Vouchers: More Data, Fewer Dollars

Sampling is a sales rep's foot in the door to doctors' offices and the quickest way to get products into consumers' hands. That's why reps handed out $5 billion worth of the freebies last year, spending 30 percent of companies' promotional budgets in the process. Despite that huge investment, few product managers can assess its impact on product inventory, consumer demand, prescription rates, or market share. But sampling's greatest failure is its inability to provide the healthcare industry with product-use or patient data.

Without a tracking mechanism, pharma marketers don't know who is actually using the samples. In fact, those who question the value of traditional samples suggest that the practice may put patients at greater risk for adverse drug reactions or drug-drug interactions. And that risk will only increase as patients' use of prescription drugs, over-the-counter medications, and nutraceuticals also increases-often without their physicians' knowledge.

This article describes a new approach to product sampling that uses coupons in place of physical samples. It discusses

• data collection opportunities

• benefits for physicians, distributors, and manufacturers

• the perceived downside for sales reps.

It also explains how vouchers can give healthcare stakeholders a new tool for tracking product sample use and gaining insight into the delivery system.

Docs Split 50/50

Sampling has been a standard practice for more than 30 years, and some sales reps fear that replacing it with vouchers could inhibit their ability to detail doctors. Yet RxCentric.com found that 50 percent of physicians surveyed prefer vouchers to product samples for the following reasons:

• decreasing liability

• ease of management

• proper labeling when dispensed.

On the flip side, doctors who prefer product samples over vouchers cite the additional patient interaction that can occur during dispensing and the ability to observe patients after they take the medications. Yet, even with demand for both types of sampling, there is no indication that sales reps would limit their access to physicians if they provided vouchers instead of actual products. Over time, voucher proponents believe that pharma sales forces will benefit from increased access to healthcare providers who appreciate the value of vouchers for tracking product use and simplifying the sampling process.

Paper-Thin Process

Vouchers-slips of paper that contain a free prescription for a specific amount and dosage of a particular product-offer healthcare providers significant advantages. A paper sampling system requires substantially less time than the recording, storage, and handling of actual packets and pills. Vouchers don't require extra space, security against theft, or climate controls. They are also exempt from state and federal requirements for dispensing prescription drugs. The standards of the Joint Commission for Accreditation of Health Care Organizations (JCAHO) for receiving, tracking, storing, and dispensing product samples do not apply to vouchers, freeing doctors and their staffs from cumbersome sample-management duties. And, because vouchers can be sent through the mail, healthcare providers can review product literature and samples at their leisure.

The paper system also can improve patient care by minimizing the potential for dangerous drug interactions. Rather than simply popping a pill on the way home from the doctor's office, patients must take vouchers to a pharmacy to be filled.

With access to sophisticated databases, pharmacists can determine if the sample product will interact with other medications the patient is taking. They can also detect other potential problems such as allergies to the sample medications or duplication of prescriptions. Because it comes from the pharmacy, the free trial medication contains directions for use and comes in childproof containers. Pharmacists also discuss the medication's proper use with patients-yet another safeguard against adverse outcomes. To continue using the therapy, a patient simply phones the pharmacy or doctor and requests a refill.

Data Opportunity

When pharmacists redeem the coupons, they record product information such as sample size, dosage, and other data. Those data, including patient information, the authorizing physician's name, and usage are available to healthcare providers and pharma marketers.

The data may also be accessible to health plan managers, who can use it to make critical decisions about formulary management, medication purchases, marketing, and other healthcare services. Pharma companies also benefit from the additional data.

Armed with the new information, product managers and sales staff can use the data to support and assess product use and make better informed decisions. Manufacturers can track the sampling and prescribing behavior of a target physician or physician group, as each redeemed voucher provides information about the prescribing physician and the dispense date. Voucher sampling programs also allow healthcare providers and pharma reps to work more effectively together. The sales force can use vouchers to help physician groups meet clinical and financial goals in areas such as health screening programs and formulary conversion, compliance, and persistency.

E-Sampling Era

An increasing number of pharma companies are piloting e-detailing initiatives, including direct-to-physician product promotions using online and video conferencing technology and websites offering self-study programs. Early studies indicate that e-detailing increases access to physicians and improves the duration and quality of product detail. Bruce Kent, Novartis' executive director of e-sales, speaking at eHealthWorld in San Diego in May, indicated that e-reps complete 13 details per day, spend 9 minutes per visit, and detail 2.7 products per call.

E-sampling is yet another new application of e-commerce and pharma sales that provides immediate fulfillment of physicians' sample needs. They can access a company's website and print out vouchers that, when signed by a doctor, patients can redeem at pharmacies for free trial medications. Static webpages, secure internet sites, and sampling programs that are integrated into electronic prescribing systems can all be used to provide e-vouchers.

Static webpages. This method requires physicians to access a website and print copies of e-vouchers. Products recently offered through online coupons include Prozac Weekly (fluoxetine), Glucophage XR (metformin), and Xenical (orlistat). Although the approach is moderately effective in driving consumer demand, it provides no information about the physicians who print the e-samples.

Secure sites. Designed as a direct-to-physician program, this method directs doctors to a website through sales and marketing efforts. Once there, they can register, verify information about their medical practices, and request and print e-samples. The registration process allows doctors to customize printed e-samples, which can include their names, addresses, and phone numbers.

Secure sites with registered physicians also track website use, the quantity of e-samples printed, and sampling trends. Both static webpages and secure sites allow the redemption of e-samples to be tracked through pharmacy sales data. But only the secure-site method allows product managers to track and compare the number of e-samples printed and redeemed. To see an example of a secure site for printing e-samples, check out www.emedsample.com.

Electronic prescribing systems. Yet another opportunity for e-sampling is e-prescribing. Such systems include hand-held, desktop, and internet-based systems. In all cases, doctors are offered samples at the point of prescribing.

Once a physician chooses a patient's category or product, the e-prescribing system shows the name of each medication sample and its availability. The doctor then chooses a sample product, completes the prescription, and prints a voucher for the patient to redeem at a pharmacy.

E-prescribing systems collect data on doctors, patients, and medications prescribed. Their value is that they can record therapy switches that occur because e-samples are available.

Targeting Elusive Docs

The biggest advantage of e-sampling programs, though, is their ability to target low prescribing and difficult-to-access physicians as well as healthcare providers in remote areas or territories not frequented by reps.

E-sampling initiatives can rapidly distribute sample vouchers to thousands of doctors. Companies benefit in two ways: there is more demand for their products through retail pharmacies and less need to package and distribute traditional samples.

E-sampling programs are also responsive to market changes, making them easy to implement, discontinue, or modify. Because of their targeting ability and tight control, they are also easy to measure. And product managers and marketers can evaluate physician use, voucher redemption, territory mapping, impact on market share, total investment, and return on investment.

The distribution of prescription samples may soon change because of

• physician demand for alternatives to traditional samples

• new technology

• the ability to track and report sample use

• the need to manage the time spent conforming with Prescription Drug Marketing Act (PDMA) regulations

• justification of the sampling budget.

Product sample vouchers, whether they are paper or electronic, provide effective tools with which to meet those demands.