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

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 ( Humira’s worldwide annual sales are approximately $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 by not acquiring Knoll. A further consideration would be how BASF would have succeeded had they not sold Knoll. Humira's commercial success was never guaranteed, undoubtedly Abbott's and White's pharmaceutical business savvy enabled Humira to hit the ground running following its launch with effective market access strategy and the ongoing addition of FDA approved indications.

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. Hospira was subsequently acquired for $17 billion by Pfizer ( NYSE: PFE ) in 2015.

MediSense diagnostic and blood glucose monitoring 

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 became a global leader in blood glucose monitoring despite numerous low cost competitors entering the sector.  

Abbott'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 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.

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 unorthodox, the arrangements allowed for Boston Scientific and Guidant to close their deal and avoid antitrust issues with regulators.

GE and Abbott Diagnostics deal implodes

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.

Solvay and Piramal acquisitions

Undaunted by the GE deal meltdown, White outdistanced this 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 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

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 “internalized” 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 or 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

Moving forward

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

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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 3^rd 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 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.  

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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. 

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:

• Commercial vibrancy based on greater import / export activity
• Political stability
• Improved educational resources 
• Domestic / international academic healthcare interests 
• Domestic businesses partnering with outside commercial organizations / investors
• Diversified economies expanding beyond agriculture and basic manufacturing
• Better access to information and technology via Internet, wireless, mobile

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

The start of something big

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. 

Cultivating fertile ground

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, often limited in scope and scale, can be a norm in emerging markets you will have to account for. Traditional healthcare and prescription benefit plans are present but service only a small part of the population. 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.

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.

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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 26% of AmerisourceBergen; 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

Walgreens is launching significant cost reduction measures

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.

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. 

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.

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 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. 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 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 generates about $142 billion in yearly sales. 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 generates about $75 billion in annual sales. 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 is an interesting and viable 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.

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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's U.S. headquarters is located in Memphis, Tennessee; its global headquarters is based in Amsterdam, the Netherlands.

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.

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 continues to climb in the Fortune 500; currently ranked at #233 and employs over 36,000 persons. The combination of Stryker’s and Wright’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
• DJO Global
• Getinge
• Hillrom
• Johnson & Johnson
• Medline
• Medtronic
• Smith & Nephew

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

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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 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

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

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. 

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.

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Facebook is partnering with the Federal Government and professional medical associations to drive innovation and better consumer health and patient care through social media. 

Facebook and these four leaders in healthcare are taking action:

American Cancer Society

American College of Cardiology

American Heart Assocation

Centers For Disease Control And Prevention

The tool is accessible by typing “preventive health” into the Facebook mobile app. After users enter their name and age, they receive customized, detailed, evidence-based preventive healthcare and wellness measures intended to cultivate consumer / patient healthcare awareness and productive conversations with primary care doctors.

As a leader in social media with diverse reach into numerous human populations and healthcare being of universal importance, Facebook is leveraging its abilities to support them as well as the medical community.  It is also working to reduce the amount of false or inaccurate information shared on social media that misleads people and / or prevents them from seeking the appropriate care needed especially in critical healthcare situations.

Some of the acute as well as chronic healthcare features supported by the application which supports the healthcare needs of men and women include:

• Blood pressure tests
• Cholesterol tests
• HPV screenings
• Immunizations / vaccinations ( Flu, Hepatitis, HPV, Measles, Shingles, etc.)
• Mammograms
• Pap smears

The application provides checklists, professionally written and approved consumer healthcare information, doctor appointment reminders, and a convenient physician finder function to locate federally qualified health centers.

Healthcare professionals on a global basis agree preventative healthcare and wellness measures help all people avoid more serious and costly medical treatments. The goal of the Facebook application and healthcare program is to support them.

LinkedIn: John G. Baresky

Twitter: Healthcare Marketing Guy

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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 benefitted 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 and Walmart 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 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 AmerisourceBergen 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.

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 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). 

