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Healthcare Marketing, Digital Marketing and Market Access Strategy - John G. Baresky

$3 BILLION PLUNGES INTO GENE THERAPY: ASTELLAS ACQUIRES AUDENTES THERAPEUTICS

by John G. Baresky on 12/03/19

Astellas Expands Therapeutic Portfolio With Gene Therapy Deal

Astellas ( OTCMKTS: ALPMY ) has announced it is acquiring Audentes Therapeutics ( NASDAQ: BOLD ) for $3 billion and plunge itself into the gene therapy market. Based in San Francisco, California, Audentes is a clinical stage research company centering on the development of  AAV-based genetic medicines for people with significant and rare neuromuscular diseases.

Astellas is a global pharmaceutical leader 

Astellas, based in Tokyo, Japan with a U.S. headquarters in Northbrook, Illinois, is Japan’s second largest pharmaceutical company ( Takeda is ranked at number 1). The current product portfolio of Astellas is defined by 4 categories and the addition of Audentes will establish a 5th with the specialty of genetic therapy:

  • Immuno-Oncology
  • Immunotherapy
  • Neuro-Muscular
  • Regenerative
  • Genetic Therapy

Astellas employs approximately 17,500 worldwide; Audentes has less than 1,000 staff members. 

Audentes has developed a robust pipeline of advanced gene therapies

Audentes' adeno associated virus ( AAV ) gene therapy technology platform and proprietary production process expertise is applied  in programs spanning 3 modalities:

  • Gene Replacement
  • Vectorized Exon Skipping
  • Vectorized RNA Knockdown

Audentes has committed significant resources to develop potential approval candidates although risk remains high in terms of chances of approval by the Food and Drug Administration ( FDA ) in the United States and the government regulatory agencies of other nations:

  • AT132 X-linked Myotubular Myopathy MTM1 ( Gene Replacement )
  • AT845 Pompe GAA ( Gene Replacement )
  • AT702 Duchenne Muscular Dystrophy Exons 2, 1-5 ( Vectorized Exon Skipping )
  • AT751 Duchenne Muscular Dystrophy Exon 51 ( Vectorized Exon Skipping )
  • AT753 Duchenne Muscular Dystrophy Exon 53 ( Vectorized Exon Skipping )
  • AT466 Myotonic Dystrophy DMPK ( Vectorized Exon Skipping / Vectorized RNA Knockdown )

Presently, the leading candidate for approval in the Auduentes portfolio is AT312 which could happen as early as mid-2020. Its clinical trial performance has generated good results in the treatment of X-linked myotubular myopathy (XLMTM) occurring primarily in male infants.

Astellas began exploring gene therapy marketplace in 2018

Astellas has already licensed a gene therapy candidate. In 2018 Astellas entered into a licensing agreement with Juventas Therapeutics for JVS-100. JVS-100 is a non-viral gene therapy expressed from stromal cell-derived factor -1 ( SDF-1 ) which is a naturally occurring signaling protein activating the endogenous tissue repair pathways.

Why is gene therapy such a hot marketplace for biotech and pharmaceutical companies to invest in?

Gene therapy is an advanced area of life sciences with potential to cure diseases by replacing missing or mutated versions of a gene found in a patient’s cells with healthy copies. Depending on the patient and the genetic challenge involved, gene therapy in some instances can resolve significant illnesses with one dose. Because of the advanced clinical technologies involved with developing and manufacturing gene therapies, they are quite costly and the processes to develop them are complex and highly coveted by pharmaceutical manufacturers.  

Large and mid-sized pharmaceutical companies are always seeking to build their clinical and commercial capabilities. Many product categories are crowded with competition including:

  • Allergy
  • Antibiotics
  • Cholesterol
  • Dermatology
  • Diabetes
  • Gastraoesophogeal Reflux Disease ( GERD )
  • Hypertension
  • Oral Contraceptives 

There are numerous brand and generic drugs in each of these categories. While the patient population prescribed these products is in the millions and the medications involved taken on a daily basis for months if not years, pharmaceutical companies devote large sums to develop these products, then even more to promote them. Then conversely, they frequently discount the products through market access strategy measures to contract for favorable positions on managed care organization ( MCO ), prescription benefit manager ( PBM ) and health system formularies or group purchasing organization ( GPO ) listings. 

While gene therapy and other advanced medications are costly and risky to produce, the investment to promote them following approval is less. The payout is larger as there are less competitors due to their high research & development and production costs plus the narrow indications they are approved for and reduced number of patients they are prescribed to results in significantly higher prices at time of launch. 

Astellas is highly selective in its acquisition strategy

It has been almost 10 years since Astellas last made such a sizable acquisition. In 2010, Astellas acquire OSI Pharmaceuticals for $3.8 billion. With annual sales of approximately $12 billion and a market capitalization estimated at $33 billion, Astellas is solidly established in global healthcare markets and has the clinical and financial resources to cultivate a successful gene therapy portfolio of products.

Astellas versus the competition in the gene therapy marketplace

By adding  Audentes’ research & development attributes and manufacturing capabilities plus its connections  with patient groups, academic institutions and the biotech research community, Astellas assertively positions itself in the expanding gene therapy marketplace.

Roche ( OTCMKTS: RHHBY ) Novartis ( NYSE: NVS ) and Pfizer ( NYSE: PFE  ) are presently the blue chip pharmaceutical manufacturer leaders in gene therapy. Roche acquired gene therapy company Spark Therapeutics for $4.8 billion in 2019, Novartis bought up AveXis, another gene therapy leader for $8.7 billion. Among Pfizer's many investments, they acquired gene therapy producer Bamboo Therapeutics for $645 million in 2016. 

Reportedly Pfizer ( NYSE: PFE ) and Novartis ( NYSE: NVS ) have been hard at work building out their gene therapy development and manufacturing capabilities. Pfizer has allocated about $600 million to gene therapy production and Novartis  slightly less at $500 million.

Potential gene therapy giants or acquisition targets

Upcoming gene therapy companies, which could substantially grow on their own if their pipeline candidates are approved, may also be attractive buyout targets. Some of the leading gene therapy companies of this caliber include:

  • MeiraGTx Holdings PLC (NASDAQ: MGTX )
  • Regenxbio Inc. ( NASDAQ: RGNX )
  • Sarepta Therapeutics Inc. ( NASDAQ: SRPT )
  • Solid Biosciences Inc. ( NASDAQ: SLDB )
  • uniQure NV ( NASDAQ: QURE )
  • Voyager Therapeutics Inc. ( NASDAQ: VYGR )

While it appears there are numerous contenders in the gene therapy market, their products are highly niche-focused so they have less or no competition within each of the therapeutic areas they are exploring to develop new medicines. The high rate of clinical trial failure also results in an ongoing reduction of competing agents throughout the product development cycle.

 Moving forward

Even before the Astellas and Audentes deal is approved by regulators, the approval of AT132 X-linked Myotubular Myopathy MTM1 ( Gene Replacement ) will be highly anticipated by investors, company staff members and the medical community. Depending upon when the deal is approved and AT132 is approved, a combined torrent of activity will follow in addition to the ongoing work underway in the existing pipelines of Astellas and the other candidates in the Audentes portfolio. 





AMAZON LAUNCHES ADVANCED HEALTHCARE DATA APPLICATION: AMAZON TRANSCRIBE MEDICAL

by John G. Baresky on 12/02/19

Amazon Combines Digital Savvy With Voice And Transcribing Technology To Drive Innovation In Patient Care And Healthcare Data Management 

Conversation Converted To Digital Text Technology

Amazon ( NASDAQ: AMZN ) is introducing a new healthcare application which will integrate with patient electronic health records ( EHR ).

Conversations between physicians and patients are recorded and converted into text content that populates the EHR at point-of-care. EHRs are also referred to as Electronic Medical Records ( EMR ).

Healthcare Clinical And Cost Advantages

The application, known as Amazon Transcribe Medical, will enable clinicians and patients to have more direct and meaningful dialogue that is retrievable for review at a later time. During face-to-face interactions, doctors and patients can converse without the doctor having to continually interrupt their dialogue to enter notes in the EHR or recall the details later either by memory or handwritten note which are not always easy to interpret.

Amazon Technology In Partnership With Cerner and Suki

Amazon developed the application by collaborating with Cerner, one of the world’s largest EHR companies and a startup company, Suki, that specializes in transcription technology. Currently, the Amazon Transcribe Medical program can only be used by those healthcare provider organizations and EHR platforms aligned with Amazon Web Service ( AWS or “Amazon Cloud”).

Amazon Transcribe Medical was designed to work with Amazon Comprehend Medical, an application that enables developers to work with unstructured medical text rhetoric aligned with patient symptoms and associated clinical details including drug therapy doses, diagnoses and other pivotal, finite detail essential for a well-fortified EHR patient file.

Patient Information HIPAA Compliance And Data Accuracy

The application meets HIPAA requirements which is absolutely pivotal in all things related to patient data, privacy and security. The advanced technology and testing involved with developing the program also demanded a high degree of accuracy in terms of medical terminology, punctuation and other details relevant to clinician and patient conversations.  

Microsoft, Google, Other Competitors

Advanced voice transcription technology is being pursued by numerous other healthcare software and technology companies. While Microsoft and Google have collaborations underway with various partners in this regard, there are many other companies developing solutions which could compete with Amazon, Microsoft and Google. They could launch independently or be acquired by one any one of these three companies or others to accelerate development of a marketable commercial product to be used by hospitals, health systems, medical practice groups or other healthcare provider organizations. 

Besides Google and Microsoft, these are some other competitors in the medical transcribing space threatened by Amazon Transcribe Medical:

 

  • Dolbey
  • Entrada
  • Nuance
  • Radekal
  • Sonix
  • SpeechRite
  • WebChartMD
  • Zydoc

 

Dolbey, Entrada and Nuance already interface with some EHRs but having a complete clinical and commercial solution that can be utilized by an entire hospital or health system is something on an entirely different scale. Amazon, Cerner and Suki, with Amazon Cloud as an integral resource, have the clinical, financial and technical bandwidth necessary to provide enterprise-wide medical transcription EHR programs that will have wide impact on broad based healthcare provider organizations. 

Voice Recognition Technology ( VRT ) And Transcription Technology

In healthcare and an array of other industries, advances in voice recognition and transcription technology are widely welcome and highly anticipated. These solutions speed processes, streamline recording and retrieval of information and bypass the keyboard interface which slows down processes and contributes to errors. As we have seen with smartphones, digital assistants, various remote control apparatuses and other uses of digital technology, the ability to control technical interfaces and collect, store, share data via voice is becoming a new technology standard in healthcare, businesses and homes.

Demands Of Clinicians And Healthcare Provider Organizations

As Amazon Transcribe Medical’s launch plans unfold, doctors, nurses and other clinicians, as well as healthcare administrative staff, will be eager to learn more about it. Amazon will be busy not only educating the market about it but also incorporating additional attributes into it to fulfill customer requirements and stay ahead of competitors. Companies like Microsoft, Google and others will spur their efforts to develop their own solutions to blunt momentum Amazon may build from the start.

Patient Information Data Companies

Allscripts, Cerner, Epic, Meditech and other EHR / EMR companies will have demands put on them by their customers in order to be able to accommodate VRT and transcription technology applications from Amazon and other organizations or develop equally sophisticated or better solutions of their own.

Unique Opportunities English-Speaking And Non-English Speaking Nations And Communities 

For all players in the voice medical transcription space, there will be a race to develop solutions that accommodate multiple languages including regional dialects. Healthcare is a universally global industry and a great way to drive user adoption and sales revenue is to be able to market solutions in primary and secondary markets as well as emerging markets and third world nations. 

LinkedIn: John G. Baresky

Twitter: Healthcare Marketing Guy

NOVARTIS ACQUIRES THE MEDICINES COMPANY FOR $9.7 BILLION - COVETS INCLISIRAN

by John G. Baresky on 11/25/19

Novartis' latest acquisition drives the company into the center of an enormous healthcare sector with deep competition

Novartis ( NYSE: NVS) has announced it is acquiring cardiovascular therapy-focused The Medicines Company ( NASDAQ: MDCO ) for $9.7 billion. Novartis, based in Basel, Switzerland covets The Medicine Company’s “Inclisiran” agent; a small interfering RNA (siRNA) PCSK9 drug compound being evaluated for its promising ability to lower low-density lipoprotein (LDL) cholesterol ( also known as LDL-C or “bad cholesterol” ). It is not on the market yet but appears to be well-positioned for approval by regulators and is expected to have a favorable administration schedule of just 2 doses annually.

The cholesterol pharmaceutical market is thick with brand and generic competition from an array of heavy hitters

With the exception of Livalo and Praluent, each of these products are available through generic pharmaceutical manufacturers; some have been prescribed for decades:

  • Alirocumab ( Praluent - Sanofi / Regeneron - no generic )        
  • Atorvastatin ( Lipitor - Pfizer )
  • Fluvastatin ( Lescol - Novartis )
  • Lovastatin ( Mevacor - Merck )
  • Pitavastatin ( Livalo - Kowa - no generic )
  •  Pravastatin ( Pravachol - Bristol Myers Squibb )
  •  Rosuvastatin calcium ( Crestor - AstraZeneca )
  • Simvastatin ( Zocor - Merck )

Novartis is a worldwide healthcare leader

Novartis is a Fortune 500 company ranked at 201. It generates approximately $52 billion in annual sales and employs overs 125,000 workers. Its top ten products each generate over $1 billion annually in sales:

  • Affinitor / Votubia ( palbociclib )
  • Cosentyx ( secukinumab )
  • Galvus ( vildagliptin )
  • Gilenya ( fingolimod )
  • Gleevec ( imatinib )
  • Lucentis ( ranibizumab )
  • Promacta / Revolade ( eltrombopag )
  • Sandostatin ( ocretride acetate )
  • Tafinlar w/ Meknist ( dabrafenib + trametinib )
  • Tasigna ( nilotinib )
The Medicines Company has a unique corporate business model and research & development strategy

The Medicines Company is a clinical development company with a strategy centered on researching compounds that have fallen short of expectations and not able to meet approval standards by the Food and Drug Administration and other regulators in earlier commercial product development ventures. They revisit the data and assess options to refine certain product attributes as well as clinical trial designs and related approval trial processes to determine if a product can be reinvestigated, entered into clinical trials once again and perhaps be approved.

Novartis planning for the future

Coincidentally, Novartis ( formed from the merger of Ciba-Geigy and Sandoz ) with a market capitalization of approximately $207 billion and The Medicines Company were both founded in 1996. Novartis has two primary business units:

  • Innovative Medicines ( which will house Inclisiran if it is approved )
  • Sandoz ( Sandoz manufactures generic and biosimilar or biogeneric products)

Novartis has been assertively working on transforming their organization into a pure pharmaceutical / biotech company. Earlier in 2019, Novartis spun off their blue chip consumer product brand, prescription drug and contact lens eyecare unit, Alcon, into a fully independent company ( NYSE / SXC: ALC) with a market capitalization of $28 billion. In 2018 it sold off its 36.5% stake in a consumer health product joint venture to their partner, GSK, for $13 billion.

Novartis a global player in billion dollar acquisitions

Mergers and acquisitions are almost routine in the healthcare industry. Novartis is well versed in the exercise. Some of their largest deals include:

  • In 2018 Novartis made two acquisitions; AveXis for $8.7 billion and Endocyte for $2.1 billion
  • Genzyme was bought by Novartis for $21 billion in 2011
  • In 2008, Novartis began acquiring Alcon from Nestle for almost $60 billion in two separate transactions. 
  • Chiron was purchased by Novartis in 2006 for $5.1 billion
  • Novartis bought Hexal AG for $8.3 billion in 2005
Novartis continuing its leadership in global pharmaceutical innovation

Novartis clearly doesn't shy away from growing its enterprise through acquisitions or making divestitures. Moving forward, they have made a sizable investment in Inclisiran and its approval will be highly anticipated by investors and medical professionals.

LinkedIn: John G. Baresky

Twitter: Healthcare Marketing Guy

SANOFI CONSIDERING $30 BILLION SPINOFF OF CONSUMER PRODUCTS DIVISION

by John G. Baresky on 11/21/19

SANOFI IS A GLOBAL LEADER IN PRESCRIPTION DRUG AND CONSUMER HEALTHCARE PRODUCTS

Global pharmaceutical leader Sanofi S.A. ( NASDAQ: SNY ) is reportedly weighing options to make significant changes to its commercial organization and its consumer products business unit. Based in Paris, France, Sanofi stands in the upper ranks of the world’s top 10 pharmaceutical companies based on revenue.  Employing over 100,000 workers, it generates over $42 billion in annual sales and is ranked at #288 in the Fortune 500. There is speculation in the investor, healthcare and consumer product business communities that Sanofi may form up its consumer products business unit as a separate spinoff or enjoin it through a partnership with another company.

SANOFI CONSUMER PRODUCTS DIVISION

Sanofi’s consumer products division is sizable; its annual sales are just over $5 billion. It has an established portfolio of familiar over-the-counter ( OTC ) and health and beauty ( HBA) brand products including:

  • Allegra
  • Aspercreme
  • Cortizone-10
  • Dulcolax
  • Gold Bond
  • IcyHot
  • Kaopectate
  • Nasacort
  • Rolaids
  • Selsun blue
  • Unisom
  • Xyzal
  • Zantac

Based on its $5 billion dollar annual sales and brand franchises' worth along with associated assets and liabilities, it is estimated Sanofi’s consumer business unit could be valued as high as just over $30 billion as a standalone company. Spinning the consumer products unit off or engaging in a partnership with another company could reduce costs and free up cash for Sanofi to invest in other parts of its organization. 

SANOFI CORPORATE STRUCTURE

Worldwide Sanofi has 75 manufacturing sites based in 33 different countries. Their leading markets are the United States, Europe and Asia. They organize their commercial enterprise based on 5 divisions:

  • General Medicines and Emerging Markets
  • Specialty Care ( Sanofi Genzyme )
  • Vaccines ( Sanofi Pasteur )
  • Consumer
  • Diabetes & Cardiovascular

SANOFI'S CLINICAL AND COMMERCIAL GLOBAL MARKET PRESENCE REMAINS FORMIDABLE WITHOUT CONSUMER BUSINESS UNIT

Whether Sanofi spins off or enters a partnership with its consumer products division, it will have plenty of options to reinvest income generated from it. Sanofi’s non-consumer, prescription drug and biotech businesses span brand and generic formulations for rare diseases, oncology, hematological disorders, neurology, immunology / vaccines, cardiovascular and endocrinology. Some of Sanofi’s top prescription drug products are:

  • Lantus / insulin glargine ( diabetes care / endocrinology )
  • Aubagio / terifluonide ( multiple sclerosis / neurology )
  • Lovenox / enoxaparin sodium ( anticoagulant / cardiology )
  • Plavix / clopidogrel ( coronary artery disease, peripheral artery disease / cardiology )
  • Toujeo / insulin glargine ( diabetes care / endocrinology )

SANOFI'S MULTI-BILLION ACQUISITIONS AND SALES 

Sanofi has been steadily reforming its business model to build up its brand pharmaceutical and advanced healthcare product operations. The plans for the potential sale or spinoff of the consumer health unit aligns with their ongoing strategy. These are deals Sanofi has orchestrated in the last ten years:

  • Baxter acquires Sanofi's Biosurgery Seprafilm product franchise for $350 million cash in 2019
  • 2018: Ablynx, a nano antibody biotech company, is acquired by Sanofi for $4.8 billion
  • 2018: Bioverativ, a hemophilia drug developer, is bought by Sanofi for $11.6 billion. 
  • 2018: Sanofi sells its generic drug unit Zentiva to private equity concern Advent International for $2.2 billion
  • 2011: Sanofi acquires biotech leader Genzyme for $20 billion

Sanofi may use the proceeds generated from the offloading of the consumer products unit to pay off debt, invest more in existing pipelines or conduct additional acquisitions. Sanofi's market capitalization is roughly $117 billion and its debt load is just under $28 billion; jettisoning some of this burden would brighten its balance sheet.

