the
impact
of
e-­‐detailing
on
these
physicians.
Fully
CONVERTED PHYSICIANS
22%
of
the
test
doctors
–
incremental
to
their
matched
controls
-­‐
who
had
not
written
the
detailed
product
in
the
six
months
prior
to
e-­‐
detailing
did
prescribe
the
product
in
the
months
afterward.
Profitability
As
might
be
expected
given
the
magnitude
of
the
incremental
prescribing
generated
by
e-­‐detailing
FIGURE 4
programs,
such
programs
are
highly
profitable.
In
fact,
the
average
return
on
investment
across
all
programs
was
677%.
As
noted
above,
this
figure
is
conservative
and
understates
the
true
ROI.
If
the
overall
profitability
of
e-­‐detailing
programs
was
unsurprising,
the
relationship
between
profitably
and
program
size
was
completely
unexpected.
Programs
were
ranked
by
size
(cost)
and
divided
into
large
(largest
third
of
programs),
average
(middle
third),
and
small
(bottom
third).
As
Figure
5
shows,
FIGURE 5 the
large
programs
delivered
double
the

6. profit
volume
of
average
programs
which,
in
turn,
provided
twice
the
profit
volume
of
small
programs.
CONCLUSIONS
Over
two
dozen
individual
e-­‐detailing
programs
provided
by
Group
DCA
were
examined
to
generate
insights
into
two
critical
aspects
of
e-­‐detailing.
The
critical
dimensions
were:
1.
the
prescription
impact
of
e-­‐detailing
and
2.
its
profitability.
Prescription
Impact:
The
ability
of
e-­‐detailing
to
stimulate
prescribing
was
both
remarkable
and
well
documented.
Across
products,
e-­‐detailing
produced
a
63%
increase
in
new
prescriptions
over
a
12-­‐month
period.
Substantial
increases
in
prescribing
occurred
regardless
of
the
level
of
the
physicians’
prescribing
volume
prior
to
the
e-­‐detailing
experience.
Indeed,
even
non-­‐prescribers
of
the
products
were
motivated
by
the
e-­‐detailing
to
offer
trial.
Profitability:
E-­‐detailing
is
a
highly
profitable
medium,
generating
returns
conservatively
measured
at
nearly
seven
times
the
initial
investment.
The
magnitude
of
the
dollar
profit
is
also
a
function
of
the
magnitude
of
the
investment;
large
e-­‐detailing
programs
generate
greater
profits
than
do
smaller
e-­‐detailing
programs.