United Healthcare 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

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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

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

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Sartorius Group ( ETR: SRT ) is acquiring the life science business unit of Danaher Corporation ( NYSE: DHR ) for $750 million. Based in Gottingen, Germany, Sartorius will add the Danaher unit to its already sizable array of product and services it develops and markets to biopharmaceutical, food and beverage manufacturers, chemical companies plus academic healthcare and research customers.

Danaher’s selloff of their life science unit is part of a shuffle Danaher is orchestrating to satisfy regulators and antitrust concerns about their ongoing deal to buy GE’s ( NYSE: GE) life sciences business unit for approximately $20 billion.

Danaher, based in Washington, D.C., already has an array of chemical, life science, laboratory and diagnostic businesses in their organization; the better known ones include Beckman Coulter, Pall Corporation and Leica Biosystems.

LinkedIn: John G. Baresky

Twitter: Healthcare Marketing Guy

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Infographs have powerful attributes to improve healthcare digital marketing, social sharing, brand awareness and sales performance

Social media and other digital channels offer an array of choices to engage consumer, patient, clinician, payer and other stakeholders. There are many resources and strategies to choose from. Infographs have powerful attributes as strategic assets to improve healthcare digital marketing performance, social sharing, brand awareness, sales / ROI. Well-designed and strategically deployed infographs can be a competitive edge in websites, social media (think Facebook, Google Plus, Instagram, LinkedIn, Pinterest, Snapchat, Tumblr, Twitter) and other digital venues –with flexibility to bolster print communications as well.

…According to HubSpot, visual content is more than 40 times more likely to get shared on social media than other types of content…

Attributes

·         Well-designed infographs are frequently linked to; audiences have an affinity for sharing them -essential elements in digital / social media marketing

·         Some processes or directions can be written in detail but not easily understood; infographs can effectively parallel text to be the ideal accessory so content is visualized and fully comprehended

·         Infographs can be an integral feature in supporting a brand launch or be an addition to refresh and reinforce digital marketing initiatives of an established brand

·         They provide differentiation but maintain brand consistency, integrity

·         Infographs effectively engage audiences adverse to reading blocks of rhetoric and can even draw viewers into reading the accompanying text they otherwise would have skipped

·         Can be targeted to specific consumer, patient, clinician (doctor, nurse, pharmacist), other stakeholder audiences and preferred social venues

Key considerations

Budget

Funding limits are pivotal. Infographs can usually be developed inexpensively but depending on their design, how many are going to be produced, interactive features and where they are going to be used, costs can run up quickly. The necessary technical aspects for them to be shared and tracked across digital venues have to be incorporated within them from the start which requires additional financial resources. If funding gets tight and corners have to be cut, visual quality and technical performance may suffer.

Goals

How and why the infographs will be used needs to be defined early. This will make it much easier for them to be designed, deployed and shared across digital venues. It will also align them with overall brand and digital marketing strategies leading to improved sales performance and ROI. This will enable them to be designed for specific tasks in supporting the brand, engaging audiences, effective social sharing, generating leads while avoiding the creation of superfluous and ineffective content which wastes resources.

…Based on HubSpot data, as the number of images in an email increases, the clickthrough rate of the email tends to decrease…

How / where they will be viewed

It seems fundamental but it cannot be overlooked; each of the display venues where the infographs will be viewed (mobile, tablet, desktop, wall displays, conference exhibits, etc.) need to be accounted for. For added versatility, consider if the content will be issued via print as well. Keeping in mind the display venues and technical attributes of how the infographs will look or function from the start can avoid costly delays and re-designs later in the development process.

Recycle

Conduct an audit of the text, graphics and other content currently being used by the brand as well as what has been used in the past. Determine what content can be re-purposed. In parallel, assess how competitors and others are using infographs and what can be adopted for your particular infograph initiative. Some of the advantages with re-purposing when developing infographs are consistency of messaging, savings in development costs and streamlining the medical / regulatory review processes since some of the content has already been approved. In parallel, assess how competitors and other entities are using infographs; adopt the best details and avoid the worst characteristics for your particular infograph initiatives.