SANOFI'S OPTIONS:

Sanofi has been actively involved with fortifying the consumer products business unit. In 2017 it offloaded its animal health unit to Boehringer Ingelheim in a swap deal for their consumer products division valued at $20 billion. A joint-venture with another company would enable them to continue to collect revenue from its consumer brands while putting more focus on biotech, prescription drug and other advanced therapies ( it is also conceivable Sanofi could choose to sell the consumer unit outright to another company). The advantages of a spinoff arrangement are Sanofi could partition the consumer unit away from their organization, benefit from the initial sale of shares and also choose to be a shareholder in the new organization. 

PRESENT STATUS

Sanofi is believed to be meeting with investment bankers plus other advisors and consultants to determine which option is best for them. No companies have emerged thus far as potential candidates for Sanofi to partner with or have expressed interest in buying the consumer unit outright. 

LinkedIn: John G. Baresky

Twitter: Healthcare Marketing Guy

HOW ABBOTT CEO MILES WHITE TRANSFORMED GLOBAL PHARMACEUTICAL, DIAGNOSTIC AND MEDICAL DEVICE HEALTHCARE INDUSTRY SECTORS

by John G. Baresky on 11/15/19

A strategic succession of executive leadership at Abbott

After 21 years as CEO, legendary pharmaceutical, diagnostic and medical device merger & acquisition strategist and corporate leader Miles White is handing over the reins of Abbott to his planned successor, Robert Ford, Chief Operating Officer and President of Abbott, Inc.

Stanford University and McKinsey alum

Miles White, born in Minneapolis, Minnesota, launched his brilliantly dynamic career beginning with his graduation from Stanford University ( Bachelors in Mechanical Engineering, 1978 and MBA, 1980 ) then signing on at the New York based blue chip management consulting firm McKinsey.

Abbott Laboratories, Inc.

White joined Abbott Laboratories in 1984 and rapidly ascended through the ranks to the senior leadership position of CEO and chairman of the board by 1999.

Once at the helm of Abbott, Miles moved forward with a series of strategic deals which re-shaped the global pharmaceutical, medical device and diagnostic industries.

Abbott acquires Knoll Pharmaceutical from BASF

In 2000 Abbott bought Knoll Pharmaceutical from German chemical and industrial conglomerate BASF ( OTCMKTS: BASFY ) for $6.9 billion. This deal was instrumental in Abbott and eventually spinoff AbbVie’s growth as it included the now multi-billion dollar blockbuster drug Humira (adalimumab - a TNF blocker). Humira’s worldwide annual sales have been as high as $20 billion. White outmaneuvered front-runner Eli Lilly ( NYSE: LLY ),  as well as Bristol-Myers Squibb ( NYSE: BMY ) and Sanofi-Synthelabo ( NASDAQ: SNY ) who were also considered front-runners seeking to acquire Knoll. 

It is something to contemplate how the growth paths of these 3 companies would have evolved had they acquired Knoll or how Abbott would have progressed without Knoll. A further consideration would be how BASF would have succeeded had they not sold Knoll. Humira's commercial success was not guaranteed, undoubtedly Abbott's and White's pharmaceutical business savvy which was carried forth and enriched by AbbVie's strategic capabilities enabled Humira to hit the ground running following its launch with effective market access strategy, a succession of additional FDA approved indications and sales drive outpacing competitors.

Abbott spinoff Hospira acquired by Pfizer

Moving on from the Knoll deal, White formed up Abbott’s older hospital products unit into a separate commercial organization that became the Abbott spinoff company known as Hospira ( NYSE: HSP ) in 2004. When it was introduced as a public company, Hospira had 14 manufacturing plants and sales of approximately $2.5 billion. Hospira was acquired about 11 years later for $17 billion by Pfizer ( NYSE: PFE ) in 2015.

MediSense diagnostic and blood glucose monitoring deals sets the stage for Abbott's long term success in global diabetes care

A second significant corporate maneuver was launched by White in 2004 as Abbott acquired diagnostics and blood glucose monitoring company MediSense for $1.2 billion. Quickly glancing ahead, Abbott and White transformed the MediSense acquisition with its FreeStyle and related product franchises into becoming a global leader in blood glucose monitoring despite numerous low cost competitors entering the sector.

MediSense's primary competitors in the diabetes care space, formidable global healthcare companies to say the least, did not fare so well.  Johnson & Johnson ( NYSE: JNJ ) exited the diabetes care business by selling off their LifeScan diabetes unit in 2018 through a private equity deal to Platinum Private Equity. Germany-based Bayer ( OTCMKTS: BAYRY ) sold their Contour diabetes care franchise to private equity firm KKR and Panasonic Health in 2015. Switzerland based Roche  (OTCMKTS: RHHBY ) significantly downsized its Accu-Chek diabetes care business unit between 2014 and 2018.

Kos Pharmaceuticals acquisition and the unorthodox deal with Boston Scientific to buy Guidant assets

Following the Knoll and MediSense acquisitions plus the Hospira spinoff; Abbott was back in the acquisition saddle by acquiring Kos Pharmaceuticals for $3.7 billion in 2006. Based on this buy, Abbott fortified their cardiovascular health oral pharmaceutical portfolio with two cholesterol agents, Advicor and Niaspan, which aligned well with Abbott's triglyceride product TriCor.

White and Abbott executed a finesse asset deal in 2006 when Boston Scientific acquired Guidant, a producer of cardiac pacemakers, implantable cardioverter-defibrillators, stents and other cardiovascular medical technology. Abbott purchased the vascular intervention and endovascular businesses from Boston Scientific and agreed to share the rights of Guidant's drug-eluting stent programs with Boston Scientific. Abbott paid Boston Scientific $6.4 billion in an arrangement comprised of $4.1 billion for the Guidant assets, a loan of $900 million plus Abbott acquiring $1.4 billion of Boston Scientific common stock. While it was an unconventional arrangement it allowed for Boston Scientific and Guidant to close their deal and avoid antitrust issues with regulators while Abbott was able to secure specific elements of Guidant's product line that it coveted.

GE and Abbott Diagnostics deal unravels 

In 2007 White encountered headwinds as a proposed $8.13 billion deal to sell two diagnostic units ( in-vitro diagnostics and point-of-care) to GE fell through. White had partitioned the diabetes and molecular diagnostics businesses away from the transaction as they had more clinical and commercial upside in their future for Abbott to benefit from. Since GE and Abbott mutually agreed to walk away from the deal, no breakup fees were involved.

Advanced Medical Optics 

Undaunted by the shortcomings of the GE deal, Abbott acquired Advanced Medical Optics or $1.4 billion in 2009. The deal instantly made Abbott a leading player in optical healthcare as Advanced Medical Optics was one of the top companies in Lasik laser vision surgery technology and cataract surgery lenses.

Solvay and Piramal acquisitions

White continued to outdistance the GE deal setback quickly with Abbott acquiring the pharmaceuticals business of Belgium-based Solvay Group for $6.6 billion in 2010. This deal was followed up by another acquisition in 2010 as Abbott bought Piramal Healthcare’s Health Solutions unit for $2.2 billion. As a result Abbott effectively became the largest pharmaceutical drug manufacturer in India.

At this point in Miles White’s vigorous tenure at Abbott he had completed an array of multi-billion deals that expanded the depth and width of the company’s marketplace and competitive scope. Moving forward from 2010 it became clear he was just getting started.

Creation of Abbott spinoff AbbVie in 2011

In October 2011, Abbott made a strategic decision to partition itself into two distinct commercial organizations, Abbott and AbbVie. Abbott’s business model would consist of diagnostics, medical devices, generic drugs and consumer products. AbbVie would be a pharmaceutical and biotech research and manufacturing enterprise that was launched as a publicly traded company in 2013 ( NYSE: ABBV ). Miles White would continue as the senior leader of Abbott while longtime Abbott corporate executive Richard Gonzalez would lead the new AbbVie corporation. AbbVie has moved forward with numerous deals of its own including its latest acquisition of Allergan for $63 billion in 2019.

Kalo Pharmaceutical and Russian drug company Veropharm acquisitions, Abbott Animal Health sale

White picked up the pace in deals again during 2014 in terms of buying and selling assets. In quick succession Abbott, retaining its NYSE symbol moniker “ABT”, acquired CFR Pharmaceutical  Kalo Pharma Internacional S.L. for $2.9 billion and Russian drug manufacturer Veropharm for $410 million. This deal included three manufacturing facilities in Russia for Abbott to establish a presence in this enormous limited market access nation. On a smaller yet still strategic scale, Abbott sold off its animal health unit to Zoetis for $225 million in 2014.

Alere and St. Jude Medical acquisitions in 2016


White kept the pedal to the metal in mergers and acquisitions for 2016 as Abbott picked up Alere for its rapid point of care diagnostics products aligned with infectious disease, molecular, cardiometabolic, toxicology and other patient testing for $5.8 billion. 


Abbott moved forward with another buy in 2016 that was almost 5 times the size of the Alere deal by acquiring St. Jude Medical for $25 billion. St. Jude was primarily built up as a company through a string of more than 15 acquisitions dating back to 1976. Its portfolio included patient care products such as implantable cardio-verter defibullators (ICD); pacemakers; electrophysiology catheters; vascular closure products structural heart repair products and neurostimulation devices as well as diagnostic and testing products for cardiac mapping and visualization systems; optical coherence topography (OCT) imaging systems and other medical technology.


Sale of Abbott vision care unit

 

Sharpening its business focus further, Abbott sold their vision care unit to Johnson & Johnson for $4.3 billion in 2017. Abbott had built up the vision care business with its acquisition of Advanced Medical Optics for $1.4 billion in 2009.


Abbott's future 

 

As chairman of the board, Miles White will still have an important role in Abbott’s affairs. As successor, Robert Ford is at the helm of a global healthcare juggernaut which White has grown from a $75 billion company into a $149 billion enterprise. As the future unfolds, patients, medical professionals, Abbott employees and investors will be expecting more great things from Ford's and White's leadership. 


LinkedIn: John G. Baresky

Twitter: Healthcare Marketing Guy

EBOLA VACCINE BREAKTHROUGH: MERCK DEVELOPS FIRST REGULATORY APPROVED AND LICENSED EBOLA VACCINE "ERVEBO"

by John G. Baresky on 11/12/19

Another vaccine breakthrough by Merck

Merck ( NYSE: MRK ) has announced its Ebola vaccine, Ervebo, has been approved by European regulators.

The product, which has already been deployed in its investigational format in the Democratic Republic of Congo ( DRC ), was cleared by Europe’s “Committee For Medicinal Products for Human Use ( CHMP )" and will be manufactured in Germany.  Merck anticipates it will be able to start shipping Ervebo product to customers by the 3rd quarter of 2020. 

Ervebo’s journey from development to approval

The development of Ervebo was a clinical research and product licensing journey. Canada’s National Microbiology Laboratory was the original developer of the immunization which it then licensed to NewLink Genetics of Ames, Iowa. When the 2014 Ebola outbreak was triggered, Merck licensed it and went to work on further developing the vaccine along with other collaborators.

Genetically engineered

Ervebo is an advanced product that is the result of rigorous research and development efforts. It is genetically engineered to express a glycoprotein from the Zaire ebolavirus so as to provoke a neutralizing immune response to the Ebola virus. Merck was able to not only fully prove the efficacy of the immunization but also demonstrate its ability to mass produce it at premium quality levels to assure reliability and safety of the product.

Until full commercial production is underway, the prototype / investigational formulation of the vaccine will continue to be deployed in Congo which has a population of about 92 million people through oversight by the U.S. Federal Government, World Health Organization ( WHO ) and vaccine alliance GAVI. Ervebo requires the administration of only one injection for it to be effective; another investigational Ebola vaccine being distributed in Congo to counter the Ebola outbreak is produced by Johnson & Johnson and requires two injections.

The U.S. Food and Drug Administration expects to review the product for potential approval to be used within the United States during the first half of 2020.

Ongoing Ebola outbreak threat

Since it first started in August 2018, the Ebola outbreak underway has killed more than 2,100 people.  

Why and how Ebola is such an enormous health threat

Ebola Virus Disease ( EVD ) is an uncommon and deadly disease in people and nonhuman primates. Viruses causing EVD are found primarily in sub-Saharan Africa. People can get EVD through direct contact with an infected animal (bat or nonhuman primate) or person; including the dead bodies of EVD victims.

Ebola virus has a harmful and often fatal impact on the ability for  blood to clot. This condition is described as hemorrhagic fever virus as the clotting disruption it causes leads to internal bleeding from blood leaks in the small blood vessels of the body. 

The Ebola virus creates further issues as it causes severe inflammation and tissue damage. Due to being so deadly as well as contagious, Ebola is a major challenge for the individuals it infects and furthermore is a ruthless danger for caregivers and medical professionals who not only care for the Ebola patients but must also take thorough precautions to protect themselves.

Ebola's Deadly History

The Ebola virus was initially discovered in 1976 near the Ebola River in DRC. Over the last 40 years, there have been several severe Ebola outbreaks. Previous to the current outbreak ( which is now ranked as the second worst to date) the West African Ebola epidemic resulted in about 30,000 EVD cases and more than 11,000 deaths between 2014 and 2016. 

Merck is a global leader in vaccine / immunization development

The commercial development of Ervebo is another vaccine development victory for Merck who has had a long standing commitment to global vaccine development. Its HPV STD and Oncology vaccine, Gardasil, has saved millions of lives and generated considerable savings for consumers, medical professionals and payers.  

LinkedIn: John G. Baresky

Twitter: Healthcare Marketing Guy

6 PILLARS OF MARKET ACCESS STRATEGY FOR HEALTHCARE EMERGING MARKETS

by John G. Baresky on 11/08/19

A pivotal element in global healthcare marketing initiatives

The global healthcare marketplace continues to evolve. Pharmaceutical manufacturers, medical device manufacturers and healthcare service companies have promising opportunities through emerging markets. These patient / customer bases are multiplying in population and in financial resources generating a greater demand and means for better healthcare. 

Seeking new revenue streams dependent upon regulatory, clinician and payer factors 

Pharma, device and health services firms, always seeking growth and new revenue streams, can look to these regions and countries to extend their reach and boost bottom lines. Comparatively speaking, many of these markets are experiencing exponential population and financial growth while numerous North American and European markets have matured and have slowing, flat or regressing clinical and commercial opportunities. Further challenges are presented by well-entrenched incumbent competitors able to maintain more than their “fair share” of the market.

Key growth drivers in emerging markets

A combination of factors improves the alignment of potential for growth of clinical and commercial opportunities in emerging markets. They include these and other developments:

Changing healthcare needs

As emerging markets evolve, their healthcare challenges and requirements develop new characteristics. They encompass these and other factors:

  • Birth rates climb and life expectancy lengthens
  • Legacy illnesses / disease native to specific locales and regions decline but remain a threat in rural or remote areas
  • New diseases and health challenges emerge based on a higher quality of living including alcoholism, diabetes, hypertension, obesity, sexually transmitted diseases
  • Increasing populations increasing strain on metropolitan living / sanitary conditions and surrounding natural resources 

Examples of emerging market nations / regions

Multiple continents and geographic centers host emerging markets. The primary emerging market leaders ( listed alphabetically ) are:

  • Brazil
  • Chile
  • China
  • India
  • Indonesia
  • Mexico
  • Philippines
  • Russia
  • South Africa
  • South Korea
  • Turkey

Setting the stage for clinical and commercial success

In established or emerging markets, growing from scratch or expanding from a sliver of market share and sales can be daunting and costly. By identifying and accounting for hurdles upfront, it’s easier to avoid bottleneck delays and cost overruns to maintain momentum. Strategic preparation focused on the specific attributes of a new market instead of a generalized approach will enable you to develop the necessary building blocks to succeed as your competition struggles. 

Prioritizing the right potential markets from the start

The array of emerging markets requires selectivity and alignment according to your organization and its products or services. Prioritizing the best ones increases your chances of success and establishes a base of experience and education to succeed in future ones. Assuming commercial viability of your product or service has been confirmed based on these considerations; these are 6 pillars of strategy to build your growth on.

Pillar One: Embrace the regulatory environment, structure and process

Nations and regions have their own way of governing clinical and commercial healthcare activities within their borders. Do not assume your teams can learn on the go. Be certain you have staffed up with persons who have experience in the specific market you are centered on and have existing contacts within regulatory agencies, provider organizations and supply chain entities. This helps assure you navigate the approval process and can speed forward into the market once your offering receives clearance. 

Pillar Two: Understand patient care topography

Treatment protocols and access to care can differ greatly within the boundaries of even small nations. Neglecting to engage even one or two centers of care like a remote hospital or clinic can cost you hundreds or even thousands of patients. If those entities are missed, your losses could multiply if their patient base expands due to marketplace growth changes and competitors exploit your errors. Stratify points of care and their nuances:

  • Metropolitan
  • Semi-rural
  • Rural
  • Remote

Be cognizant that an area can robustly change based on investment in manufacturing, shipping or other commercial activity. New business opportunities quickly attract new workers with healthcare needs to their locales

Pillar Three: Familiarize yourself with clinicians, protocols, customs

Established nurses, doctors, pharmacists and other members of the healthcare provider community need to be consulted early and often. This will accelerate your learning curve and help these future customers become intimately familiar with your company, its products and services and increase their comfort level. Do not rely on assumptions, syndicated reports or second-hand “expert” knowledge to base your strategy and tactics on. Even small disconnects will leave gaps competitors will fill quickly.

Be prepared that “new” is not always immediately perceived as better. Certain drugs, medical devices and procedure protocols have been in place for decades in many emerging markets. Think simplicity, utility and economy; generic drugs, basic devices, outdated apparatus and equipment retrofitted for improvised use to make do with whatever was available at the time and thus has become the standard for care. 

Effectively introducing new therapies, devices and equipment accompanied by new methods takes time and money. Engaging the key clinician stakeholders and accounting for their personal, professional and organizational personas will make for a more productive introduction and quicker acceptance of your offerings. Distinct care, cost and overall outcome advantages must be featured in a value proposition meeting the requirements of each emerging market you enter and the decision making stakeholders involved.

Pillar Four: Unconventional or restrictive distribution and procurement processes

Emerging markets have their own unique ways to facilitate the flow of goods and services into and through points of care. Reflect on how wholesalers, distributors, suppliers, GPOs, dealers and other supply chain, logistics and trade relations entities differ within cities, states, nations and regions in established markets. This goes for evaluation, procurement, materials management and requisitioning processes and procedures within healthcare provider organizations. The primary difference is your organization has become familiar with these channels and routines.

You will now have to repeat this process in an emerging market. Be certain to act on it quickly because your competitors could thwart your success early on if they adapt earlier than you. The sooner you accept and adjust your processes in accordance with the emerging market’s structure and material flows the better your operations will perform and ease the way for customers to use your products and services.

Pillar Five: Contracts and pricing

While emerging markets usually possess a surge in economic prosperity, do not assume this translates to a maximum in your margin ask. It is also necessary ( and this should have been a part of your emerging market commercial viability assessment ) to understand the contracting, pricing, exclusivity and other features within each emerging market you choose to enter. The similarities between emerging markets may seem to mirror each other but even one financial requirement or clinical mandate may disadvantage your marketing, sales and pricing strategies from the start.

Supply chain players and provider organization processes aside, knowing the payer landscape inside and out for each emerging market you choose to enter is a pivotal advantage. By possessing this, you have the opportunity to lock in a new market with the assurance your products and services will flow freely in the direction of your customers and their payments back to you will be just as smooth. 

