Direct to Consumer: Building the Super Consumer

They can't leap tall buildings in a single bound, but in the world of pharmaceutical marketing, "super consumers" are undisputed heroes. Long recognized in the United Kingdom and acknowledged recently in the work of Kate Lorig at Stanford University, the super consumer is, simply put, an expert patient.

Kristine Nash-Wong

Super consumers are self-driven, take-charge folks who possess the confidence, skills, and knowledge to better self-manage chronic conditions and general health challenges such as obesity, stress, and lack of sleep or exercise. Compared with the rest of the population, they make better use of healthcare resources, have better relationships with providers, and exhibit higher levels of treatment compliance. Super consumers have not only the ability to identify their symptoms, but also the initiative to go to the doctor and request a prescription, generally by brand name. They also readily fill their prescriptions, take medication as prescribed, and get refills on time. Once acquired, brand managers should have little trouble maintaining long-term relationships with super consumers. And, these expert patients typically share their great brand experience with friends and family, who become potential new customers for the brand.

But here's the rub: Super consumers currently represent only a fraction of the drug-buying population. What is promising, however, is that most "average Joe" consumers aspire to be expert patients, too. They are highly motivated to manage their healthcare, but they just don't know how.

The Path to Super Consumer

How can brand managers empower average Joes to become super consumers? Self-management programs have been shown to develop confidence and motivation by teaching participants how to use their own skills and knowledge to take control of their healthcare. According to a recent study by HealthMedia, 60 percent of those who participated in its chronic condition self-management programs enrolled as average Joes. Of that group, 53 percent reported that the programs improved the way they managed their medical conditions. (See "The Path to Super Consumer," page 106.) And, particularly when administered online, self-management programs are an extremely cost-effective alternative to traditional media.

From Average Joe to Super Consumer

Meet "Joe," a 47-year-old man with hypertension and type II diabetes. Because he has a demanding job, Joe relies on his wife to make his doctors' appointments and to fill his prescriptions. Joe doesn't like going to the doctor and sometimes forgets to take his medications and check his blood sugar. And, because his hypertension is now symptom-free, he questions his need for medication. Still, Joe is very motivated to take better control of his health so he can get back to his Saturday golf game.

To transform Joe into a super consumer, a self-management program must address his ability—or inability—to identify symptoms and treatment and to communicate clearly with his physician. This program also must look at Joe's willingness to fill and refill prescriptions and to take medications as prescribed. And finally, the program must successfully identify and break down each of Joe's many hurdles to success.

A number of psychological and practical barriers could be interfering with Joe's initial doctor appointment, such as not having a regular healthcare provider or having a poor relationship with his established provider, general discomfort about going to the doctor, lack of insurance to cover the visit, lack of transportation to the doctor's office, an inability or unwillingness to get time off for the appointment, and so on. Once Joe finally makes it past these barriers to get to the doctor's office, he'll have to jump over several new hurdles before earning the title of super consumer: Can he converse with his physician in a clear, concise, and self-assured manner? Does he have the information he needs to make behavior changes that will improve his overall health? Is he educated about his treatment options? And will he be both compliant and persistent with a prescription regimen?

A self-management program can get to the root of these issues and offer tailored solutions to overcome specific barriers. For example, Joe could indicate on an online questionnaire that he does not like to go to the doctor because his doctor doesn't listen to him. In response, the program could give him specific questions to ask his physician using language that is likely to get his attention, and simultaneously boosting Joe's knowledge of his ailment or the medication that he is taking.

A Tailored Approach

Some people may think that a self-management approach seems too complex to tackle in the world of pharmaceutical marketing. It might seem easier to get a patient to complete one single behavior or action rather than change her entire approach to healthcare. DTC advertising, for example, increases self-identification and treatment-seeking behaviors, and coupons encourage consumers to fill prescriptions.

But, a self-management approach can cost significantly less than either of those approaches in time and money for both the brand team and the participant. It also can provide consumers with invaluable skills, such as how to communicate with a healthcare provider, and increased product knowledge that they retain over the long-term. The self-management approach also complements and increases the effectiveness of future brand marketing initiatives.

All self-management programs begin with a questionnaire used to gather the information needed to create a custom-made plan for each participant. Costs can be cut dramatically if the surveys are administered online. These online programs can be compiled in a single self-management session, reducing the need for multiple sessions with a physician or health counselor.

By leveraging Web- or print-based tailoring technology, pharma companies also can offer every consumer a customized action plan for addressing his or her unique barriers, cutting costs even further. For example, if a medication takes two weeks to become fully effective, a self-management program created for that medication could provide additional support designed to help each patient address his or her unique concerns during that time. Such programs also can alleviate individual patients' reservations about side effects, thereby improving compliance.

Traditional self-management tools, such as brochures, Web sites, and other typical patient-marketing materials, are generic, meaning they treat everyone with a particular disease or condition the same. Tailored self-management programs, in contrast, start with the premise that Joe, Jane, John, and Patty may all have diabetes, but they experience their illness very differently. Each person's individual information is translated into a program geared to them, complete with customized visuals and videos. The HealthMedia study demonstrated that offering something patients can relate to and see the value in will dramatically increase the likelihood that they will succeed in changing their behavior, taking them one step closer from average Joe to super consumer.

Tailored self-management programs can significantly improve a patient's knowledge, self-efficacy, and use of self-management behaviors by helping them care for their whole selves—body, mind, and soul. Those skills help average Joes become super consumers who are ready, willing, and able to actively participate in every stage of their healthcare. Tailored self-management programs result in tangible brand benefits that can cost-effectively increase the success of pharmaceutical marketing initiatives, from acquisition to retention.

Kristine Nash-Wong is manager of the HealthMedia Consulting Group.She can be reached at info@healthmedia.com

SUPER CONSUMER SKILLS

According to a 2003 Harris Interactive survey, a tailored, behaviorally-based patient-support program can help potential super consumers better understand and learn the skills they need for self-management, including:

• Acknowledging the connection between behaviors and staying well

• Putting beliefs into action (e.g. improved exercise, nutrition, smoking cessation, stress management)

• Becoming a good patient (e.g. monitoring symptoms, preparing questions for doctors, demanding answers)

• Maintaining a proactive attitude

• Viewing their condition as long-term rather than chronic.

A self-management program can also help patients overcome personal barriers such as:

• Lack of acceptance of the condition

• Lack of ability to properly communicate with healthcare providers and pharmacists

• Lack of medication compliance

• Lack of knowledge about symptom management and lifestyle behaviors and issues (weight, smoking, etc.)

• Inability to manage associated issues, such as sleep, pain, stress, depression, and fatigue

• Inability to seek out social support

• Lack of appropriate goal setting and planning skills.