Audiences

Healthcare digital marketing encompasses an array of venues and target audiences. Where will the brand and sales performance benefit the most from the use of infographs? By targeting specific audience sectors and their preferred digital / social sharing venues, content can be developed with greater focus. Initial deployment via website and/or direct sharing can be strategically selective. Here are a few to consider in developing an infograph strategy:

·         Clinicians (doctors, nurses, pharmacists) according to medical specialty and point of care

·         Consumers

·         Employee benefit consultants

·         Employers

·         Hospitals, health systems, large practice group administrators, clinical / financial decision makers, etc.

·         Managed care / managed markets (MCO, PBM, Home Infusion, LTC, Specialty Pharmacy, Surgery Centers, TRICARE, etc.)

·         Patients

·         Wholesalers, distributors, medical suppliers, GPOs

Sharing

Infographs travel well; while they can start out at a brand website, consider how else they may be shared once released. Consider more assertive strategies to deploy them directly via social media channels or other digital venues. This will enable the brand and its infographs to be present in the most strategic hubs to have quicker initial impact, accelerated sharing, direct / indirect sales or lead generation and even immediate ROI. Pack their bags with the right key word phrases and coding so their journeys are productively long with multiple sharing destinations beginning in the most strategic digital / social sharing venues.

Aesthetics

Good visuals are critical in creating robust infographs. There’s an array of elements to think about, here are a few to start with:

·         Brand alignment / cohesiveness

·         Ease of reading / flow of information

·         Distinctive without being distracting (unless that’s a goal!)

·         Too simple? It may end up being a cluttering feature

·         Too long? It may need to be simplified or require a second infograph

·         Will it retain the right appearance and functionality as it’s shared across platforms?

·         If animation is used (a great way to engage viewers), this will add costs, time to develop and require more medical/regulatory review –verify funding is not an issue

·         Does it effectively fit in the presentation? Some infographs can be used as standalone communications but it’s advisable to feature them as supporting communicators of adjacent print content; assess what works best with each infograph

·         Always test infographs carefully. Content flow may seem clear to brand teams, creatives and other insider stakeholders but confusing to consumers, patients, clinicians and other viewers; a little fine tuning based on outsider feedback can make a tremendous difference

·         Be certain branding / messaging elements will remain reasonably constant in the foreseeable future before infographs are deployed — avoid the duress of having to retrofit color, messaging and other elements to align with new branding and/or messaging

·         Does the aesthetic design and messaging content support technical needs and vice versa; be certain it is rich with strategic keyword content to accomplish SEO / SEM objectives

Technical

Throughout content development and design phases of infographs, SEO, SEM and other key elements of digital marketing must be accounted for; here are some tips:

·         Be certain content supports a keyword phrase. Placement of a keyword phrase in the URL is important (this also applies to Meta Description, H1 headings); furthermore, it’s necessary for the Alt Text, too, as the standalone infograph is just an image; search engines can’t crawl image content, they need to be told what it is

·         If multiple infographs are in a campaign; the keyword phrase should be incorporated within each but carefully differentiated or search engines may consider the group of infographs to be duplicates of one

·         A website address should be featured within the image as well; no matter how/where the infograph is shared, it serves as a homing beacon

·         Be certain the embedded code for the infograph is easy to copy so it’s easier for others to republish it and includes a link back to its original site

·         Go the distance in making it easy to share; there are countless infographs and other content featured in blogs and websites not easily shared or push button friendly; invest in the coding required to facilitate its travel –skimping on this is brand, digital marketing and ROI neglect

·         Make a list of primary social venues your infographs may be shared through (Facebook, Google Plus, Instagram, LinkedIn, Mobile Text, Pinterest, Reddit, Twitter, Tumblr, etc.) and secondary venues they may travel through such as consumer, patient, clinician sites, etc. Identify specific tools and strategies to track them; minimize dark social before the infographs are issued

Evaluation

Once infographs are deployed, evaluate their impact:

·         Align their performance with pre-determined goals which include sales performance and customer awareness / engagement, assess effectiveness

·         What expected / unexpected sharing developed?