Government-sponsored healthcare can be a norm in emerging markets you will have to account for.  As emerging markets develop, government healthcare programs may improve while conventional payer business models become more common as outside companies establish their presence and introduce benefits plans to workers plus organizations native to the marketplace modernize their healthcare offerings. Updated or new healthcare plans offered by insurance carriers or employers will still need to meet the cost, coverage and feature requirements of government regulators. 

Improvement of government payer healthcare benefits and the presence of more commercial healthcare insurance plans entering an emerging market are good building blocks to center market access contracts and pricing strategies on.

Pillar Six: Maximize competitive immunity

Throughout development and execution of your market access strategy, continually refine and reinforce your competitive position. Emerging markets are attractive to all players; many will deploy all means necessary to enter them including drastic price plays, unrealistic guarantees and other measures. Anticipate these threats from the start and be certain your contracts are well-secured and have sound contract extension / renewal strategies in place to minimize opportunities for competitors to penetrate your established base of market share and sales. Monitor government or provider policy changes that may disadvantage your position and move in advance to rectify any weaknesses these create.

Moving forward

Taking the journey into emerging markets can be a rewarding venture by avoiding the mistake of focusing too much on the raw potential of a new opportunity and not centering on intricacies involved to assess, develop and maintain successful market access strategies and tactics from the beginning. Launching a product or service in an established or emerging market can be costly and risky no matter how innovative they are. It is important the resources allocated to entering emerging markets ( time, money, staff and other provisions ) are deployed efficiently and effectively to minimize waste and maximize traction. 

In emerging markets, it is imperative to account for the customs, needs and requirements of regulatory gatekeepers, logistical channels, clinical and commercial stakeholders to formulate an effective market access strategy -and do it better than your competition.

LinkedIn: John G. Baresky

Twitter: Healthcare Marketing Guy

WILL WALGREENS BE ACQUIRED BEFORE THEY GO PRIVATE?

by John G. Baresky on 11/06/19

A substantial private equity play

Reportedly Walgreens ( NASDAQ: WBA ) is exploring options to take itself private. Officially known as Walgreens Boots Alliance, the global pharmacy and consumer healthcare leader going private would create one of the largest leveraged buyouts in history.

A consumer retail, pharmacy, healthcare services, supply chain leader

Taking Walgreens private may involve an estimated range of $50 billion to $60 billion to execute the transaction. Most of the company’s global scope and scale are overlooked by consumers and even those in the healthcare sector:

  • Founded in 1901, their present CEO, billionaire Stefano Pessina, owns about 16% of the company
  • On a daily basis, Walgreens interacts with over 8 million customers in stores and online
  • They operate more than 9,000 stores in the United States and more than 13,000 units worldwide in 11 countries.
  • Walgreens owns 28% of AmerisourceBergen ( NYSE: ABC); one of the world’s largest drug wholesalers
  • They are a minority share owner of Option Care Health; one of the largest home infusion providers in the nation servicing patients in all 50 states and administers over 2 million doses of various IV therapies per month
  • About 78% of the population in the United States lives within 5 miles of a Walgreens store or a Walgreens-owned Rite Aid or Duane Reed store.
  • Walgreens has an active partnership with Blue Cross Blue Shield affiliated prescription benefit manager Prime Therapeutics known as AllianceRx Walgreens Prime
  • The company has select business collaborations underway with grocery retail giant Kroger ( NYSE: KR ) 
Walgreens is launching significant cost reduction measures to reduce debt, boost earnings

The company recently announced a corporate cost cutting initiative with a goal of $1.8 billion in expense reduction by 2022 -an amount that was increased from an original objective of $1.5 billion.

One portion of it consists of closing about 40% of its in-store clinics as it initiates new strategies to boost profitability. The clinics selected to close are those which are operated by Walgreens. The remaining store-based clinics operated through partnerships with healthcare provider organizations such as hospitals or healthcare systems will remain open.  About 150 clinics are impacted by this and slated to be closed by the end of the year.  Over 200 clinics will continue to run through the existing healthcare provider partnerships.

Opportunities to partner with an industry leader

This announcement triggered hospitals, health systems and other healthcare provider organizations located near the units with clinics designated to be closed to inquire about taking over those operations. TriHealth, a 5-hospital healthcare system in Cincinnati, Ohio has already moved forward for the opportunity to operate 7 of the in-store Walgreens clinics in their area.

Investment required for a Walgreens Boots Alliance private equity deal may involve several players

The estimated $50 billion to $60 billion required to take Walgreens private is quite a large sum. It is likely more than one investment firm would be needed not just for the funding but to share some of the risk involved. Private equity firm KKR already has a stake in the company from past deals with the organization. A key consideration in taking the company private is managing its current debt load which is about $17 billion. Reportedly Walgreens is working with investment banking advisement firm Evercore to assess what is involved to proceed further.

Does the prospect of Walgreens going private trigger someone else to buy them?

Based on its many attributes, Walgreens is an extraordinarily valuable company and potentially a target for another type of ownership change. It generates over $136 billion in annual sales. Conceivably another company could make a run at acquiring Walgreens before they went private. Key considerations for another retailer to buy Walgreens would include the financing of the deal itself, integrating the new organization and assuring profitability while servicing their existing debt and the new debt of the deal --which would have the added burden of Walgreens' existing $17 billion debt load. 

Unique potential that demands a solid suitor

It is very unlikely their largest retail pharmacy rival, CVS, to even consider acquiring them based on antitrust issues and their recent acquisition of insurance company Aetna but there are several other potential buyers to think about.

Despite Walgreens' debt load and the scale of a deal, their consumer retail and pharmacy business savvy plus technology and logistics leadership are undeniably platinum assets not to mention excellent store locations and large share ownership of AmerisourceBergen.

Largest contenders would have to confront enormous operations and financial challenges

On the surface, there are some big retail and online players to consider. Once the fiscal and organizational details are looked at more closely, only a small number of companies are viable contenders:

Amazon is a viable long shot but several factors must be considered. They generate about $233 billion in annual sales. They are not acquisition or risk adverse. Walgreens would give them direct penetration into numerous retail markets and access to millions of everyday consumers and prescription drug customers. Amazon has already stepped out of its online-only business model through its acquisition of Whole Foods in 2017 for $13.4 billion and opening of Amazon Go stores. Walgreens stores gives them a strategic storefront presence without having to commit to larger retail footprints like grocery outlets or mass merchandisers. The Walgreens store concept is based on walk-in consumer convenience as are Amazon Go stores. 

Amazon is seeking to widen its business in healthcare and fortify its PillPack unit. A Walgreens deal would be gargantuan even for them.  It offers incredible opportunities as well as challenges which makes it conceivable for Amazon to at least mildly consider.

Kroger is currently collaborating with Walgreens on a few initiatives. Kroger recently announced it was moving forward with cost cutting initiatives. The combination of Kroger, the nation’s largest grocery chain, and Walgreens would be a formidable tandem. Kroger is the world’s third largest retailer with over $119 billion in yearly sales; they trail only Walmart and Costco Wholesale. Their combination is viable; it would reasonably diversify and complement their existing business models and customer bases.

Netherlands-based Ahold could be another contender based on domestic and global market potential. Ahold operates stores in numerous global markets as well as the United States. Their annual sales are roughly $73 billion. Picking up Walgreens would widen their business model and add revenue streams to their bottom line in the U.S. and Europe but financially it's out of their reach.

Grocery chain Albertsons ( NYSE: ABS ) generates about $60 billion in annual sales. Their acquisition of Walgreens would be a stretch but enable them to broaden their organization beyond the grocery sector and give them exposure into more geographic markets. The financial scale of the deal even without the $17 billion debt load is not something Albertson's can consider in their plans.

Costco ( NASDAQ: COST ) produces over $142 billion in yearly sales could pull it off but may not be the best fit in their business model. Acquiring Walgreens would indeed diversify their business model which could be a primary reason for them not to explore a deal outside of the scope of where they have had such great success. It would indeed provide them opportunity to augment their overall presence in consumer health and pharmacy sectors. Such an extreme departure from their winning commercial formula has its pros and cons. Financially Costco could have the fiscal horsepower to undertake such a deal but likely not consider the rewards to be worth the risks. 

Target Corporation ( NYSE: TGT ) generates about $75 billion in annual sales --its relationship with CVS a major hurdle to overcome. Buying Walgreens would be a significant hurdle for them financially and involve another sticking point. Target’s pharmacy units within their stores are owned / operated by CVS. If Target were to acquire Walgreens, the CVS pharmacy ownership arrangement would someway have to be undone. Target Corporation is not going to entertain an acquisition of Walgreens.

Walmart ( NYSE: WMT ) is an interesting and qualified prospect for numerous reasons. A number of former Walgreens pharmacy executive leaders are presently working at  Walmart headquarters within the U.S. pharmacy business unit. Walmart generates over $514 billion in annual sales. Walmart and Walgreens have been dueling over consumer and pharmacy sales for years despite their differing big box versus chain drugstore business models. Walmart has experimented with smaller footprint stores to efficiently and profitably gain access to more retail customers. Buying Walgreens would give them that access plus bolster their consumer health and pharmacy business.

Undoubtedly antitrust concerns would come into play but there may be enough differentiation based on the pairs' big store / mass merchandiser and convenience retail / pharmacy organizations that regulators would approve the combination.

Moving forward

There is a lot for Walgreens, its competitors, investors and potential suitors to consider. Based on this lineup, Amazon Kroger and Walmart are potential suitors; Costco a runner up based on a presumed reluctance to tamper with its unique and successful business model. The attractiveness of a present-day opportunity to acquire Walgreens is great, the long-term commitments and challenges still have to be considered. A takeover by public or private entities requires the new ownership to undertake swift, strategic action to boost Walgreens profitability without disrupting day-to-day operations and whittle down its $17 billion debt load; a tough prescription to fill.

LinkedIn: John G. Baresky

Twitter: Healthcare Marketing Guy

STRYKER CORPORATION BUYING WRIGHT MEDICAL FOR $4 BILLION

by John G. Baresky on 11/05/19

Stryker continues to advance its position in medical device, orthopedics and health technology

Stryker Corporation ( NYSE: SYK ) is acquiring medical product manufacturer Wright Medical for $4 billion. Wright Medical ( NASDAQ: WMGI ) was started in 1950; it manufactures an array of products aligned with orthopedics including fixation and fusion systems designed for ankles, elbows, shoulders, toes and wrists. 

Wright Medical and Stryker overview

Wright's U.S. headquarters is located in Memphis, Tennessee; global operations are orchestrated in Amsterdam, the Netherlands and London, UK.

Stryker Corporation, founded in 1941 and based in Kalamazoo, Michigan, produces numerous categories of products used throughout the healthcare sector including implants used in joint replacement and trauma medical procedures; surgical equipment and surgical navigation systems; endoscopy and communications systems; patient handling and emergency medical equipment. Stryker also manufactures neurosurgical, neurovascular and spinal devices plus a variety of other healthcare specialty products.


Acquisitions a key element in Stryker's growth


Mergers and acquisitions continue to be a go-to strategy in the medical device and pharmaceutical healthcare industry sectors to catapult growth and reduce costs. Stryker acquired Mobius Imaging and Cardan Robotics in September, 2019, for $500 million. Since 2016, Stryker has spent over $12 billion to acquire these and other companies: 

  • Arrinex
  • Entellus ( $664 million ) 
  • Hygia Health Services
  • HyperBranch Medical Technology ( $220 million )
  • Invuity
  • K2M ( $1.4 billion ) 
  • Mobius ( $500 million )
  • Orthospace ( $220 million ) 
  • Patient Safety Products
  • Physio Control ( $1.28 billion ) 
  • SafeAir
  • Sage Products ( $2.8 billion )
  • Scopus
  • TSO3

Stryker a robust contender in the Fortune 500 and healthcare business sector

Stryker continues to climb in the Fortune 500; currently ranked at #233 and employs over 36,000 persons. The combination of Stryker’s and Wright Medical's products will form a robust portfolio of devices, implants, equipment and technology for hospitals, health systems, surgery centers and other medical provider organizations. Their competitors include:

  • Catalent ( NYSE: CTLT )
  • DJO Global ( privately held ) 
  • Getinge ( OTCMKTS: GNGBY )
  • Hillrom ( NYSE: HRC ) 
  • Johnson & Johnson ( NYSE: JNJ )
  • Medline ( privately held ) 
  • Medtronic ( NYSE: MDT ) 
  • Smith & Nephew ( NYSE: SNN )

The two organizations expect to finalize their transaction by mid-2020 pending final approval by each organization and regulatory agencies. 

LinkedIn: John G. Baresky

Twitter: Healthcare Marketing Guy



NEW DATA INDICATES MEASLES DAMAGES IMMUNE SYSTEM MEMORY: 2 NEW CLINICAL STUDIES

by John G. Baresky on 11/01/19

Far reaching effects of Measles

The results of two clinical studies centered on the lasting effects of the Measles virus reinforce the importance of immunization and other preventative measures. There is evidence the Measles virus not only exerts the symptoms of its illness upon those it infects but advances further into human immune cells and tampers with their “memory” attributes which can lessen their ability to rearm themselves and defend against other infections.

The two studies are:

Measles Virus Infection Diminishes Preexisting Antibodies That Offer Protection From Other Pathogens

Incomplete Genetic Reconstitution Of B Cell Pools Contributes To Prolonged Immunosuppression After Measles

Measles more complex than most realize

A pivotal concern with Measles is its impact upon children and their ongoing health as they mature through adolescence and into adulthood. The data indicates children infected by the Measles will possess weakened immune systems following their recovery from the disease. Further study will be required to learn more about how long and how severe post-Measles weakened immune systems persist.

The concept of immune cells losing their ability to fight infection has been referred to as “immune amnesia”. Measles beats up on white blood cell counts but even as a person recovers, their system remains compromised for an undetermined amount of time. The studies indicate immune systems retain their sensitivity and defensive response to Measles to prevent re-occurrence of Measles infection but lose their ability to recall the defensive postures developed over time to ward off other infections they have encountered.

Global emergence of Measles is a critical challenge 

Unfortunately, for a variety of reasons, the World Health Organization ( WHO ) has estimated the incidence of Measles on a global scale has increased by 280%.

The United States is entering Flu season --yet the challenge of Measles is still underway:

  • From 1/1/2019 to 10/1/2019, a total of 1,249 measles cases and 22 measles outbreaks were reported in the United States
  • The numbers are critically important as they are the most cases reported in the United States within a single year since 1992 --and the second highest ranking number of reported outbreaks annually since measles was declared "wiped out"  in the United States in 2000
  • Among the 1,249 measles cases reported in 2019, 1,163 (93%) were associated with the 22 outbreaks, 1,107 (89%) were persons who were not vaccinated or had an unknown vaccination status --and 119 (10%) measles patients were hospitalized
  • The emergence of a surge has serious implications as there is true potential for cases to multiply quickly; it presents a large scale health threat that had been minimized through decades of medical research, pharmaceutical manufacturing expertise, rigorous immunization schedule planning and vaccine administration

Clinicians, government and consumers taking action

Moving forward, it is important that parents, pediatricians and other medical professionals take assertive steps to be certain preventative care healthcare regimens follow the complete schedule of recommended immunizations ( unless clinically recommended otherwise ) and this includes the Measles vaccine.  Please find below details about the Measles vaccine and other immunization recommendations from the Centers for Disease Control and Prevention:



UNITEDHEALTH GROUP ACQUIRES REMOTE PATIENT MONITORING TECHNOLOGY COMPANY VIVIFY HEALTH

by John G. Baresky on 10/31/19

UnitedHealth Group Embraces Telehealth

Telehealth continues to build momentum in the United States; and UnitedHealth Group’s acquisition of Vivify Health exemplifies this trend and will help drive it further. Vivify, based in Plano, Texas ( a suburb of Dallas ) centers on remote patient monitoring technology. It enables individuals to be monitored while they are home and as symptoms, vital signs and other variables change, healthcare providers can be notified. This can prevent emergency room visits as well as facilitate a nurse visit to the home of the patient to care for them before conditions progress to a more serious state. 

Vivify's Patient Care Attributes

Vivify utilizes mobile, cloud-based information technology and its own suite of healthcare software applications which encompass these and other capabilities:

  • Biometric data monitoring
  • Personalized care plans
  • Text-to-speech configured to the needs of each patient
  • Video education and conferencing

Some of the patient care issues Vivify technology supports includes:

  • Asthma
  • Chronic Obstructive Pulmonary Disease ( COPD )
  • Congestive Heart Failure
  • Diabetes
  • Hypertension
  • Oncology
  • Pain Management
  • Weight Management

Vivify Deployed With Healthcare Provider Organizations 

UnitedHealth Group’s Optum business unit orchestrated the deal. Vivify, which was founded in 2009, is used by these and other healthcare provider and service organizations:

  • Alignment Health
  • American Medical Response
  • Ascension Health
  • Children’s Hospital of Colorado
  • Interim Healthcare
  • Memorial Hermann
  • Ontario Telemedicine Network
  • SCL Health
  • Shannon Medical Center
  • Trinity Health
  • University Health Network ( Canada )
  • University of Vermont
  • University of Pittsburgh Medical Center ( UPMC )
  • Vanderbilt University Health

UnitedHealth Group's History Of Acquisitions

The acquisition of Vivify is part of UnitedHealth Group’s ongoing initiatives to change its business model. They are going beyond being a healthcare plan / healthcare insurance firm or managed care organization and building themselves out as a healthcare provider organization. Recent mergers, acquisitions and investments it has made include:

  • Surgical Care Associates ( $2.3 billion )
  • DaVita Medical Group ( $4.3 billion )
  • Reliant Medical Group ( $28 million )
  • Equian, a healthcare billing firm ( $2.3 billion )
  • A hearing aid health insurance company and a sizable investment into a physician staffing firm

As other plans, such Anthem and Aetna, have chosen to expand their covered lives, conventional managed care plans and PBM units, UHC has chosen a different route. By acquiring medical practices and provider organizations, UHC has more direct influence on patient care, treatment protocols and costs associated with them. 

UnitedHealth Group's Business Model Expands

Through adding SCA and the other medical provider organizations to their business model, it provides different streams of revenue for UHC.  It also improves their position to negotiate rates with other health systems and care providers. While United Healthcare has a long way to go to reach the scale Kaiser Permanente has in terms of being a patient care services provider, its investments in the provider sector seem to indicate they have a long term plan to strategically grow the provider side of their business.

Terms of the Vivify Health transaction were not disclosed. As an integrated healthcare enterprise, Vivify and United Healthcare can develop their own proprietary telemedicine solutions according to their specific requirements which other health plans and provider organizations will have to coordinate with outside partners. The acquisition of Vivify adds a new resource dimension to UnitedHealth Group which it can deploy in its own healthcare provider organizations to save money while marketing it to existing Vivify Health customers as well as new clients to increase revenue.

LinkedIn: John G. Baresky

Twitter: Healthcare Marketing Guy


WALGREENS NEW COMMERCIAL STRATEGY AND COST CUTTING MEASURES

by John G. Baresky on 10/28/19

Part Of The Walgreens Boots Alliance New Business Strategy: In-Store Clinic Closings Plus Grocery, Weight Loss And Healthcare Provider Partnerships

Walgreens ( NASDAQ: WBA ) will close about 40% of its in-store clinics as it initiates new strategies to boost profitability. The clinics selected to close are those which are operated by Walgreens; the remaining stores operated through partnerships with healthcare provider organizations such as healthcare systems will remain open.  About 150 clinics will be impacted by the new strategy and closed by end of the year.  Over 200 clinics will continue to run through the healthcare provider partnerships. Walgreens was proficient at operating their company-owned clinics but was not satisfied with their profitability levels and prefers to allocate resources to other more profitable ventures.

In-Store Consumer Clinic Care

Walgreens clinics typically provide care for minor healthcare needs such as vaccinations, flu, moderate respiratory infections, urinary tract infections, strep throat, school physicals and other patient services.  The closing of the clinics will draw the attention of healthcare provider organizations and perhaps serve as a catalyst for new partnerships to be formed between Walgreens and healthcare systems in those markets. For those stores in which the clinics are not taken over by an outside entity, the space dedicated to clinic care will be repurposed.

