• Digital marketing to physicians is amazing. And concerning.

    I’ve written about physicians’ financial conflicts of interest at The Upshot. I’ve made a Healthcare Triage episode, too, if you prefer that medium. As this discussion goes more public, overt marketing to physicians has decreased. For instance, visits from sales representatives have gone from 77% of physicians in 2008 to 55% in 2013.

    But there are new, digital ways to market to docs. A new piece in the NEJM highlights just a few. For instance, there are EHRs:

    EHRs are increasingly common and contain detailed data about patients’ encounters with the health system — data that have tremendous value for health care improvement efforts. These same data also provide opportunities for marketing. Using EHR data, it’s possible to determine the clinical and demographic characteristics of patients within a given practice and the circumstances under which physicians choose particular treatments, even when information is anonymized at the patient level. Although most large EHR vendors do not sell data to third parties, some have made information sales part of their business model. For example, Practice Fusion offers its EHR software to physicians free of charge but generates revenue by selling access to anonymized clinical data derived from more than 80 million patient records.

    EHRs can also be used for direct marketing to physicians at the point of care, through features such as banner ads, industry-sponsored clinical resources, and tools for requesting samples, article reprints, and other items — a role previously filled by sales representatives. Unlike traditional forms of advertising, digital technologies (e.g., MD On-Line) enable tailoring of advertisements to individual physicians on the basis of data from clinical encounters. Some marketing platforms (e.g., Physicians Interactive) integrate advertising at the point of prescribing with “eCoupons” that are generated in real time and transmitted directly to pharmacies when physicians select promoted medications

    There’s Twitter:

    Peerin is an online technology company that can monitor Twitter conversations and generate an interaction map that visually demonstrates which providers initiate the most popular conversations, who responds to those messages, and how individuals are connected to one another.

    There are social media sites:

    Physicians use sites such as Doximity and Sermo to read medical news, manage continuing medical education credits, and engage with colleagues. These sites also employ marketing tools including advertisements, sponsored discussion forums, solicitation of physicians’ opinions through voluntary and paid surveys, and recruitment of physicians for focus-group participation. Sermo has integrated games into advertising. One recent example was an “Alzheimer’s Challenge” that allowed physicians to read through clinical trial data (in a format similar to print journal advertisements) for a brand-name medication and answer questions about its indications to earn points redeemable for cash.

    There are mobile apps:

    For example, when physicians use mobile applications to look up clinical information, they generate trackable data that can inform advertising. The best example is Epocrates, a widely used mobile application for physicians that provides information about drug indications, interactions, and insurance coverage. Individual physicians’ search patterns are tracked and used to target “DocAlerts” (often industry-sponsored) that appear on the screen.

    The piece reports that pharmaceutical companies now spend 25% of their marketing budgets on digital technologies like there. They’re very, very good at what they do.

    @aaronecarroll

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