·         Track user engagement in primary / secondary venues; selectively refuel sharing by re-distributing them through initial venues and in new ones

·         Evaluate competitive responses

·         What learnings can be applied to other healthcare digital marketing initiatives to generate sales?

·         Account for dark social; have a strategy to gain insights from discovering more about hidden sharing and abstract data, provide your infographs and digital marketing initiatives with a competitive edge and improve ROI

Summary

…Infographs are versatile high performers for digital healthcare marketing initiatives…

Their aesthetics can vary widely; the tandem of text and graphics enables them to appeal to a variety of healthcare audiences and potential sales opportunities. The inclination of audiences to share infographs and the digital mechanisms available to send them on travelling content journeys make them even more economically and assertively practical to deploy in healthcare digital marketing and sales initiatives. When evaluating options to challenge competitors, engage customers with meaningful, creative content and drive healthcare digital marketing ROI performance, be sure to consider the valuable attributes of infographs.Good luck, we're all counting on you.

LinkedIn: John G. Baresky

Twitter: Healthcare Marketing Guy

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CDC, FDA and the Medical Community Are Taking Action: The "EVALI" Crisis

As the issues surrounding the use and healthcare consequences of e-cigarettes and vaping continue, medical professionals and the Centers for Disease Control are dialing in quickly while engaging multiple related concerns at once.

Status of EVALI in the United States:

• For now, CDC has defined vaping-related illnesses as “EVALI” –an abbreviation for “e-cigarette, or vaping, product use associated lung injury”
• EVALI has triggered illnesses in approximately 1,350 people that have resulted in 33 fatalities thus far
• The CDC and medical professionals are not only working on present patient care concerns but also engaged with prevention and strongly encouraging consumers to avoid any form of tobacco PLUS e-cigarette or vaping products of any kind ( adolescent and teen use of such products is especially concerning )
• For the approximately 1,350 EVALI patients the CDC has compiled age and gender data on, 79% are under 35 years of age with an average being 23 years old; roughly 70% of the EVALI diagnosed patients are men and the youngest patient is 13 years old
• In parallel to these measures, CDC and medical professionals are combing through vast amounts of patient care records and other data to potentially identify previous cases and those cases presently misdiagnosed
• Evidence has presented itself regarding past cases of relapses as patients initially were admitted to hospitals, treated and discharged then re-admitted; unbeknownst to medical professionals the respiratory symptoms were a result of e-cigarette or vaping product use
• The CDC has already issued new guidelines to help medical professionals assess EVALI and other respiratory issues with the goal of accelerating diagnosis and effective treatment for patients as well as differentiating EVALI from other respiratory cases for tracking and treatment protocol development purposes

Flu Season and Measles Outbreaks:

• A significant concern is the timing of the EVALI crisis; the U.S. is entering the Flu season; a highly contagious illness often accompanied by respiratory issues -medical professionals will have to differentiate between EVALI and flu cases or combined EVALI and FLU cases
• For consumers continuing to use e-cigarette and vaping products, they may be more vulnerable to the Flu and severely impacted by respiratory problems should they contract it.
• An ongoing challenge are Measles outbreaks; Measles cases can result in respiratory issues which may be multiplied in event the patient is also an e-cigarette or vaping product user –in addition to piling on more challenges for the CDC and medical professionals to deal with over the course of this Fall and upcoming Winter months
• CDC and the medical community strongly urge consumers to seek flu immunizations in advance as well as consult their primary care physician or other suitable healthcare professional regarding the Measles vaccine

Payers are concerned:

• Payers ( managed care organizations, health insurance companies ) are busy quantifying care, risk and cost implications related to EVALI

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Amazon's steady expansion into selectively targeted healthcare industry sectors continues. 