Advantages Of Partnering With Healthcare Systems

Health systems, for example Advocate Health Care System in the Chicagoland area, have benefited from operating clinics in Walgreens stores.  They are an extension of care services provided outside of hospitals and help to retain patients within the health system’s realm for other medical needs in the future. For consumers, in-store clinics are all about convenient access to care and for Walgreens ( or other in-store clinic operators like CVS, Walmart, etc. ) they seek to pull more customers into their stores which helps drives pharmacy as well other sales throughout a retail unit.

In-Store Clinic Competition

As an immediate care provider, in-store clinics do face competition on several fronts. Competing health systems often own / operate care clinics and there are metropolitan and regional chains of immediate care clinics which compete for the convenience care needs of consumers.  Telehealth is an emerging competitor in the convenience care space with services provided through kiosk terminals, smartphones and other digital platforms ( tablets, laptops, etc.).

CVS And Walmart Always A Threat

Competitors like CVS ( NYSE: CVS ) and ( NYSE: WMT ) have been making some big splashes lately. CVS acquired health insurer Aetna and operates clinics and pharmacies in its own stores as well as mass merchandiser Target ( NYSE: TGT) stores.  Walmart is expanding its patient care business with pilot programs in their stores including featuring primary and urgent care, labs, x-ray and diagnostics, counseling, dental, optical and hearing services all in one facility.

Walgreens Has Ample Locations, Brand Recognition, Multi-National Presence, Several Business Units

Walgreens operates over 9,000 stores in the United States and overall just over 13,000 worldwide in 11 countries. They also own 26% of giant drug wholesaler AmericansourceBergen ( NYSE: ABC ) and a minority share owner of home infusion provider Option Care Health. 78% of the U.S. population lives within 5 miles of a Walgreens store (or Walgreens-owned Rite Aid or Duane Reed store). Founded in 1901, Walgreens interacts with over 8 million customers per day in stores and online.

Walgreens Pivotal Cost Cutting Goals

A big focus of Walgreens new strategy is cost cutting and they have shared their goal of $1.8 billion in expense eliminations by 2022. This amount was increased from an original mark of $1.5 billion. Staff reductions, strategic outsourcing and assertive vendor contract negotiating are some of the key elements involved.  

Beyond Cost Cutting And Into New Revenue Generating Options Or Even Bigger Deals

While reducing expenses is important, it is certain Walgreens has other commercial initiatives within their plans to increase sales and drive innovation both in retail consumer and healthcare sectors. The company is beginning a new initiative with weight loss leader Jenny Craig in 100 of its stores. Walgreens has established partnerships with Blue Cross Blue Shield PBM Prime Therapeutics ( AllianceRx Walgreens Prime) and have various initiatives underway in collaboration with Kroger ( NYSE: KR ).

Food For Thought; Is Walgreens Preparing For A Large Strategic Acquisition?

CVS / Aetna ( and Target pharmacies ) is a sizable combination as is Cigna / Express Scripts. The threat of Amazon ( NASDAQ:AMZN ) goes up and down the retail pharmacy, mail order pharmacy and big box mass merchandiser sectors; Amazon is assertively expanding it healthcare business enterprise which includes its online pharmacy business unit PillPack  and recent acquisition of Health Navigator). 

UnitedHealth Group ( NYSE: UNH ) continues to bulk up with PBM and MCO pharmacy and healthcare benefit plan capabilities and is expanding further into patient care services through acquiring various medical practice groups and a large scale medical billing service company. 

Perhaps Walgreens Boots Alliance is slimming down and optimizing in preparation for it to make a large scale acquisition or perhaps has Kroger or Walmart expressed an interest in acquiring them?

LinkedIn: John G. Baresky

Twitter: Healthcare Marketing Guy



AMAZON BUILDS HEALTHCARE ENTERPRISE WITH ACQUISITION OF HEALTH NAVIGATOR

by John G. Baresky on 10/24/19

Amazon ( NASDAQ: AMZN ) continues to trek forward into the healthcare industry with another acquisition; Amazon has purchased a healthcare startup known as "Health Navigator".

Health Navigator, based in Chicago, Illinois, is a clinical healthcare information firm founded by an emergency medicine physician, Dr. David Thompson, which provides these and other solutions: 

  • After Care Instruction
  • Clinical Documentation Support
  • Coded Chief Complaints
  • Diagnosis Engine
  • Natural Language Processing
  • Non-Commercial Research Database*
  • Triage Engine

References for evidence-based clinical decision making

The *resource database features over 25,000+ Internet resources comprised of non-commercial websites linked to more than 2,800 clinical concepts?—?plus has over 7,200 references in the database of which quite a few are directly linked to the reference through a PubMedIC

Health Navigator works with these and other applications or functional providers:

  • Answering Services
  • Digital Health Assistants
  • Electronic Health Records ( EHR / EMR )
  • Medical Call Centers
  • Telemedicine

Some of Health Navigator's current client partners include Avizia, MDLIVE, Microsoft, NextGen and RUSH Medical.

As part of their enterprise-wide rollout internally and externally of healthcare innovation, Amazon will be deploying Health Navigator within its recently launched Amazon Care employee healthcare provider program.

Between its agreement with Oasis Medical ( a family practice organization based in Seattle, WA ) to serve as a provider for its Amazon Care employee health program, the acquisition of  Health Navigator and its partnership with the Pittsburgh Health Data Alliance and with Cerner Amazon is not deterred from its healthcare mission despite the ongoing issue with its PillPack online mail order pharmacy unit and Surescripts

As Amazon moves forward, it will be interesting to see how its actions are reflected within the realm of Haven Healthcare, its healthcare management partnership initiative with Berkshire Hathaway and JPMorgan Chase. The organization is seeking ways to improve quality of care while reducing cost. 

Amazon is clearly investing a considerable amount of staff, financial and technical resources to support its own employee medical care program as well as develop commercial opportunities for the future. It is navigating multiple channels in healthcare, developing partnerships and making strategic acquisitions which for now are submerged threats to unsuspecting, less strategic competitors.

LinkedIn: John G. Baresky

Twitter: Healthcare Marketing Guy



PRACTICAL INNOVATION FOR HEALTHCARE DIGITAL MARKETING: 5 OPTIONS

by John G. Baresky on 10/15/19

Ongoing Strategic Digital Marketing Innovation Prevents Competitive Stagnation 

Healthcare digital marketing initiatives need to stay ahead of the pace as patient care, technology and competitor innovation never stagnate. Even when digital assets are performing at peak levels and sales are robust, there is already room for improvement. These are 5 options to consider to fortify existing digital marketing attributes or establish new ones:

Video Features

Video is a go-to norm now in healthcare websites being driven by ever-growing adoption and technology improvement across Facebook, Instagram, LinkedIn, Pinterest, Tumblr, Twitter, YouTube and other social media venues. Live, recorded or animated, use of video has proven to be  directly proportional to higher engagement, user retention and satisfaction. 

Assess existing video assets for updating or enhancement and focus on where new video assets can augment them and other digital marketing measures. Strategically direct time, financial and technical resources to maximize their effectiveness to drive sales.

Artificial Intelligence and Chatbots

Artificial Intelligence ( AI ) is taking the business and healthcare world by storm. Through deploying it in websites, it scrutinizes search patterns, visitor behavior and buyer characteristics to base content improvements on or in real-time deliver personalized text copy and imagery to align with a customer’s journey. Additional investments can lead to developing predictive lead scoring, advanced trigger-based campaigns and further measures to sharpen lead inbound or outbound lead generation actions. 

Chatbots are a great example of the real-time user engagement phenomenon. They can be integrated into a healthcare website, mobile appl, social media venue or other applications to facilitate customer service interaction, lead generation or immediately serve up data and other content to digital audiences.

Content Marketing

Clicks don’t count when they don’t convert to meaningful interaction and sales performance; how demanding are you of your mainstay digital resources? Are you assertively evaluating visit duration, website visit pathways and bounce rate? Are your blog and parallel assets merely existing as standard website features or are they delivering value to users, cultivating productive engagement and driving sales? 

Asking these questions and acting on them appropriately will uncover digital nuggets of opportunities hiding in plain sight. Those vast SEO reports contain valid, focused insights that justify going over them more than once. Be cautious not to change things up just for the sake of variety; strategically isolate specific elements for modification and enhancement then critically assess performance improvements.

Programmatic Advertising

Using automation to orchestrate buying, selling of online ads, television commercials, streaming modules, voice and video to digital-out-of-home media plus other applications is proliferating behind the scenes. Savvy healthcare digital marketing and advertising professionals are using it to make real-time decisions to embrace economic, effective outreach opportunities on the fly and generate trend data quicker for use with these measures and coordinate with other digital marketing assets.

Programmatic advertising is typically not an in-house competency for healthcare organizations, pharmaceutical and medical device manufacturers or service providers. Research its potential then evaluate how it may benefit present and future marketing and adverting goals. If there is a fit, assess the competency of your present advertising / marketing vendors and assess what others have to offer to succeed with programmatic advertising initiatives.

Voice Search

Consumer and commercial engagement of Alexa, Cortana, Google Home and Siri is exponentially multiplying and its on-demand, hands-free attributes have great utility in the healthcare setting. Exploring and piloting new voice search technology or fortifying existing voice search applications can push your digital marketing outreach and engagement levels ahead of the competition. Amazon Alexa, Microsoft Cortana, Alphabet Google Home and Apple Siri are investing heavily in voice search and interaction technology plus there is an array of other healthcare ventures devoted to exploiting its great potential. 

Based on technology advancement and user adoption trends, proficiency in the sophistication of voice technology to engage patient, clinician and business stakeholders for healthcare digital marketing purposes is well on its way to becoming a norm.  Voice search boosts user experience. Due to its prolific use, Google and other search engines are placing a higher emphasis on voice search optimization. This will likely pave the way for SEO performance and voice search ranking measurements in reporting tools and in the design of websites soon in the future. The time to act is now.

LinkedIn: John G. Baresky

Twitter: Healthcare Marketing Guy


JOHNSON & JOHNSON LAUNCHING NEW EBOLA VACCINE IN AFRICA: NOVEMBER 2019

by John G. Baresky on 10/14/19

Johnson & Johnson

Johnson & Johnson ( NYSE: JNJ ) will launch an Ebola virus vaccine in the Democratic Republic of Congo ( DRC ) during November. An Ebola outbreak considered to be the second largest outbreak to date has been underway in the nation’s eastern provinces since 2018. Johnson & Johnson developed their Ebola agent in partnership with Bavarian Nordic ( OTCMKTS: BVNRY ).

Merck Ebola vaccine in DRC now

Merck ( NYSE: MRK ) already has their Ebola vaccine ( rVSV-ZEBOV ) deployed in the country; more than 200,000 doses of it have been administered. The Johnson & Johnson vaccine requires two injections eight weeks apart; the Merck product requires only a single administration of their product. Despite requiring an additional injection, the Johnson & Johnson Ebola immunization is still an essential addition to combat Ebola not only to sustain ongoing immunization initiatives in the DRC and other areas of Africa but also to have available in the event Merck’s product were to be in short supply.

Present Ebola outbreak

Since it first started in August 2018, the Ebola outbreak underway has killed more than 2,100 people.  

Why and how Ebola is such an enormous health threat

Ebola Virus Disease (EVD) is a rare, lethal disease in people and nonhuman primates. The viruses triggering EVD are located mainly in sub-Saharan Africa. People can get EVD through direct contact with an infected animal (bat or nonhuman primate) or person; including corpses of EVD fatalities.

Ebola virus disrupts how blood clots. It is known as a hemorrhagic fever virus as the clotting issues it triggers lead to internal bleeding; blood leaks from small blood vessels in the body. The virus also causes severe inflammation and tissue damage. Due to being highly contagious and potent, Ebola is a significant challenge not only for patients but for caregivers and healthcare providers who not only help the sick but must take assertive, thorough action to protect themselves.

Ebola's Introduction To Medical Researchers

The Ebola virus was discovered in 1976 near the Ebola River in DRC. Over the last 4 decades, there have been numerous Ebola outbreaks. The worst to date has been the West African Ebola epidemic, which generated nearly 30,000 EVD cases and more than 11,000 fatalities in 2014-2016. 

LinkedIn: John G. Baresky

Twitter: Healthcare Marketing Guy



 

8 ACTIONS BOOST HEALTHCARE EMAIL MARKETING PERFORMANCE

by John G. Baresky on 10/10/19

Marketers say building engagement is their top priority with email marketing…

While numerous digital communication and promotion options exist, email continues to be one of the most preferred channels to promote brands and generate sales. Despite the demise of email marketing forecast years ago, it continues to be an attractive and effective tool in engaging audiences. Its performance and utility intrigues marketers and at the same time challenges them and their audience based on sheer volume and content relevancy.

These are 8 action items to gain critical advantages in your healthcare email marketing and sales initiatives…

Security / Privacy

All email marketing initiatives need to consider security and privacy — especially in healthcare. Be certain security updates in your systems and applications are up-to-date and installed as soon as possible when they become available. Take maximum precautions to ensure your audience and your organization are as protected as possible. Likewise, always be cognizant and fully compliant with any privacy standards which apply. Security and privacy issues are at the forefront of our Internet society and their significance is highly magnified in the healthcare sector.

Key Performance Indicators ( KPIs ) / Sales Goals Attainment

Sales goals and KPIs for healthcare email marketers are the equivalent to weather and crop reports for farmers. These should always be monitored closely and continually reassessed. Even if your lead generation, direct sales or other benchmark goals are being consistently surpassed, be certain they aren’t reaching a point of a “comfortable” plateau — the forerunner to potentially dropping. Always seek alternatives to further uptick performance. While some may consider these options to be “on reserve”, they can also be under-served leads which the competition captures before you do.

Sharpen Segmentation

Continue to slice and dice your email marketing database to further define targeted healthcare audiences and subcategories within them. The respective customer personas in the subgroups offer prime opportunities to fine tune targeting, focus content and increase engagement. Reassess how you are segmenting your customer database resources to devise new engagement opportunities and truly refine your targeting to get the right content to the appropriate audience every time.

Deeply defined subgroups enable you to connect with new audience members or those in which you were not successful with through earlier attempts. You could end up sending less emails and be rewarded with better sales results and ROI based on efficient persona profile development and optimized database drill downs; go the extra step to personalize them for greater impact. It is important to be aware your company and its offerings, the subcategory members and / or the healthcare marketplace may have changed. New developments on either side always warrant updated considerations to revisit audience subcategory email database opportunities to maintain customer connections and generate sales.

Automation

Review what processes and tools you are using to develop and implement your email campaigns. Familiarity with a routine / email marketing tool may lead you to overlook better methods or platform technology to use. You may not be recognizing existing or new features your platform has which can make your life easier and email marketing efforts more effective.

There may be better platform options available to execute email marketing campaigns. New platform technical features enabling you to execute more options could deliver more for less. Carefully evaluate your current processes and setup; changes in procedures, utilization or technical resources can lead to significant operational, sales and ROI improvements.

Benefit From Opt-outs

Don’t abandon opt-outs as “lost causes” and leave it at that to move onto others. Use opt-outs to critique campaigns and deliverable details including targeting, frequency, content, touchpoint features, offerings, and other variables. Your targeted audiences are already receiving emails based on personal / professional communications; email marketing messages pile on top of those — no matter how earnest and legitimate your outreach is, it is still fighting for attention. Healthcare, among other characteristics, is a clinical, financial and technical marketplace; there are many stakeholders which share the same customers your email marketing and sales initiatives are targeting.

Sizable audiences’ segments are opting out merely to reduce clutter. Opt-outs are a great way to objectively learn to re-focus your campaign strategy. They also cultivate the importance of offering other ways for the audience to stay engaged with your company through social media or website follows and other sign-up opportunities which may start with an email but continue on in other digital venues. Be certain your content features these touchpoint features and channels to provide your organization and the audience ways to continue to be connected outside of the email realm.

Be Current And Relevant

The healthcare industry is continually changing. Develop and share content specifically relevant to your healthcare audience aligned with current events, new developments and your products / services. Use them to make the connection between the industry, the customer and your company; position your offerings as timely solutions to their needs.

Trending topic examples can be aligned to numerous healthcare industry sectors (health system, PBM, MCO, etc.), medical specialty (anesthesiology, cardiology, obstetrics / gynecology, etc.), condition (acid reflux, asthma, hypertension, etc.), payer (Medicaid, Medicare, DHA/ TRICARE, etc.), professional (health system CFO, CIO, CMO, etc.) or other defined interests. As healthcare assertively evolves; wide and narrow audience segments value timely updates enabling your company to be recognized as a front runner with answers to their challenges triggered by industry change.

Change Up Your Approach

A good healthcare email marketing strategy does not always include an offer, sale or other promotion. Informational content can be shared with your targeted audience and lead to sales without a “pitch”. The content can demonstrate your organization’s leadership / knowledge in a particular area; it is important to established positive notoriety, professional credibility in the healthcare sector.

Review the last 6–12 months of emails your organization has shared with a particular segment; if they are all “pitch-focused” with diminishing returns, it’s a good indicator you are fatiguing your audience and need to change up content to more effectively engage them. There is always a strong push for more sales and it’s easy to overlook redundant approaches which audiences will eventually associate with spam. Choosing a “non-pitch” approach to change things up is a good consideration. Personalize messaging whenever possible to reinforce audience engagement.

Mobile

Mobile-friendly campaigns are part of successful healthcare email marketing strategy formulas which can also enhance non-mobile venue engagement. Content should be easily viewed / scrolled, quickly understood and acted upon through touchpoint features. Fortify your email / digital marketing with trigger email features pivoting on audience interactions is an example. Maximize quality design and content attributes to minimize steps and optimize messaging so processes are convenient for the audience to respond to favorably which increases direct sales, lead generation and other revenue-positive engagement opportunities.

Moving Forward

These 8 actions are only the beginning. Connect them with your present and future healthcare email marketing initiatives to build engagement, sales and ROI. The more effectively your email marketing is executed will not only strengthen your position but also provide more encouragement for your trusted audience to disregard those from competitors.


LinkedIn: John G. Baresky

Twitter: Healthcare Marketing Guy

UCB BUYING RA PHARMACEUTICALS FOR $2.5 BILLION

by John G. Baresky on 10/10/19

UCB Covets RA Pharmaceutical Phase 3 gMG Candidate

 

UCB ( OTCMKTS: UCBJF ) seeks RA's ( NASDAQ: RARX ) Phase 3 rival to Alexion’s ( NASDAQ: ALXN) Soliris which has an indication for generalized myasthenia gravis ( gMG ), a chronic, debilitating neuromuscular disorder impacting respiratory and limb movement. Presently, Soliris is the only complement inhibitor for gMG. 

 

Once-Daily Administration

 

The Phase 3 peptide Ra has underway for gMG is a once-daily, self-administered, subcutaneous C5 inhibitor called zilucoplan. 

 

UCB Research Presently Underway In gMG / MG Category

 

UCB already has a Phase 3 MG product in the works, Rozanolixizumab (UCB7665), an investigational humanized monoclonal IgG antibody ( mAb or moAb ).

 

UCB AND RA PHARMACEUTICAL FINANCIALS

 

UCB focuses on neurology and immunology therapies; it is based in Brussels, Belgium with a U.S. headquarters in Atlanta, Georgia. Ra Pharmaceuticals is based in Cambridge, Massachusetts. The UCB deal covers the RA Pharmaceutical shares at $48 each; more than a 100% premium over its closing price on 10/9/19.  


LinkedIn: John G. Baresky

Twitter: Healthcare Marketing Guy

HEALTHCARE DIGITAL MARKETING 4TH QUARTER STRATEGY AND TACTICS

by John G. Baresky on 10/05/19

How can you up your digital marketing KPI game plan to put your organization's sales over the goal line?

For many healthcare, medical device and pharmaceutical product manufacturers and service providers, the 4th quarter is underway and the end of the fiscal year is approaching. Every minute and every dollar count more than ever. 

It is time for brand, product and digital marketing teams to quickly drill down, get their bearings and make critical decisions. Individually and collectively, these primary marketing stakeholders need to ask business critical questions:

  • Are we on task to achieve our goals?
  • What is necessary to exceed our goals?
  • We are barely making our goals, what are the best options to step up to acceptable levels?
  • We are behind on our goals, what can be done to at least narrow the gap?
  • If a measure is beyond saving, can it be ended quickly in time to avoid waste and perhaps reallocate resources?
  • Based on present activity, how well positioned are we for 1st quarter 2020 and beyond?

These questions are not easy to answer and depending on how positive or negative revenue, sales and margin performance is, they may seem to be overwhelming.

For healthcare digital marketing initiatives, there are primary considerations to assess and opportunities to act on:

  • Can PPC be tweaked to spark a boost in performance?
  • Are email marketing measures satisfying KPI benchmarks?
  • If not, is targeting, messaging, offering or other element(s) fixable? 
  • What is / is not working with website assets including UX, content, SEO and other attributes; even if fixes will not result in immediate returns, can they lift 1st quarter 2020 performance?
  • Is content sharing optimized, average or languishing; what is being done to take advantage of unrecognized or under-utilized dark social opportunities?
  • Due to 4th quarter budget limitations, what assets can be fully re-deployed and / or repurposed?
  • What social media channels or other venues can be further exercised for additional lead generation purposes?
  • Are marketing / sales collaborations synchronized, including Salesforce or other CRM platform resources, to be all they can be?
  • What are the 3 most potent digital tools that Sales relies on and how can one or all three be sharpened?
  • Can time, financial, technical resources be shifted so high producing options can outperform KPI expectations?
  • What time, financial, technical resources could be shifted to salvage underperforming options?
  • Can entirely new measures be deployed in time to make a difference in 2019?
  • Are there opportunities to start 2020 digital marketing initiatives early so momentum is already underway prior to the New Year?
Under positive or negative pressure, the most novel and successful strategic and tactical approaches can be developed. The pivotal consideration for digital marketing leaders and other commercial stakeholders is taking action based on the answers to the questions above. Good luck, we're all counting on you.

 





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Week Of 1/28/2018
6 Options To Improve Healthcare Content Marketing Performance


Quality Healthcare Content Can Be Invisible To Search Engines And Millions Of Viewers; sometimes even the best healthcare content can’t be found. Quality healthcare content requires significant time, financial and technical investment to develop. Even with solid expertise and considerable resources, the highest quality material can be seemingly ineffective as search engines and audiences stream by it. Sometimes it’s understandable based on sheer volume of healthcare / non-healthcare content uploaded to the Internet each minute, the enormous number of venues where content is shared and even the most seemingly unique healthcare topics already having well-placed quality content published. It’s time to assess your options to give you and your content the attention and ROI it deserves.


Verify Technical Attributes Are In Place And Functioning Properly

  • Be certain the digital framework of your healthcare content is optimized; key considerations include:
  • Get on Google’s good side and equip your website with HTTPS
  • Stay on Google’s good side by making your site mobile-friendly
  • Eliminate redirects
  • Mend broken links
  • Use social sharing buttons
  • Assess and deploy reasonable ways to cultivate backlinks
  • Submit an updated sitemap to key search engines
  • Optimize site performance with better page speed
  • Delete or revamp out-of-date or presently irrelevant content


No matter how good your healthcare content is, even the best needs to have a sound technical operating base and supporting cast to reach full effectiveness.


Revisit Keyword Selection


Keyword research, especially when it’s being revisited, can be tedious but well worth the effort. Seek out those keywords with high profile but low competition and repopulate your content accordingly. Be certain your content is appropriately worded and aligned with the specific healthcare audience (clinician, consumer, commercial, etc.) perspectives in mind. For some, this means rewriting the entire work but this is not always necessary and it will serve you and your ROI goals better if you learn to keyword-smith proficiently.

Fortify it with additional key supporting facts / current trend details to establish credibility and enrich your keyword volume. This may be sourced from KOLs / Influencers or medical references. The highly specialized rhetoric of healthcare offers unique combinations of vocabulary to effectively optimize content if you invest time, research and creativity.


Consult Your Repurposing Strategy

When you are creating content, always have alternate methods in mind to share it further apart from the original format / placement of it. Assess your repurposing options and strategically deploy your content in another format or venue. If you do not have a repurposing strategy, chances are you have quality content that’s languishing and capable of generating more ROI.

Paid Search

Some promotional funding can go a long way in helping languishing content get on its feet. Be sure you have adequate of finances available to do it. Before launching a campaign, be certain the content you are promoting is at it optimal best and designate KPIs and other goals to measure effectiveness and ROI. A great way to cultivate organic reach is to boost traffic streams via paid search strategies and facilitate audience notoriety / sharing to carry it forward.


Redefine Your Topic

This requires additional research, time, financial and other resources. Re-think the content and the healthcare audience you are seeking to reach. Narrowing the focus may make it appealing to fewer viewers but may reward you with better engagement. Hopefully it’s not a complete do-over but sometimes it’s necessary to effectively reach your original audience or a subset of it. One of the positive aspects of healthcare is its complexity and the multiple perspectives various stakeholders have in it. Realign your content with a niche strategy in mind to drill down to those personas and audience sectors it matters to most.


Strategically Utilize Social Media

Depending on the healthcare topic and audience, some mainstream social media options may provide your content with some lift. Unfortunately, quantity does not immediately result in quality ROI. Take it a step further; identify ways to share your carefully crafted content in the narrower social media venues preferred by your prime healthcare targeted audience for greater effect. Always be prepared with a strategy to take your content to the audience and once they have it, be certain they circle back via links or other channels and easily share it with peers.

Revenue-effective ROI is challenging to achieve for many healthcare marketing initiatives. Even the most established brands have to maintain constant vigilance and commit substantial resources to be certain the high ranking they enjoy continues to stay aloft. A combination of these options will increase the opportunities for you to improve your healthcare content marketing performance and meet those KPI / ROI goals you are driving towards.


WEEK OF 1/21/2018
8 Actions Improve Healthcare Email Marketing ROI


54% of marketers say building engagement is their top priority with email marketing according to Ascend2 …

While numerous digital communication and promotion options exist, email continues to be one of the most preferred channels to promote brands and generate sales. Despite the demise of email marketing forecast years ago, it continues to be an attractive and effective tool in engaging audiences. Its performance and utility intrigues marketers and at the same time challenges them and their audience based on sheer volume and content relevancy. These are 8 action items to gain critical advantages in your healthcare email marketing and sales initiatives.

Security / Privacy

All email marketing initiatives need to consider security and privacy — especially in healthcare. Be certain security updates in your systems and applications are up-to-date and installed as soon as possible when they become available. Take maximum precautions to ensure your audience and your organization are as protected as possible. Likewise, always be cognizant and fully compliant with any privacy standards which apply. Security and privacy issues are at the forefront of our Internet society and their significance is highly magnified in the healthcare sector.

Key Performance Indicators ( KPIs ) / Sales Goals Attainment

Sales goals and KPIs for healthcare email marketers are the equivalent to weather and crop reports for farmers. These should always be monitored closely and continually reassessed. Even if your lead generation, direct sales or other benchmark goals are being consistently surpassed, be certain they aren’t reaching a point of a “comfortable” plateau — the forerunner to potentially dropping. Always seek alternatives to further uptick performance. While some may consider these options to be “on reserve”, they can also be under-served leads which the competition captures before you do.

… Based on insights from MarketingProfs, 15% of marketers surveyed say their companies still do not regularly review email opens / click-through rates; only 23% say they have uniformly connected website / email for tracking what happens after a click …

Sharpen Segmentation

Continue to slice and dice your email marketing database to further define targeted healthcare audiences and subcategories within them. The respective customer personas in the subgroups offer prime opportunities to fine tune targeting, focus content and increase engagement. Reassess how you are segmenting your customer database resources to devise new engagement opportunities.

Deeply defined subgroups enable you to connect with new audience members or those in which you were not successful with through earlier attempts. You could end up sending less emails and be rewarded with better sales results and ROI based on efficient persona profile development and optimized database drill downs. It is important to be aware your company and its offerings, the subcategory members and / or the healthcare marketplace may have changed. New developments on either side always warrant updated considerations to revisit audience subcategory email database opportunities to maintain customer connections and generate sales.


Automation


Review what processes and tools you are using to develop and implement your email campaigns. Familiarity with a routine / email marketing tool may lead you to overlook better methods or platform technology to use. You may not be recognizing existing or new features your platform has which can make your life easier and email marketing efforts more effective.

There may be better platform options available to execute email marketing campaigns. New platform technical features enabling you to execute more options could deliver more for less. Carefully evaluate your current processes and setup; changes in procedures, utilization or technical resources can lead to significant operational, sales and ROI improvements.


Benefit From Opt-outs


Don’t abandon opt-outs as “lost causes” and leave it at that to move onto others. Use opt-outs to critique campaigns and deliverable details including targeting, frequency, content, touchpoint features, offerings, and other variables. Your targeted audiences are already receiving emails based on personal / professional communications; email marketing messages pile on top of those — no matter how earnest and legitimate your outreach is, it is still fighting for attention. Healthcare, among other characteristics, is a clinical, financial and technical marketplace; there are many stakeholders which share the same customers your email marketing and sales initiatives are targeting.

… Based on information from Yes Lifestyle Marketing, Click-to-Open rates are declining; average click-to-open rate (CTO) is 8.9 percent, a 13 percent drop YoY resulting in a 22 percent drop over the last two years …

Sizable audiences segments are opting out merely to reduce clutter. Opt-outs are a great way to objectively learn to re-focus your campaign strategy. They also cultivate the importance of offering other ways for the audience to stay engaged with your company through social media or website follows and other sign-up opportunities which may start with an email but continue on in other digital venues. Be certain your content features these touchpoint features and channels to provide your organization and the audience ways to continue to be connected outside of the email realm.


Double Up On Focusing Content And Offerings


The healthcare industry is continually changing. Develop and share content specifically relevant to your healthcare audience aligned with current events, new developments and your products / services. Use them to make the connection between the industry, the customer and your company; position your offerings as timely solutions to their needs.

Trending topic examples can be aligned to numerous healthcare industry sectors (health system, PBM, MCO, etc.), medical specialty (anesthesiology, cardiology, obstetrics / gynecology, etc.), condition (acid reflux, asthma, hypertension, etc.), payer (Medicaid, Medicare, DHA/ TRICARE, etc.), professional (health system CFO, CIO, CMO, etc.) or other defined interests. As healthcare assertively evolves; wide and narrow audience segments value timely updates enabling your company to be recognized as a front runner with answers to their challenges triggered by industry change.

Change Up Your Approach

A good healthcare email marketing strategy does not always include an offer, sale or other promotion. Informational content can be shared with your targeted audience and lead to sales without a “pitch”. The content can demonstrate your organization’s leadership / knowledge in a particular area; it is important to established positive notoriety, professional credibility in the healthcare sector.

Review the last 6–12 months of emails your organization has shared with a particular segment; if they are all “pitch-focused” with diminishing returns, it’s a good indicator you are fatiguing your audience and need to change up content to more effectively engage them. There is always a strong push for more sales and it’s easy to overlook redundant approaches which audiences will eventually associate with spam. Choosing a “non-pitch” approach to change things up is a good consideration. Personalize messaging whenever possible to reinforce audience engagement.

…The top email providers are Gmail, Yahoo, Outlook, GMX, Zoho, iCloud, AOL, Elude according to MUO…

Mobile

Mobile-friendly campaigns are part of successful healthcare email marketing strategy formulas which can also enhance non-mobile venue engagement. Content should be easily viewed / scrolled, quickly understood and acted upon through touchpoint features. Fortify your email / digital marketing with trigger email features pivoting on audience interactions is an example. Maximize quality design and content attributes to minimize steps and optimize messaging so processes are convenient for the audience to respond to favorably which increases direct sales, lead generation and other revenue-positive engagement opportunities.

Moving Forward

These 8 actions are only the beginning. Connect them with your present and future healthcare email marketing initiatives to build engagement, sales and ROI. The more effectively your email marketing is executed will not only strengthen your position but also provide more encouragement for your trusted audience to disregard those from competitors.



WEEK OF JANUARY 7, 2018
Healthcare Becomes Largest Employer Sector In The United States

Based on an article in The Atlantic and GAO statistics, the healthcare industry is the nation’s largest employer –surpassing even retail. This represents challenges and opportunities for many stakeholders. Here are 7 considerations regarding the ever-evolving healthcare sector with consumer, commercial and clinical perspectives in mind:

1. Government is the primary payer in the United States; spanning Medicaid, Medicare, DHA / TRICARE and other programs / sources of reimbursement; less companies feature retiree health benefits for workers --increasing reliance on government funding support

2. The aging population in the United States is a key factor in the healthcare industry job boom

3. As a quarter of the workforce will be older than 55 by 2025, a significant number of persons, both caregivers and non-caregiver workers associated with healthcare, will be key elements in the employment sector 

4. Traditional healthcare roles largely centered on Nurses, Doctors, Pharmacists; new positions have evolved (typically referred to as “Care Extenders”) and they include Nursing Assistants, Physician Assistants, various Therapist and Aide specialties

5. Nurses, Doctors and Pharmacists can consider an expanding multitude of their own specialties / sub-specialties as additional academic credentials and certifications are available and required

6. For health insurers / payers, existing and new caregiver specialties each need their own billing / reimbursement assignments which create their own financial and data management growth requirements and challenges

7. Healthcare product and service marketers, healthcare management (hospital / health system, group practice administration, etc.) and other stakeholders need to account for the growing complexity / expansion of organizational staffing structures, specialties and roles associated with patient care

WEEK OF 12/31/2017
Hospital / Health System Mergers Of 2017

There were scores of hospital / health system mergers and acquisitions in 2017. Even smaller deals involving 2-4 hospitals will have huge importance within their immediate metropolitan areas whereas the larger deals will have metropolitan, regional and even national impact. Non-Profit and For-Profit hospital / health system sectors had significant activity; Illinois, New Jersey, New York and Pennsylvania experienced the most transactions...

…UNC Health Care and Carolinas HealthCare seek merger to form 50+ hospital health system … Ascension acquiring Illinois-based Presence Health, a 12-hospital system … Catholic-sponsored SSM Health buys four hospitals from Congregation of Sisters of St. Agnes … Hackensack Meridian Health and JFK Health merge to create 16-hospital system in New Jersey … Dignity Health and Catholic Health Initiatives combine to form hospital chain spanning 28 states ... Advocate Health Care and Aurora Health Care deal will create $10.7 billion two-state health system … Ascension Health-Providence St. Joseph Health merger encompasses 191 hospitals / 27 states (annual revenue of $44.8 billion) … With acquisition of IASIS Health Care; Steward Health owns 36 hospitals across 10 states… Cooper University Health Care, Lourdes Health and St. Francis form 3-way health system merger … HCA Gulf Coast buys 4 hospitals from Tenet … Greenville Health System and Palmetto Health merge to form largest health system in South Carolina … Baptist Memorial Health and Mississippi Baptist Health System plan to merge ...

WEEK OF 12/25/17
Healthcare Product Manufacturer Mergers Of 2017

Look for these 2017 merger and acquisition deals to have even more impact in 2018 on the rest of the healthcare industry. There will be competitive countermeasures in the form of additional mergers and acquisitions in the sector as well as new contracting arrangements impacting patients, clinicians, hospitals / health systems, payers, GPOs, PBMs and other stakeholders. Seven of these deals were over $5 billion dollars...

… Johnson & Johnson’s $30 billion takeover of Swiss pharma firm Actelion … Gilead’s $12 billion acquisition of Kite Pharma … Abbott finalizes Alere deal for $5.3 billion … Reckitt Benckiser Group acquires Mead Johnson Nutrition for $17.9 billion … Sanofi picks up Protein Sciences with upfront payment of $650 million … Cardinal Health acquires Medtronic business unit for $6.1 billion … Teleflex buys Vascular Solutions for $1 billion … Hologic acquires Cynosure for $1.7 billion … Stryker purchases Novadaq for $700 million … Allergan completes deal to buy Zeltiq Aesthetics for $2.4 billion … Integra Lifesciences buys J&J’s Codman Neuro business unit for $1.05 billion … Gilead purchases Cell Design Labs for $567 million … Takeda acquires Ariad Pharmaceuticals for $5.2 billion … Stryker picks up Entellus Medical for $662 million … Boston Scientific snaps up Symetis for $435 million … Mallinckrodt buys Sucampo Pharmaceuticals for $840 million … Becton Dickinson buys C.R. Bard for $24 billion …

WEEK OF 12/18/2017
Ascension And Providence St. Joseph Health forming mega-merger…

In mid-December, 2017; two major hospital systems were in merger discussions which would create a new leader in U.S. hospital ownership totaling 191 hospitals. Non-profit Ascension, based in St. Louis, Missouri and non-profit Providence St. Joseph Health, headquartered in Renton, Washington, would create a new mega hospital entity comprised of 191 hospitals across 27 states.

Ascension already easily ranks as one of the largest health systems in the nation. Its staff includes 150,000 associates and 36,000 providers. They operate 2,500 points of care including 141 hospitals and over 30 senior living facilities spread across 22 states and the District of Columbia.

Providence St. Joseph Health is a sizable health system entity with 50 hospitals and over 825 clinics. Their facilities are located across 8 states. The organization employs about 111,000 staff members.

…According to hospital / healthcare consulting firm Kauffman-Hall, “Transactions among larger and like-sized organizations are rising as health systems across the country look to build scale and new capabilities for an uncertain healthcare environment”…

If the two entities combine, its annual revenue is estimated at $44.8 billion. The next largest competitor would be HCA. Presently, HCA owns 177 hospitals which generate roughly $41.5 billion in annual revenue. The new tandem would have considerable leverage in negotiating with insurers and medical / pharmaceutical product manufacturers as well as being a competitive force against other for-profit and non-profit healthcare provider organizations. It would also be able to establish a fortified healthcare marketing brand across multiple medical specialties and consumer / patient health services.

The proposed Ascension and Providence St. Joseph Health merger caps off a year of extraordinary large scale health system deals conducted by Steward Health Care, Advocate Health, Aurora Health Care, Dignity Health, Catholic Health Initiatives, UNC Health Care and Carolinas HealthCare System and others. They impact for-profit and non-profit health system organizations and span metropolitan as well multi-state regional geographic areas. As clinical, technical, financial and competitive changes continue across the United States, the wave of mergers and acquisitions across the healthcare provider organization sector (which includes hospitals, practice groups and specialty providers) will be an ongoing process representing challenges and opportunities.


WEEK OF 12/11/2017
Five Winning Healthcare Content Marketing Practices

…The most successful healthcare content marketing strategies embrace the concept of relentlessly jockeying for position when it comes to audience engagement, search ranking and ROI…

Healthcare And Technology Compete Against Themselves Everyday…

Healthcare content marketing is a never ending race. Healthcare and digital technology are two industries which literally outpace themselves with innovation. This tandem of change represents challenges and opportunities for healthcare marketers to consistently go the distance with their content marketing initiatives.

Commit Your Content To The Audience

The healthcare audience consists of a variety of stakeholders. There are significant differences between communicating with clinicians, healthcare administration, patients, consumers and other audience sectors. Don’t hesitate to develop two distinctly different communications regarding one healthcare topic to engage specific audience stakeholders effectively. Fine tune your messaging accordingly so it is appropriate for the persons you seek to engage. Furthermore, the wrong language may mislead your audience which is something to avoid at all costs when it comes to healthcare.