These seven articles are exclusively dedicated to Amazon's strategic planning and execution centered on the development of an industry-leading healthcare business unit: 

• Amazon Ventures Deeper Into Healthcare: "Amazon Care"
• Amazon ( Nasdaq: AMZN ) And Its Online Pharmacy PillPack Have Options
• Amazon's New Online Mail Order Pharmacy Business Unit "PillPack" Is Underway
• Amazon Web Services Teams Up With Pittsburgh Health Data Alliance
• Amazon Web Services / Aws Cloud In Talks With EHR / EMR Healthcare Data Giant Cerner
• Amazon: Who Will They Bite In Healthcare
• Amazon: Preparing To Flood The Healthcare Industry 

Access all seven of the articles by clicking this link:

AMAZON IN HEALTHCARE

Amazon's commercial, technical and clinical enterprises include these and other elements featured in the articles:

• Artificial Intelligence, Cloud Computing 
• Clinical Research, Employee Medical Benefits 
• Consumer Marketing, Healthcare Marketing Strategy
• Competitive Strategy, Industry Transformation
• Digital Marketing, Ecommerce
• FTC Antitrust Litigation
• Healthcare Supply Chain, Online Pharmacy 
• Hospital Electronic Health Records ( EHR )
• Managed Care, Market Access, Pharmacy Benefits
• University Academic Partnerships including University of Pittsburgh and Carnegie Mellon University
• University of Pittsburgh Medical Center ( UPMC ) Collaboration

LinkedIn: John G. Baresky

Twitter: Healthcare Marketing Guy

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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

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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.

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

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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 unvaccinated 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 minimalized through decades of medical research, pharmaceutical manufacturing expertise, rigorous immunization schedule planning and vaccine administration

• Assertive and consistent information sharing must be maintained through broadcast and social media, clinicians, healthcare regulatory agencies, payers / health insurers and consumers to erase  misinformation about vaccine safety and the pivotal importance of immunizations prior to advance of outbreaks in Flu, Measles or other preventable disease

Early in 2019, the President of the American Academy of Pediatrics, Kyle E. Yasuda, M.D., FAAP, issued letters to the chief executive officers of these leading Internet search and social media companies seeking their assistance in assuring parents using their tools or venues are provided factual, clinically correct information:

• Alphabet / Google - NASDAQ: GOOGL ( owner of Verily, YouTube )
• Facebook - NASDAQ: FB ( owner of Instagram and WhatsApp)
• Pinterest - NYSE: PINS

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The FDA approved a new drug to treat migraines from Eli Lilly ( NYSE: LLY ). Brand name, " Reyvow", the drug has  proven effective to resolve Migraine pain and other symptons, including nausea and light sensitivity, in two hours.

Nick Kozauer, M.D., acting deputy director of Neurology Products for the FDA commented:

“Reyvow is a new option for the acute treatment of migraine, a painful condition that affects one in seven Americans”

Researchers believe Migraines are the result of fundamental neurological abnormalities caused by genetic mutations at work in the brain. New models are aiding scientists in studying the basic science involved in the biological cascade, genetic components and mechanisms of Migraine.

Understanding the causes of Migraines and the events that effect them will give researchers the opportunity to develop and test drugs that could be more targeted to preventing or interrupting attacks entirely. 

On a global scale, it is estimated Migraines impact about 10% of the population; women three times more than men.

LinkedIn: John G. Baresky

Twitter: Healthcare Marketing Guy

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Started in 2015

Established in 2015 to drive awareness and support of healthy eating habits and lifestyle practices, World Obesity Day is here to help everyone feel better and live better.

Worldwide impact

According to the World Health Organization ( WHO ), Obesity is a global challenge impacting over 2 billion people. Its complexity and need for long lasting solutions mark it as an important issue for all cultures and nations.

Personal and societal benefits

World Obesity Day seeks to build awareness and encourage action to help people everywhere maintain a healthy weight which will also contribute to numerous other aspects of their social and physical well-being.

Cost of obesity

The Centers of Disease Control and Prevention mirrors the World Health Organization with its concern; in the United States alone, obesity costs are forecasted to weigh down the health system by $644 per person. Even more alarming is the rising incidence of obesity in children which can have immediate and lifelong negative impact on them.

LinkedIn: John G. Baresky

Twitter: Healthcare Marketing Guy

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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

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