…Details from Pew Research shows 74% of internet users engage social media with 80% of those users focusing on specific health information -plus nearly half of them are searching for information about a specific physician or other type of clinician…

Help Google Help You

Healthcare content has an enormous global web presence. Be certain your content is strategically well-written and search friendly. Key words are good, long-tail key words are better. Views don’t matter unless they are from the persons you are targeting and hope to further engage. Take a little more time to craft your healthcare content so it can be found by those it matters to most.

…Spinning Out Of The Curve…

Practice Good Form

Be certain the format of your content / text is laid out cleanly and well organized. It is always courteous and digitally important for your content to be easily read; now more than ever mobile viewing needs to be accounted for. Carefully evaluate and confirm your healthcare content can be easily read whether it is displayed on a desktop, laptop, tablet or mobile phone. As time goes on, don’t forget Google will either reward or penalize your healthcare content ranking based on its mobile-friendly attributes.

….Based on research from Wolters Kluwer Health…

72% of doctors access drug information from smartphones
63% of doctors access medical research by tablet
44% of physicians communicate with nurses and other associates from smartphones

Be Time Sensitive

Throughout history, healthcare has been an industry driven by change. Therapies, treatment guidelines, procedures medical technology and regulations are continually evolving at a rapid pace. As you develop your healthcare content’s conversational dialogue, factual details and other elements, be certain what you are communicating and how you are wording it is accurate and up-to-date.

…As you charge late in the stretch to the finish line…

Spur Your Content To Stay On The Move

The better the content is, the more audience members are likely to want to share it. It is important to reinforce its portability. Make sure your healthcare content can easily be sent on its way between audience members. By doing so, your audience will grow accordingly and so will your ROI.

…On average, healthcare marketers spend 23% of total marketing budget on content marketing initiatives, compared to 31% percent for all marketers according to the Content Marketing Institute…

There are numerous contenders in the healthcare content marketing digital space. To be successful, it is necessary to have a consistent and effective strategic stride to move ahead of the competition. These five concepts will bring your marketing goals, objectives and ROI across the finish line.

Week Of 12/04/17
CVS Health Proposes To Acquire Aetna: Eight Fast Facts

An innovative and competitive move if the debt load can be effectively managed. The healthcare industry continues to evolve; business models within the sector are changing and propelled by large scale merger and acquisition initiatives…

The proposed CVS Health / Aetna deal combines two healthcare industry leaders with wide and deep reach across commercial and consumer business sectors nationwide. Both organizations are well-established and as a combined tandem, represent a significant competitive threat to Centene, Cigna, Express Scripts, Fred’s Pharmacy, Humana, Kaiser, Optum / UnitedHealth Group, Prime Therapeutics, Rite Aid, Walgreens-Boots Alliance, Walmart and select Blue Cross Blue Shield plans (CVS Health recently formed a strategic alliance, IngenioRx, with Anthem, the largest BCBS affiliate).

Eight Fast Facts…

CVS Health will pay about $69 billion for Aetna; Aetna stockholders will receive $207 per share, $145 in cash and $62 in stock
Aetna, based in Hartford, Connecticut, was founded in 1853; CVS Health, founded in 1963, is headquartered in Woonsocket, Rhode Island
Roundly calculated figures reveal CVS Health employs about 158,000 persons; Aetna has over 49,000 employees
Within the latest Fortune 500 rankings, CVS Health is listed at number 7; Aetna is placed at number 47
CVS Health produces over $146 billion in annual sales; Aetna’s annual sales exceed $63 billion
CVS Health operates more than 9,700 retail stores (including more than 600 pharmacies within Target stores) and is one of the leading pharmacy benefit management ( PBM ), home infusion and specialty pharmacy companies in the United States
Aetna is a global organization which includes Coventry Health Care and Continental Life Insurance; it offers conventional and consumer-directed health insurance comprised of medical, pharmacy, dental, behavioral health, long-term care and disability plans
The CVS Health and Aetna deal needs to be approved by regulators; either the U.S. Department of Justice ( https://www.justice.gov/ ) or the Federal Trade Commission ( https://www.ftc.gov/ ) will review their case

The CVS Health / Aetna deal is also viewed by some as a preemptive move in anticipation of Amazon’s still unfolding entry into the healthcare sector. Optum / UnitedHealth Group has already undertaken an assertive strategy to diversify its business model through strategic acquisitions of physician practice groups. These include buying Surgical Care Affiliates ($2.3 billion) and DaVita’s medical group ($4.9 billion).

Antitrust concerns are paramount for acquisitions in the healthcare provider and healthcare insurance sectors. Regulators will carefully assess the proposed arrangement from multiple perspectives. If approved, CVS Health and Aetna will be busy with executing integration initiatives to optimize the combined attributes of their new company.

To finance the deal, CVS Health reportedly plans to issue $44.8 billion in new debt plus $21 billion in new equity and deploy about $4.1 billion of cash on hand. Cost cutting and other financial belt-tightening measures will get underway quickly if regulators grant their approval; these will challenge the new company to effectively compete while equally meeting customer service and shareholder expectations.

Undoubtedly, CVS Health / Aetna competitors will be assessing their business models and strategically evaluating their merger & acquisition options moving forward.

Week Of 11/26/17
CVS Healthcare Reportedly In Advanced Discussions To Acquire Aetna

CVS Health, the retail, mail order, specialty pharmacy, home infusion and PBM healthcare services conglomerate is reportedly in acquisition talks with health insurer Aetna. Such a deal would reach or exceed $66 billion dollars.  

...CVS Health and Aetna executive leadership have not officially commented on any details regarding a potential merger – acquisition deal...

...Just months ago, Aetna's proposed deal to acquire rival health insurer Humana fell through due to regulatory / antitrust concerns...

CVS Health has been on a roll. It just recently entered into an agreement with Anthem, the nation’s largest Blue Cross Blue Shield affiliate comprised of 14 BCBS plans. CVS Health will be Anthem’s PBM partner. The deal is especially lucrative in that it allows for CVS Health to enhance the position of its Minute Clinics as a healthcare provider for Anthem members. A frequently overlooked detail is CVS Health owns / operates the retail pharmacy units within Target stores; these total over 600 locations. Anthem’s present PBM, Express Scripts, will no longer be Anthem’s PBM partner effective January, 2019.

...CVS Health ranks at number 7 in the Fortune 500, Aetna ranks at number 47...

An acquisition of Aetna by CVS Health would fortify CVS Health’s position as a provider and payer, a business model option currently being hotly cultivated by UnitedHealth Group and its Optum unit. It would also help CVS Health defend its business against potential incursions by Amazon as it seeks to widen its reach into the healthcare industry. It is reported the CVS Health / Aetna deal would be formally announced as soon as December, 2017.

Week Of 11/19/17
Amazon Web Services ( AWS / Cloud ) In Talks With Healthcare Data Giant Cerner


…Based on insights from management consulting leader PwC; “Amazon does have expertise that makes it a natural candidate to look for ideas that would reform the U.S. health care industry as it tries to control costs”…

It is no secret Amazon has been diligently expanding its presence in the healthcare sector. Their activities include obtaining pharmacy wholesaling licenses in at least 12 states and expanding the number of medical products well beyond those typically found in the medicine cabinets of consumers worldwide. Over the Thanksgiving week word was out that Amazon and Cerner were in latter phases of discussion regarding more advanced initiatives involving Cloud and healthcare technology applications.

Amazon and Cerner have worked together on other healthcare data management / storage deals in the past. This new arrangement may involve more access to advanced analytics related to population health with an emphasis on medical data insights to improve care and lower costs. For Amazon, a clinically strategic arrangement with Cerner would expand its presence in healthcare. It potentially would engage hospitals / health systems, health insurers / managed care organizations, medical researchers, pharmaceutical manufacturers and other healthcare entities where deep analytics, patient care, treatment costs, healthcare outcomes, healthcare records ( EHR / EMR ) and other big data management capabilities are highly valued.

…Based in North Kansas City, Missouri, Cerner is a global healthcare information technology company generating over $4.5 billion in annual sales with more than 20,000 employees…

…Amazon’s Web Services (AWS) unit is generating almost $5 billion in quarterly revenues…

Healthcare is a privacy, data-driven and precision-based industry. While Amazon has excellent data security and broad analytic capabilities, they do not have these attributes recognized and established in the healthcare community. They have made deliberate steps to change this including fortifying its AWS services to meet HIPAA requirements and secure protected health information ( PHI ). Collectively, Amazon API Gateway, Amazon SQS, AWS Direct Connect and AWS Database Migration Service are HIPAA compliant.

Cerner, founded in 1979, has a proven track record and positive reputation in the healthcare industry. Cerner’s HealtheIntent software platform is a heavy hitter in population health management. As a tandem, Amazon and Cerner have better potential to effectively compete against some of the other unique healthcare initiatives underway at Epic, Google, IBM / Watson, Meditech and Microsoft / Azure.

Looking ahead, there is an array of options and strategies for Amazon and Cerner to consider. Amazon’s master plan for the healthcare industry is difficult to decipher but clearly they are approaching the sector from multiple angles. Cerner can continue to amplify and enhance its present offerings and develop new ones with Amazon as a resource partner. There is a reasonable fit for each as they seek to grow taller and wider within the healthcare space. The innovation they can bring would undoubtedly benefit multiple stakeholders in the medical community and pose a serious threat to competitors.


Week Of 11/5/2017
Mobilize Your Mobile Healthcare Marketing

Mobilize Healthcare Marketing And Sales ROI…

With much of the globe accessing the Internet for information from mobile devices, mobile marketing is a critical element to consider in effectively engaging customers and driving sales. Clinicians (nurses, doctors, pharmacists, researchers, KOLs, etc.), healthcare administrators, risk management, purchasing professionals, patients and consumers rely on mobile devices to readily access information.

…According To Google…

1 out of 20 searches is related to healthcare
More searches take place on mobile devices than on computers in 10 nations including the U.S. and Japan
49% of B2B researchers using mobile devices for product research do so while at work
About 50% of B2B queries today are made on smartphones

Effective mobile marketing is never fixed in place, it is readily responsive to customer, marketplace and your company’s changes. It is a component of your overall brand, social media and healthcare digital marketing strategy. The world is more likely to have a mobile device immediately accessible to them instead of a computer; aligning and exploiting mobile venues can directly contribute to larger profits and brand stability. These are key elements in an effective mobile healthcare marketing strategy…

Start With Regulatory, Legal, IT…

During the initial phases of a mobile healthcare marketing initiative or with established, ongoing mobile marketing activities, consistently consult your medical / regulatory and legal units. Their input is critical. They can provide you with the guidance / boundaries needed and help you avoid developing / changing something they cannot approve. As new initiatives are being developed, they can be on the look out for recent clinical or legal changes impacting them.

IT is just as critical especially if you are partnering with outside vendors. Mobile marketing content and associated digital assets need to be assessed by IT to be certain they can be optimally supported and as secure as possible. Across the board, mobile marketing endeavors must conform to regulatory, legal and technical requirements.

KPIs, Goals / Objectives…

Define your KPIs, goals and objectives from the start, they need to be scaled and planned according to budget, staff and technology resources. If your organization is trying to break into wider scale mobile marketing initiatives and / or experiencing significant challenges with specific brands or market sectors, these sales gaps are a great place to focus. Consider addressing the gaps with specific mobile-friendly initiatives to sharply focus resources and strategically engage customers. For new or established offerings supported by mobile initiatives, be certain you have a duration point in mind to support them financially / technically for short or long term deployment based on the agreed upon your KPIs, goals and objectives.

Define, Target The Right Audience…

It is important to determine from the onset how to individualize and prioritize customer sectors so you can focus your resources accordingly. Determine which sectors best align with a mobile marketing initiative which your organization can solidly deliver for maximum ROI. There are numerous audience / customer stakeholders in healthcare; the most basic considerations include patients, consumers, nurses, doctors, pharmacists; then there are payers (MCOs, PBMs), hospitals / health systems, GPOs, distributors, wholesalers, etc. — which ones will deliver the greatest ROI via mobile marketing? Defining the target provides the focus through which to deploy resources. It will also help determine what social media venues and mobile technical features you may use to engage them effectively.

Critically Assess Your Website…

…Google has announced their mobile-first index will be active in 2018…

It sounds backwards in a mobile-focused strategy but it’s an important basic early first step. If your website isn’t aligned with mobile; your overall digital marketing will suffer in two ways. First, instead of engaging patients / consumers, your website via mobile will irritate them and perhaps steer them to your competitors with mobile-friendly sites. Second, it is assumed Google will favor websites with mobile-endearing attributes so if your website isn’t mobile lovable, Google will eventually get around to giving it a lower ranking in search results. Brands frequently change landing pages due to new product or service launches and improvements. Be certain the landing pages are identically effective for mobile web users and traditional web users.

Consult Customers…

….Based on research from Wolters Kluwer Health…

72% of doctors access drug information from smartphones
63% of doctors access medical research by tablet
44% of physicians communicate with nurses and other associates from smartphones

…Research by Boston Consulting Group ( BCG ) reveals B2B customers are seeking the same digital experience they encounter as consumers and that mobile can accelerate time to purchase by 20%…


Consult your patient / B2C, HCP and B2B customers about their mobile engagement. Learn as much as you can from them whether you are building something new or evaluating how to make improvements to an existing mobile resource. Monitor their feedback to identify new trends and learn how their particular mobile engagement differs from others within and outside of their segment. They can tell you what was or is successful and what they deem to be valuable moving forward.

Use Competitor Mobile Marketing Initiatives As Part Of Your R&D…

Strategically assess what competitors are doing in mobile and determine if it is successful or not. Competitors are key elements of your mobile / digital marketing research and development program. If they have something successful, evaluate it and determine if you can develop something better. Be certain what they have is not only useful but has legs to go the distance. In mobile and other aspects of technology, there can be an upward, vertical trajectory quickly followed by a downward landslide of abandonment. Customer, technology, competitor, regulatory and other changes can propel engagement forward or backward quickly; be certain what you are investing in has a lifecycle long enough to meet your ROI goals.

Evaluate Mobile Marketing Initiatives In Other Industries…

While the healthcare sector has plenty of innovation underway in the mobile space, don’t confine your mobile approach to it. Look into multiple industry sectors and assess their mobile-driven marketing initiatives. Transfer their ideas, knowledge and approaches to the healthcare sector as appropriate. Commonplace strategies in one industry can be overlooked in another; transferring a proven utility customized for healthcare stakeholders can set your mobile initiatives part from the competition.

….Results Of An Indegene Physician Marketing Study Reveal…

In 2016, preferred channels were brand promotional emails, KOL webinars, HCP portals
By 2018, preferred channels will be social media, mobile apps and HCP portals
Life science digital marketing spend will exceed $14 billion by 2018

Interactive Calls-To-Action…

Take special advantage of the mobile platform and its touch screen attributes. Utilize these to develop and cultivate mobile-friendly calls-to-action. On a computer, these are not clickable; on a mobile device, the ability to click a phone number, engage an email or link is a great way to measure customer engagement and drive sales. Be certain your mobile marketing initiative pivots on these features rather than just one-way communications to cultivate more ROI-driven interactions.

To App Or Not To App…

…Based on an mHealth Economics 2017 study which surveyed over 2,000 mobile health stakeholders, there are about 84,000 health app publishers — with about 325,000 health apps available through the leading app stores…

…26% of consumers start mobile research with a branded app according to data from Smart Insights…


Be careful in what you invest in when it comes to app development. Be certain it not only works flawlessly but is also widely embraced and used by your customers. Dozens of healthcare mobile marketing initiatives pivot on apps without demonstrating meaningful or even traceable ROI performance.

The average person has 60–90 apps on their phone and regularly use up to ten. Avoid the embarrassment and waste of developing a wonderful app which your organization anticipates as the pivotal edge of digital marketing and then is panned by customers. If this happens, good luck in fighting for more digital marketing dollars in next year’s budget exercise. As for your customers, they will eventually delete your app and perhaps be less receptive to downloading another one from your company.

Apps must download quickly, have a high utility in their use and operate consistently at high speed. They require their own marketing campaign (be sure to plan this in your budget) to launch them and then ongoing promotional support to remind existing users of their presence and gain new subscribers. Apps need to be enhanced / updated periodically; be prepared technically and financially to execute this.

Mobile-Friendly Email Marketing…

Email marketing is one option to consider. Email marketing is a widely used strategy / tactic but has not become fully mobile friendly yet. Adaptations to traditional approaches like e-mail marketing must be made so customers have mobile-friendly versions with clickable links. These links should direct the customer mobile journey to access your website, converting emails into engagement / transaction pathways through the marketing / sales funnel. Maximize quality design to minimize clicks, optimize messaging so the process is convenient for the customer which will be reflected in sales and ROI.

SMS/MMS Text Subscription Options…

Texting can be touchy. Make sure in advance your targeted customers are receptive to it otherwise you may be spewing a lot of messages but still miss your ROI goals. While primary messaging is delivered very efficiently, it can be annoying. If you choose texting in your mobile strategy, do not be cryptic in the greeting / messaging; be certain your company, brand and nature of the communication is clear upfront. If your customer is interested, they will engage it; if not, they will delete it. What you want to avoid is leading the customer on and ultimately wasting their time in determining who sent the text and what the exact nature of it is.

Video Growing In Popularity…

Video has multiple communication attributes and can help effectively share more complex details, features and processes. With video, it is critically important that it is seamlessly functional and fast. If it takes too long to load or tends to have intermittent pauses on user devices, it will be abandoned by the user in short order.

…A study from Cisco predicts mobile video traffic will account for 75% of total mobile data traffic by 2020…

…Data from Blue Corona reveals more than half of all YouTube views are on mobile devices…

Video can augment the overall communication you are introducing to viewers; getting their attention and emphasizing key aspects to encourage them to further engage the content you have provided. As with the other features noted, be certain its use contributes to ROI performance.

Voice is coming on strong as well…

…Search Engine Land says 20% of search queries on Google’s mobile app and on Android devices are voice searches…
…43% of mobile voice search users do so because they say it is quicker than going on a website or using an app; ; 21% of mobile voice search users do so because they say they don’t like typing on their mobile based on information from Statista…

Technical Alignment…

Technology innovation is a friend and foe. Be certain what you develop takes full advantage of existing technology and is adaptable to future changes. If very significant technological changes are about to occur, pause your initiative and build it around the new standards for optimum performance while competitors scramble to develop re-worked upgrades on older apps. Be wary of seemingly innocuous mobile technical changes, they may impact speed, functionality and display attributes negatively which users will be quick to experience.

Be Certain You Deliver What You Promise…

Good content marketing strategy doesn’t just support customers with information and feel good reinforcement; it influences behavior and encourages customers to definitively take action in your favor. Strategic contenting marketing and mobile healthcare marketing initiative KPIs, goals and objectives are not built on the rhetoric of “back ordered”, “please hold”, “not available at this time”, “check back with us” or “maybe next month”. Be certain whatever is being promised can be provided to your customers. Customers engaging mobile prioritize and value immediacy; if your company is not prepared to provide them what they have requested based on the content you have shared with them, they will be disappointed and likely disregard content you share with them in the future. Depending on what your mobile marketing initiative involves; these considerations may include care, service and product deliverables:

account management
appointment times
clinicians / care providers
customer service
product inventory
proficient order processing
reliable data / reporting
technical support

Continually Evaluate And Refine…

Keep your healthcare mobile marketing initiatives on the move:

Be certain to develop quality content with a mobile perspective in mind
Leverage data insights platforms and analytics; simplify reporting to consistently assessing progress according to your KPIs, goals and objectives
Whenever possible, fortify your mobile initiatives with two-way engagement attributes to embrace your audience / customers while collecting valuable data from their interactions
Collaborate unilaterally with your expanded teams (brand management, digital marketing, product management, marketing communications, IT, outside vendors, etc.) to prioritize aesthetic, technical and UX changes to improve mobile ranking, user experience and ROI
Both mobile and desktop are essential so do not abandon desktop; a great deal of mobile engagement leads to desktop in the buyer / user journey

Don’t Stand Still…

Just like the healthcare industry, mobile and the digital realm runs on perpetual innovation. It is important to continually assess mobile marketing effectiveness as change is always underway. Be certain your KPIs are still relevant and accurately measuring your progress towards meeting the goals and objectives you defined. Monitor managed care, clinical, technical, financial, legal, competitive and user factors in the effectiveness of your mobile marketing actions. By keeping your healthcare mobile marketing initiatives aligned and ahead of changes; it continually optimizes ROI and outdistances competitors in the long run.


Week of 10/29/17
Healthcare Digital Marketing / Social Media Marketing Course Correction Strategies

Healthcare digital marketing and social media marketing strategies are complex and inherently challenging to effectively manage.

They require close alignment of significant staff, financial and technical resources to achieve maximum ROI. Upon reaching prime level of performance, the new challenge is maintaining productive results, breaking through plateaus and cultivating further growth. By carefully accounting for close and distant key elements in your digital / social media marketing strategy and tactics, you can avoid running aground and keep your initiatives productively underway.

Amazingly, just one variance across the balance and execution of the resources and / or the marketplace can trigger efficiency leaks leading to a drag and downturn of performance:

Consumer / patient / professional social media preferences change
Competitors launch assertive, novel strategies temporarily or permanently disrupting established success
Provider, regulatory, payer positions pivot in another direction
New and established products in the market rise or descend as threats

These and other changes can always be expected to occur. Even the most well-planned and successful initiatives can flourish and then flame out. They can be impacted by a singular, seemingly small-scale development which turns into a series of consecutive unmet challenges. By identifying changes as they occur and assessing what their ripple effect can be, course correction strategies can be developed and executed to remedy issues and sustain momentum.

Check your bearings…

As changes occur in various sectors, this digital / social media marketing strategy cross reference can be a helpful compass. It is important to anticipate changes accordingly and respond quickly to unexpected ones to realign digital marketing strategies and tactics, along with the complete brand strategy, to maintain alignment with the marketplace and your customers:

Sustain and continue marketing / sales momentum
Unbalance competitors with quick and effective response to their threats
Maintain steerage of digital marketing / social media effectiveness to remain in constant contact with pivotal customer segments
Continue alignment, leadership position of responsiveness as marketplace changes continue to occur

Chart Your Course…

By cross-referencing key elements in your healthcare digital / social media strategy in a depth chart, you can move up and down the scale to determine which will need to be maintained, changed or monitored more closely as changes occur; depending on your healthcare enterprise, these elements can be used for pharmaceuticals, medical devices, clinical programs / health services and other offerings or you can develop your own matrix:

Digital / Social Media Marketing Elements

website
social media (Facebook, Instagram, LinkedIn, Pinterest, Snapchat, Tumblr, Twitter, Yahoo, YouTube, etc.)
dark social (especially link sharing pathways)
mobile marketing
email marketing
inbound / outbound marketing strategies
consumer / patient / advocacy group disease-focused venues
healthcare professional dedicated venues / medical specialty — focused associations
audience social media and app migration trends
SEO, SEM
technical developments (Google search algorithms, smartphone platform changes, new apps, etc.)

Brand Elements

indications / therapeutic area(s)
targeted patients / consumers
targeted clinicians (nurses, physicians, pharmacists)
medical specialties
brand / product life cycle phase (launch, 2–3 years old, established, mature, approaching generic)
competitive threats
primary, secondary, tertiary salesforces connected to product / service
non-digital / social media marketing initiatives (print, broadcast, etc.)
annual plan goals / objectives
budget

Marketplace Channel Elements

conventional primary care
hospital / health system
ancillary sectors (dialysis, home infusion, long term care, surgery centers, etc.)
pharmacy (retail, mail order, compounding, institutional, specialty)
distributors, wholesalers, medical suppliers

Managed Care / Market Access Elements

reimbursement
pharmacy benefit / medical benefit coverage
DHA / TRICARE
GPO
MCO (BCBS, health insurance plans, etc.)
Medicaid
Medicare
PBM
340B
regulatory (Federal, State, FDA, FTC, etc.)

Depending upon which element(s) change, move up and down the depth chart to assess overlapping effect and determine what adjustments can be made strategically, technically, financially to correct your course.

Are the changes only in your Digital Marketing / Social Media Marketing Elements or in one of the lower tiers and rolling up into them?

Too often, corrective actions are taken within the scope of the immediate challenge and address only one element and not the others. Although it is not immediately perceived and it is presumed core strategies remain intact, effectiveness begins to erode:

Digital /social media marketing effectiveness is less effective as it has not been adjusted although key elements below it have been
Digital / social media marketing effectiveness is less effective as it has been adjusted but one or more of the contributing elements has not

Sailing Ahead…

Healthcare digital / social media strategies and tactics perform in a fluid environment. If they are not swimming in the currents customers are in, they will eventually be sailing away from them unless accurate and quick corrections are made. Using cross reference methods as a compass to maintain your healthcare digital / social media marketing initiatives helps them stay on course now and over the horizon. 

WEEK OF October 22nd, 2017
Centene Corporation: Bucking The Trend

Over $40 billion in annual sales…

Centene is a unique managed care conglomerate based in St. Louis, Missouri which has quietly grown into an industry leader. Founded in 1984, Centene has over 30,000 employees and generates over $40 billion in annual sales. Their book of business is about 12 million members located in 28 states; a large number of them are covered via government-sponsored health plans. Centene’s many accreditations include NCQA, URAC and Phase III / CAHQ Core.

Specialized markets, services and plans…

Centene is well known in Medicaid and Medicare markets. Their Medicaid business unit supports TANF, CHIP, foster care, ABD and long term care markets. Centene’s Medicare business is centered on Medicare Advantage dual-eligible special needs and Medicare — Medicaid plans. Centene’s health insurance marketplace unit (HIM) offers benefits through which some members qualify for government subsidies; these benefit programs are marketed via their Ambetter plans. In addition to these areas, Centene operates in an array of other specialized markets; this is an overview of their key business units:

Casenet: population health and care management software
Celtic: commercial insurance for the uninsured
Centurion: correctional systems healthcare
Evolve: supplemental health benefits, administrative support
Health Net Federal Services: military and veteran communities
LifeShare: integrated long term care
U.S. Medical Management (USMM): integrated home health care

Significant risk management business challenges…

Much of Centene’s business is considered to be more complex to administer with potentially lower revenues when compared to conventional health plans and market sectors. In many cases, other insurers have reduced focus in these segments to avoid the burden of complex benefit management tied to government funding. They equate this business equation with higher operating costs, lower premiums / margins resulting in less revenue / profit. Various insurers including Aetna, Anthem, Cigna, Humana, UHC and a number of others have business in these areas but limit the scope of their exposure. They prefer to allocate organizational resources to more traditional, profitable health insurance offerings and customer segments. Centene successfully engages government-sponsored healthcare and other non-mainstream markets as a routine, well-executed core strategy of their business model.

A growing organization...

Centene has been able to grow organically and through a series of strategic acquisitions. Their latest expansion purchase is sizable. In September, 2017, they announced their acquisition of Fidelis Care (New York State Catholic Health Plan) for $3.7 billion. In 2016 they completed their deal to buy Health Net for $6.8 billion.

Centene’s empire, based on servicing less traditional healthcare market sectors, continues to pursue business and grow where other companies failed to meet their goals. In 2018 the company projects to do business in 3 additional states (Kansas, Missouri and Nevada) by offering plans on those states’ health insurance exchanges. Centene seeks to expand its business in several states including Florida, Ohio, Texas and Washington next year. As other insurers reduce or entirely exit Obamacare markets, Centene sizes up those gaps as opportunities, strategically develops benefit plans to introduce to those areas and then has an effective go-to-market strategy to launch and promote their offerings to consumers and other stakeholders.

Moving ahead…

Centene’s ongoing growth is impressive and it appears to be well-positioned to continue the trend. It has built up considerable administrative, clinical, financial, marketing, operational and sales experience over the years with successful results. Risk management is something they take in stride. This enables it to accurately assess difficult markets and develop viable health insurance and other solutions for consumers plus additional customer stakeholders. Their tolerance for unconventional markets and higher risk is greater because that is their specialty; they assertively manage this business to their advantage.

New or established competitors find it challenging to perform at Centene’s level given the markets they have to play in. Centene is ranked 66th in the Fortune 500 and 27th in Fortune’s 100 fastest growing companies. As medical and pharmacy costs increase, marketplace needs change and healthcare insurance industry churn continues, Centene has a promising future ahead.


Week Of October 15th, 2017
IngenioRx: Anthem and CVS Health Join Forces

IngenioRx — A Business Climate Changer…

The recent announcement of a partnership between CVS Health and Anthem is a significant development. Anthem is one of the largest managed care organizations in the United States. CVS Health is a coast-to-coast healthcare conglomerate comprised of retail / mail order / specialty pharmacy, home infusion, PBM and other clinical, commercial healthcare units. The combination of these two entities provides them formidable competitive and organizational advantages. Scheduled to begin formal operations in 2020, their contract agreement is for 5 years.

Express Scripts Explores A Different Path…

Anthem’s present PBM is Express Scripts. Express Scripts and Anthem were not able to come to an agreement to extend their exisitng contract. Express Scripts recently acquired a medical benefits manager (EviCore Healthcare) for $3 billion to offset the loss of Anthem at the end of 2019 and to diversify their business model beyond pharmacy-centric healthcare industry sectors. There is also speculation Express Scripts may have also done this to avoid being acquired by Amazon who is expected to launch healthcare-focused business initiatives, including pharmacy services, in the near future.

Anthem is the largest Blue Cross Blue Shield affiliate; it operates plans in 14 states. The Anthem / CVS partnership will have its own business unit called IngenioRx. While CVS has its own PBM (Caremark), IngenioRx will be a separate unit and have its own management team and pursue business in other states beyond the 14 in which Anthem is established.

AllianceRx Walgreens Prime…

The IngenioRx partnership is similar to one already underway between Prime Therapeutics and Walgreens Boots Alliance (WBA) known as AllianceRx Walgreens Prime. It was introduced in 2016 and is a long-term strategic alliance comprised of a retail pharmacy network agreement and a combination of the companies’ central specialty pharmacy and mail service businesses. It is a collaboration of the nation’s fourth largest PBM owned by 14 leading Blue Cross and Blue Shield health plans (none are part of the Anthem organization) and one of the nation’s largest drugstore / pharmacy services providers.

United HealthCare / OptumRx And Catamaran…

In 2015, United HealthCare (UHC) acquired what was then the 4th largest PBM in the nation, Catamaran. Catamaran in many ways resembled Express Scripts including its penchant for driving growth through continually acquiring smaller PBMs and other specialized companies to fortify specific business units within it. UHC integrated Catamaran into its internal PBM unit OptumRx.

Each of these PBM arrangements is enormously significant. They impact a large portion of the population in the United States and have pivotal influence on pharmaceutical and other healthcare product manufacturer marketing, sales and market access strategies. Express Scripts is by far the largest independent PBM. It will be interesting to see how they align the existing pharmacy benefit and the new medical benefit capabilities to operate independently and individually moving forward.

Forging Ahead…

For now, the CVS / Anthem duo will be busy maintaining, growing their existing businesses and making extensive preparations to migrate the Anthem business from Express Scripts at the end of 2019. For other healthcare industry competitors in the marketplace with substantial interests in the pharmacy business like Aetna, Cigna, Costco, Humana, Rite Aid, Walmart; they will closely scrutinize their existing business models and marketing strategies to determine what they need to change to remain competitive and get maximum value from pharmaceutical and other healthcare product manufacturers.

Some of the larger health systems marketing their own medical / pharmacy plans may be impacted by these large collaborative agreements. If Amazon is indeed moving forward in the healthcare sector with pharmacy-related programs, they will need to strategically account for them as well. Healthcare industry business models continue to evolve; hybridization is an ongoing trend with wide reaching business to business, healthcare and consumer / patient impact.

Week Of October 8th, 2017
California Regulations Drive Up Costs

On Monday 10/9, California Governor Jerry Brown signed into law legislation requiring pharmaceutical manufacturers to report certain price hikes for prescription medicines. In the United States during 2016, brand pharmaceutical prices rose almost 13 percent on average. Generic pharmaceutical product prices increased by an average of roughly 0.32 percent. Specialty pharmacy pharmaceutical products (injectable therapies, biologicals, etc.) increased by an average of about 8 percent.

The rules are being put in place to provide more visibility to drug manufacturer pricing practices. The legislation (known as “SB 17”)requires drug companies to provide a 60-day notice if their prices are raised over 16 percent during a two-year period. Added measures to the legislation include the requirement of health plans and insurers file annual reports outlining how pharmaceutical costs affect healthcare premiums in California.

A Wilderness Of Exhaustive Complexity

Brand and generic pricing models are not simple. Starting with the basics, drug makers have to account for R&D, manufacturing and commercial support costs plus competitive measures, marketplace trends and contracting strategies to devise wholesale acquistion cost (WAC) for a product -its published “list price”. Once the pharmaceutical company engages the actual marketplace to sell a product; original WAC pricing is significantly transformed through an array of discounts, rebates, chargebacks and other contract agreement features. WAC is a manufacturer’s list price of a drug when sold to a wholesaler; then typically a 20% mark-up is applied to the manufacturer’s price which results in the average wholesale price known as “AWP”. SB 17 focuses on WAC pricing, not AWP pricing.

WAC is at the top of the pharmaceutical pricing funnel but once product pricing winds its way down in a particular channel’s contracting process; it is drastically different by the time it is tied directly to provider, payer and / or patient product acquisition costs. Contracting strategies impacting the original AWP are aligned with specific healthcare sectors. These include group purchasing organizations (GPOs), managed care organizations (MCOs), pharmacy benefit managers (PBMs), retail / mail order / compounding / specialty pharmacies, Medicaid, Medicare, 340B, DHA / TRICARE and others. Drug wholesalers and distributors each have their own way of contracting with pharmaceutical manufacturers and then apply different pricing / margin management / incentive formulas to their respective customers. AWP is diced and sliced differently once it travels into various healthcare industry business channels. A single contracting / pricing formula cannot be devised for use within a single or across business channels; each one operates differently to accommodate customers, align with class of trade and be in compliance with regulatory / reimbursement standards.

Whether it’s a direct sale from the pharmaceutical manufacturer to the point-of-care provider and / or through the wholesale / distribution supply chain, another series of variables comes into play including: national drug code (NDC) number, active ingredient, original or repackaged product, brand or generic status, formulation, route of administration and package size.

Digging down further in the details about package size alone represents its own pricing challenges. Depending on the unit volume of a container, the number of containers sold in one package and / or case, pricing is also differentiated. This can apply to pills, capsules, vials, pre-filled syringes, IV products and other formulations.

Procurement practices by purchasing / finance units along the way have an impact on final pricing. Depending upon how much of a particular product is distributed / administered / dispensed, pricing is impacted. Bulk quantities typically have better pricing and buyers may prefer them if their organization goes through a lot of the product or they may use less of the product but still choose to buy the bulk quantities to save money. Depending upon the organization, this can be a good practice (buying drugs at low prices) or a bad practice (outlaying funds and not converting the inventory back into cash fast enough).

Buyers also contend with the particular contract arrangement they are purchasing the drugs through as rebates, chargebacks and other incentives come into play. Other considerations include competitive measures between manufacturers, changes in formulary, brand / generic status, clinician preferences and product availability. These factors span all categories of pharmaceutical products and need to be accounted for in purchasing decisions. Based on these variables and AWP, the relevancy of WAC further erodes.

A Gold Rush Of Controversy

There is well found criticism of the legislation as it looks and sounds good to the media and consumers (i.e. voters) but falls short of accounting for the true complexities involved. While it puts a spotlight on pharmaceutical company pricing, it fails to address the pricing practices of wholesalers, distributors, health systems, pharmacies, PBMs and other stakeholders through which pharmaceutical products change hands. Another consideration is the premiums health insurers and MCOs levy on their memberships in relation to medical loss ratios (MLRs) and other risk management variables. To what extent are premium and copay increases attributed to rising drug costs versus the profits of health insurers and managed care organizations?

In the case of the California legislation, the requirement for health insurers and MCOs to file annual reports regarding the impact of drug costs adds to their operating costs. They will need to setup and manage ongoing streams of pricing data and other information to be compiled, analyzed and submitted to the state. Likewise, pharmaceutical manufacturers will need to account for these reporting requirements by developing tracking, analysis and compliance measures which will require data, staff and financial resources.

For state government, they will need to develop their own management processes requiring staff, IT and budget resources to manage the reports being submitted by dozens of pharmaceutical manufacturers, health insurers and MCOs. It is widely recognized administrative costs play a tremendous role in the spiraling expenses of healthcare; the requirements of SB 17 significantly contribute to the administrative burden for government, health insurers, managed care organizations and pharmaceutical manufacturers.

Pharmaceutical Manufacturers Stake Their Claim

The pharmaceutical industry delivers enormous value in minimizing the impact of acute and chronic health issues which can include the avoidance of costly medical procedures and constant professional care. While its profits are scrutinized, it is equally important to recognize the high cost of doing business in the healthcare product manufacturing sector. Complex research and development initiatives have staggering costs. Manufacturing, quality control, commercialization, legal fees and other factors all contribute to pricing considerations. It is also important to note pharmaceutical pricing and contracting practices are not essentially in the pure interest of profit. They are also in place so manufacturers can assertively compete against each other which helps to lower prices.

Pharmaceutical manufacturers have numerous options to choose from to minimize scrutiny of pricing practices beyond disclosing WAC. Pricing and margin advantages can be shrouded in contractual arrangements between GPOs, PBMs, MCOs and other business partners which are well within compliance and legal requirements. Other states have deployed or are in various stages of passing legislation similar to California’s so some drug manufacturers have already voluntarily committed to specific price increase limits on an annual basis. Price increases at the maximum level below the reporting requirements implemented across a series of calendar intervals are fair and reasonable options drug companies will consider regarding California and those states with similar requirements. Pharmaceutical companies still have the option to raise prices at their own discretion above the 16 percent over a two-year period threshold, routinely report it and be in compliance with the California laws. It may also encourage them to spike prices in a single year and revert to considerably smaller price increases in subsequent years.

Looking ahead, pharmaceutical companies may also choose to launch products with significantly higher WAC prices in the future. This will give them more room to maneuver with customers through various contracting arrangements. If the goal is to eventually limit pharmaceutical price increases through government price controls, WAC at launch will be a paramount starting point for pharmaceutical manufactures to introduce a new product. It may potentially trigger a trend in higher than normal drug prices for new and conceivably better pharmaceutical products moving forward as drug makers strategize they need to make more money out of the gate versus increasing profit gradually over the lifespan of a product. Pharmaceutical manufacturers may also be encouraged to acquire others to widen pipelines and portfolios of established products to make up for the loss of per product margin.

Will More Regulation Provide A Positive Payout?

Lawmakers, industry stakeholders, clinicians and patients / consumers are seeking a middle ground. Ultimately, it is higher care at lower cost. It is clear the State of California government and dozens of other state governing bodies want to do more to reign in healthcare costs. Political leaders want to be recognized and re-elected. Merely by introducing such legislation, politicians can claim they are taking action on behalf of their constituents. If states enact measures that are not well-conceived and administered, they generate bureaucratic waste, cultivate complexity and drive up costs for multiple stakeholders including government, health insurers, MCOs, pharmaceutical manufacturers, providers and ultimately patients / consumers / voters.


Week Of 10/1/17
Steward Health – A New Contender

Largest Private For Profit Health System In The United States…

At the close of September, 2017, Steward Health announced it had completed another hospital / health system acquisition and this one has particular significance. Its buyout of IASIS Healthcare now makes it the largest private for-profit health system in the United States. Steward Health, based in Boston, Massachusetts, picked up Franklin, Tennessee-based IASIS Healthcare for about $1.9 billion dollars. The deal was originally announced in May, 2017 and is now completed.

Expansive Organizational Reach…

Deals of this magnitude cumulatively impact the national healthcare provider landscape. Steward gains 18 hospitals primarily in the south / southwest; Arizona, Arkansas, Colorado, Louisiana and Texas. They are now the operator of 36 hospitals distributed across 10 states. It also gets ownership of a managed care business operating in Utah, Arizona and Massachusetts. The IASIS Healthcare acquisition immediately follows other Steward Health deals involving the purchased of 8 hospitals in Florida, Ohio and Pennsylvania.

Business Impact…

Steward Health will now be competing against a variety of new and established health systems across its marketplace coverage. The IASIS acquisition takes them further west than they have ever been. Their organizational size will provide them additional negotiating leverage against health insurers, group purchasing organizations and healthcare product manufacturers. For healthcare product manufacturers like pharmaceutical and medical device companies, Steward has much greater prominence in their business and marketing plans.

There is a great deal of M&A activity in the hospital / health system sector across the country. Tenant Health has been seeking to divest some of its hospitals and numerous organizations including Ascension, HCA, OCF Healthcare, Paladin, SSM Health, UPenn and UPMC have been seeking to expand their hospital / health system holdings. Some other proposed deals have been scuttled due to regulatory 
limits but they have not been enough to blunt the overall trend.

In addition to acquisition activities, a number of health systems have merged as well including Baptist Memorial and Baptist Mississippi, Geisinger Health System and Jersey Shore Hospital, Greenview Health and Palmetto Health plus a tri-combination merger of Cooper University Health Care, Lourdes Health and St. Francis Medical Center. Based on the ongoing hospital / health system M&A activity that shows no sign of slowing down, it can be presumed Steward Health will maintain its M&A momentum as the wave of consolidation continues.

Week Of 9/24/2017
The Horsepower Behind Healthcare Mergers Acquisitions

Giddy Up For A Deal

The healthcare product manufacturing sector as always been a changing landscape of new and old firms impacted by mergers and acquisitions. Biotech, pharmaceutical, diagnostics, medical devices, supplies and other producers have travelled the M&A range. Over the last 3 years, a remarkable run has established itself in healthcare M&A activity. A combination of conditions, resources and triggers has proven to be a catalyst for healthcare product manufacturers to charge ahead with merger and acquisition strategies.

Margins

Continued pressure on margins by managed care, regulatory agencies and patient / consumer advocate groups are having an impact. They help to drive healthcare product manufacturers to widen product lines to add revenue streams. If per patient / per unit income is less, increasing sales volume gets more consideration. Having more products to sell increases sales and provides bargaining leverage which are a tandem to drive sales and increase revenues despite margin pressure.

Diminishing Returns / Damaging Effects Of Continual Cost Cutting

Detrimental effects of relentless cost-cutting measures are more apparent. There is only so much out-sourcing, budget slashing and other “optimizing” measures can achieve until they have a corrosive effect on organizational effectiveness and deliver less return on the bottom line. It becomes necessary for companies to bolt on assets (which they seek to make more profitable through reduction of redundancies once deals are completed) to acquire additional capabilities and lines to sell. As more companies demonstrate their ability to outdistance competition through innovation in an increasingly technology driven business world, cost-cutting in many ways is a lower-tier option; the favorable strategy being M&A and innovation as an optimum tandem as long as debt loads can be optimally managed and reduced.

Plug The Revenue Leak

Blockbuster products are harder to develop and technology reinvents higher standards and levels of performance across product sectors. To engage more difficult patient types / diseases, therapies are more complex and challenging to develop. High margin niche products deliver good income but treat fewer numbers of patients. Technology and material advances can quickly render existing medical devices obsolete. Pipeline candidates don’t make it to the approval stage or are outdated before they are launched. Meanwhile, established products reach the end of their patents or fall out of favor with clinicians and contemporary care standards. Acquiring another company’s products and their pipeline buys time, widens / refreshes lines and hopefully provides new products to introduce.

Growth By Acquisition Strategy

Some established and new healthcare product manufacturers are relying much more on buying other companies and investing less in traditional internal research and development. Their research and development initiatives literally center on finding embryonic and startup firms with novel product concepts. These companies can be invested in as satellite research and development units and funded as appropriate depending on progress and promise of product approvals.

Come Buy Me ( CBM )

A variation of the Growth by Acquisition Strategy is the “Come Buy Me” (CBM) business model strategy. CBM organizations make a series of small acquisitions which are usually focused in select healthcare sectors for example dermatology, respiratory, lab diagnostics, etc. As a cluster, the company establishes a market presence within the particular medical sector. Collectively, the products produce more impactful revenue and with launches, the company further establishes itself as a proven entity within the specialty.

The CBM continues to ratchet up its growth through incremental product launches and additional deals. The strategy is to build up enough of a profitable portfolio of products and market presence that another company seeking to have a wider footprint in the sector for long term growth acquires them. The goal is not to build a dominant entity in the sector, the goal is to assemble a group of sector products under one organization which can be sold as a bundle to enable another company to quickly widen market presence.

Competitive Threats

Even established healthcare product companies historically adverse to mergers and acquisitions are engaging in them to blunt competitive threats. Other companies accelerate their market presence and product line heft through acquiring other companies and quickly scale up to become assertive challengers to sector incumbents. Conversely, to prevent challengers from penetrating a long-held sector or invading a new one that an established product company is just beginning to enter, they conduct an acquisition to firmly entrench themselves in the new sector, fortify their position and disadvantage competitors.

Private Equity

Healthcare has always been a popular playground for private equity (PE). They can take large and small companies private and with a variety of options available to them, either retain them as cash cows for other deals, sell them to other PE companies or re-launch them into the public sector again. They are strategically savvy enablers of M&A activity in the healthcare industry.

Favorable Financing

Strategically creative and assertive lenders, large cash reserves and solid stock performance build corporate confidence in exploring their M&A options. Investors are seeking more from their holdings and companies have to find ways to satisfy them. They can choose to build themselves up further through acquisition or have a “going out with a bang” sale to another company.

Technology

In pharmaceutical, medical device and healthcare supply manufacturing, technology can be a difference maker. Technology driven insights, processes, and production capabilities are critical contributors to competitive performance. Healthcare product producers can buy a competitor using these advances and apply them to their own commercial operations; they can also choose to acquire the companies developing these resources. There is always the option to develop these advantages internally but there is not always time or the appropriate mix of staff, finance and IT to generate productive ROI quickly from them.

Saddle Up

Depending on the company, any combination of these conditions, resources and triggers can result in the undertaking of a merger and acquisition strategy. They have a wide ranging effect on patients, consumers, providers, public / private investors and various commercial entities. Market conditions can change rapidly and reverse the trend; companies then choose to rein in their merger and acquisitions activities. Large or small, mergers and acquisitions in the healthcare sector are an ongoing and eventful ride.


Week Of 9/17/2017
A Deceptively Unique And Effective Healthcare Broadcast Ad / Digital Marketing Strategy
Two-Screening Strategy Scores Points During Super Bowl 51…

A new NFL season is underway but a quick look back is warranted at how last season ended with a Super Bowl upset and a deceptively unique and effective broadcast ad / digital marketing strategy was executed. A regional building material and supplies retailer and a Pittsburgh-based ad agency successfully deployed a two-screening strategy during Super Bowl 51. They effectively combined brand identity, a “customer journey” of sorts and broadcast advertising with digital marketing attributes and contemporary TV audience viewing habits. For healthcare industry and other marketers, it is an optimum model to revisit and compare against existing TV advertising and digital marketing activities to develop more impactful and measurable marketing initiatives with greater ROI.

Understand Two-Screening Behavior…

Two-Screening is the act of watching TV while also engaging another digital device; frequently a mobile phone, or tablet. Viewers tuned into TV programming are dividing their time between the TV screen and the screens they readily control in their hands. Two-screening is controversial and here to stay. While television ratings are based on the number of viewers and audience demographics associated with the featured programming shown, two-screening diminishes true rating performance. While the ad is shown at the ideal time coupled with the programming most closely aligned to the audience being targeted; audience members can make a choice of watching the ad or catching up with text messages, emails, their social media accounts or other options through their mobile phone or tablet. A report published by Accenture in 2015 estimated about 87% of consumers used a second screen while watching TV. 84 Lumber and Brunner, their ad agency, developed a two-screening strategy to work in their favor.

Understand Two-Screening Technical Enablement…

Displays in mobile and other devices are excellent. Batteries and wireless are constantly improving, devices don’t have to be constantly tethered to a cord to recharge; great wireless / wifi eliminates the need for them to be latched to a cable. Downloading and viewing is almost seamless, the speed / consistency of displayed content is virtually real time. To add fuel to the fire, some consumers are using their phones and tablets to control their TVs, making two-screening all the more an integral part of the TV viewing experience.

A Contributing Driver Of Two-Screening Behavior…

Advertisers and networks seek to cultivate more revenue by featuring multiple clusters of ads over the course of an hour. The clusters of multiple ads encourage viewers to look at something that specifically interests them until the featured programming content resumes. Commercial breaks trigger consumers to reach for their mobile phones and tablets where they control content they prefer that is accessed, scrolled, swiped in seconds. The longer the commercial break, the more deeply engaged the two-screening audience is with the content shared from the device in their hand. The customer has a choice of journeys, why not encourage them to choose the journey your brand offers? Based on these challenges, healthcare and other industry marketers with heavy TV ad spend need to be more innovative in how they can effectively span broadcast and digital venues and generate measurable ROI; a strategy that embraces two-screening may be a viable option.

Profile Of 84 Lumber And Their Ad Agency, Brunner…

Founded in 1958, 84 Lumber is a privately-held retail building material supply company. 84 Lumber is based in 84, Pennsylvania (near Pittsburgh). Brunner was founded in 1989 and is a privately-held, independent agency headquartered in Pittsburgh. Brunner has worked with a number of notable brands. For both firms, it was their first Super Bowl ad.

How 84 Lumber And Brunner Developed And Executed Their Two-Screening Strategy…

When the ad was reviewed by Fox, the network televising the Super Bowl, some of its content was deemed “controversial”. The content was then partitioned, some to be featured via broadcast and the remainder via digital. The broadcast portion began the journey / pitch and then guided the audience to go to their website to view the outcome. Based on the rumored “controversial” content, there was already a media buzz about the ad prior to the Super Bowl. The story content on the broadcast side was compelling enough, however; for a large number of viewers to follow through on their own via their mobile phones, tablets to experience the rest of the commercial.

Impact…

Once the ad aired, within one minute following its showing the 84 Lumber server experienced more than 300,000 hits; excess volume had to be routed via paid social to YouTube (the enormous surge of traffic was one thing 84 Lumber and Brunner had not fully accounted for in their technical preparation). Despite the other advertising candy the Super Bowl is known for and of course the game itself, a sizable viewing audience immediately opted to further engage the brand via digital. YouTube, featuring the broadcast ad and the digital extension, continued to experience high traffic navigating to the 84 Lumber content for days. 84 Lumber and Brunner masterfully executed a two-screening strategy to their advantage; bridging unique, story-based content from the broadcast space to the digital space where the audience could purposely engage the messaging further and also be measured accordingly by web analytics. What are some of the takeaways for healthcare and other industry marketers to consider?

Get More From Broadcast Television Advertising And Digital Marketing…

For healthcare and other marketers investing millions in television ad development, testing and deployment; two-screening is a growing part of the challenge when it could be part of the formula. Audiences migrating to non-TV network provided programming are challenging broadcast advertising strategies even further. A deliberate strategy to take advantage of the two- screening audience can enable marketers to get more ROI from their broadcast and digital marketing budgets along with collecting ongoing valuable data. With a structure of quality content, an effective segue and knowledge of audience viewing habits, they can convert the two-screening threat into a competitive edge.

There are significant details involved with direct-to-consumer advertising on TV. Scenarios, aesthetics, animation versus live action, written / voiceover messaging (including the required fair balance rhetoric) all have to be accounted for within a 30-second space –-60 seconds is a luxury but sometimes used if the budget is right, the product is at launch, under competitive siege or especially complex. Imagery and messaging must be powerful enough to steer the patient journey in the direction of the call to action, i.e. “Ask your doctor if __________ is right for you”.

Considerations…

Why should the patient journey with your brand end there when it maybe more impactful / measurable by continuing at the brand’s website?
How can the audience’s recall be more effectively reinforced to “ask their doctor”?
How many times and at what cost does it take for 30-second ads to have measurable impact?
How can the consumer / patient be technically enabled to share the ad’s information with family members or friends?

Know your audience…

An effective two-screening strategy purposely develops compelling content and deploys the broadcast ad with an integrally effective segue guiding the viewer to the website for the rest of the story. Based on Accenture’s data, there is a good chance overall audience members will have the second screen device within easy reach to do just that. Depending on the desired audience sector targeted, market research will need to assess what their viewing habits are and their propensity to be “two-screeners”. If the greatest portion of the desired audience is typically without a second device, the two-screening approach is not an effective strategy or the ad can be designed to effectively deliver the brand message via broadcast while somehow accounting for two- screeners as well to garner their engagement on the digital side.

Two-Screening Advantages…

Healthcare marketers can effectively span broadcast and digital venues

The TV portion of the ad is not over-burdened with encapsulating the brand experience from start to finish

By aligning TV ad times with website visits, the immediate response to ads can be assessed

Further audience insights on the extent of two-screening and their use of devices, locations, etc. can be cultivated

Website engagement will reveal further insights on the audience and their particular interests in the brand and the information provided in the digital realm

Web content, optimized with sharing features, can enable the audience which originated on the broadcast side to propel the digital content through social sharing to a secondary audience and so on without having to pay for more ad time and result in even greater overall ROI

If engagement is lower than expected despite being positioned with the intended audience, explore the reasons why; is the content not compelling, the segue not well communicated or is the ad already a two-screening casualty and not being viewed by as many audience members as anticipated?

How To Plan A Two-Screening Initiative…

Carefully interpret industry data on audience mobile, tablet usage and TV viewing patterns and conduct your own research initiatives as well; this knowledge is pivotal for a successful two-screening strategy

Develop detailed budgets in advance, initiating an effective two-screening initiatives may require more financial resources than originally anticipated

A two-screening strategy requires more preparation and resources to effectively execute plus its novel approach should be reserved for high priority use; examples include A) new product launch or new indications B) countering an assertively potent competitive threat C) new campaign for an established brand D) special televised event sponsorship

Establish goals and objectives on the broadcast side and digital side to individually and collectively measure effectiveness and ultimately ROI

Test story concepts, account for the patient journey, test content, test the segue from broadcast to digital, test effective continuity on the digital side

Pilot the two-screening approach with a miniature budget and targeted audience to fine tune and scale up

Account for all medical / regulatory requirements on the broadcast and digital side

Be certain website capacity is able to easily accommodate surges in traffic

Verify the broadcast and digital content is well assimilated and viewed via mobile and tablet screens

Maximize social sharing technical attributes; make it easy and encouraging for the broadcast audience who travelled to the digital realm to share the brand experience with others digitally

As audience groups continue to migrate to new digital / social / streaming venues, develop modified two-screening strategy options accordingly

Closely monitor ad fatigue; determine ways in advance to produce new digital experiences for the broadcast audience to segue to in the future

An Innovative Healthcare Broadcast And Digital Marketing Strategy…

A successful two-screening initiative is much more than a request to “visit our website”. It’s an integrated content and technical strategy to embrace a broadcast audience and comfortably transport them from their living space to the brand’s living space where they can spend longer, more meaningful time than just 30 or 60 seconds with your brand. They can explore the brand experience at their leisure; share it with family members and friends while determining what their next steps are.

Follow the customer / patient journey map…

In many ways the two-screening strategy can align well with today’s digital consumer and their respective patient journeys. It is imperative to know where and how you can align your brand strategy to it first before you invest in deploying it. As audience preferences change and technical innovation provides them with more routes and destinations to choose from, follow their map and modify two-screening strategy accordingly; stay ahead of the customer journey and your competitors.

Week Of September 10th, 2017
Healthcare Digital Marketing Organizational Effectiveness:
Put Five Ducks In A Row

Digital marketing initiatives are a mainstay action in healthcare industry commercial organizations. On the surface, they are aesthetically engaging and smoothly functional. Underneath, there is a wide array of organizational, financial and technical resources deployed to develop and deliver them. How these goals and assets are shared before digitalization of business concepts occurs can make a tremendous difference in the overall customer experience, a company's competitive advantage and ROI. By having their ducks in a row first, organizations can have the fundamental elements aligned to develop and launch deeply successful healthcare digital marketing initiatives despite ever-changing marketplace undercurrents.

Leadership Commitment

• Consistent forward-thinking by present and future senior company executives to fund and optimize healthcare digital marketing initiatives as something as integral as managing payroll

• Realization by upper management that digital marketing is never completed; changes in technology, regulations, information sharing practices, marketplace forces and social media fluidly impact each customer segment and respective customer journeys

• "Be in it to win it"; outdated, under-funded approaches are quickly revealed to customers by who else but competitors seizing the opportunity to better align with customers with more strategic, assertive deployment of digital marketing assets

Customer Connection

• In concept, the company understands the importance of reaching out to customers and with equal or greater importance; learns how customers reach the company and its products / services through their journey and make decisive buying decisions

• Healthcare digital marketing is complex; to what degree can digital marketing initiatives / customer focus overlap before they are dilution occurs and separate initiatives to be developed?

• Which digital marketing customer segment (consumer, patient, nurse, physician, pharmacist, payer, institution, trade partner and other entities) and respective initiatives provide the greater ROI?

Integrated Marketing / Brand And Digital

• Brand and digital marketing units must share common goals and objectives otherwise they separate to serve their own agendas and become jointly dysfunctional; they should be equal stakeholders in how customers perceive, engage and choose the company's offering and the overall customer experience

• Effective brand and digital marketing teams interoperate as a multidisciplinary business unit; they are an integral hub with direct conduits to sales, managed markets, market research, trade relations, regulatory, corporate communications, IT 

• A primary, binding objective of the integrated marketing units is equal improvement of ROI and the customer experience 

Technical Resources

• Technical resources will be continually assessed, upgraded, discontinued or changed out due to innovation, improved cost efficiencies and impact on the strength of maintaining the optimal customer experience and ROI

• Internal (company stakeholders) and external (outside vendors) must be synchronized in technical approach otherwise a gap in resource ROI will emerge and widen -degrading focus, eroding customer experience and ultimately running up costs

• Brand and digital marketing teams, along with multidisciplinary counterparts, take ongoing technology changes in stride; maintaining focus on customers and business goals while effectively rotating tires on a rolling carload of technology innovation 

Partnership With Sales

• No matter the level of "feel good" factor, uniqueness of approach or messaging, level of detail or volume in content, digital marketing initiatives must be steered in the direction of the company's bottom line and ultimately sales

• Sales is a beast, the "Transactionator", which must be well fed; if it goes hungry, it weakens and so does the company that surrounds it; digital marketing initiatives must contribute to feeding the Sales beast

• Brand and digital marketing teams, with their multidisciplinary stakeholders, need to partner with Sales and be certain the content generated and delivered contributes to a positive customer experience resulting in actions taken to generate sales

Strategically developed and deployed healthcare digital marketing initiatives are a mainstay in cultivating revenue regardless of competitive, technological or marketplace change undercurrents. . Uncoordinated efforts clutter customer perception, deplete resources and dilute organizational focus. By collaboratively defining, aligning and supporting their ducks in advance; organizations avoid swimming in circles while maximizing customer experience and ROI.