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

FDA APPROVES RECORDATI'S ISTURISA (osilodrostat) TO TREAT CUSHING'S DISEASE

by John G. Baresky on 03/09/20

Isturisa, Developed By Novartis, Scores FDA Approval And Orphan Drug Status

Recordati (BIT: REC) and Novartis have been issued FDA approval for Isturisa. In 2019 Recordati licensed the rights to the product from Novartis and the approval enables Recordati to start recouping its investment.  Isturisa further benefits from the FDA approval as it was given Orphan Drug status that establishes 7 years of market exclusivity. 

Isturisa is indicated for the treatment of Cushing’s Disease 

Cushing’s Disease is a rare condition in which a patient’s adrenal glands generate an excessive amount of cortisol. Cushing's disease is usually found in adults 30 to 50 years of age and is more prevalent in women. Cortisol affects all tissues and organs in the body; collectively the symptoms and the healthcare problems as a result of excess cortisol are referred to as “Cushing’s Syndrome”.

Osilodrostat is a steroidogenesis inhibitor of 11-Beta-hydroxylase, an enzyme that catalyses the last step of cortisol synthesis in the adrenal cortex. Isturisa is the first therapy that is FDA-approved that treats cortisol overproduction by blocking the 11-beta-hydroxylase enzyme that triggers it. 

Isturisa (Type 1 New Molecular Entity) is a tablet which will be available in 1mg, 5mg and 10mg dosages that is taken orally. With its specific indication for Cushing's disease, Isturisa will be a welcome therapeutic option for endocrinologists and other clinicians treating this highly specialized patient care challenge.

Recordati focuses on developing treatments for rare diseases

Founded in 1990 with origins dating back to 1926, Milan, Italy-based Recordati has a unique portfolio of products of which only a few besides Isturisa are approved by the FDA for patient treatment in the United States:

  • Chemet (succimer) capsules
  • Cosmegen (dactinomycin) injection
  • Desoxyn CII (methamphetamine hydrochloride) tablets
  • NeoProfen (Ibuprofen lysine) Injection
  • Panhematin (hemin) injection
  • Peganone® (ethotoin) tablets
  • Tranxene T-TAB (clorazepate dipotassium) tablets

Recordati has additional therapeutic agents approved in Europe, China and other markets. 

Recordati's deal with Novartis included the Signifor brand franchise that is also used in the treatment of Cushing's disease

Recordati paid Novartis $390 million for Signifor and Signifor LAR (each indicated for Cushing’s disease and acromegaly in adults who have failed or cannot undergo surgery) plus Isturisa (osilodrostat). Isturisa was not approved by the FDA at the time of the transaction. In addition to the $390 million licensing transaction, Recordati will be providing Novartis with milestone and royalty payments associated with Signifor and Isturisa.

Novartis (NYSE: NVS) generates over $53 billion in annual sales. Presumably their strategy is to concentrate on therapies which produce larger sales numbers (margin and total revenue). The deal with Recordati (a smaller scale organization specializing in more niche market therapies) enables Novartis to generate revenue from products they develop which can be more effectively commercialized by another company. 






APPLE AND JOHNSON & JOHNSON LAUNCH DIGITAL HEALTH STUDY

by John G. Baresky on 02/26/20

A large scale digital health initiative

Apple and Johnson & Johnson have launched a new study to detect atrial fibrillation among seniors while promoting wellness and pro-active heart health.

The clinical study focuses on Atrial Fibrillation

Atrial fibrillation (referred to as "A-fib") is a cardiovascular issue which may increase the risk of strokes and other serious heart-related problems. 

Patients over age 65 can pick up a discounted Apple Watch ($49 plus applicable sales tax) at a Best Buy store if they are assigned one for the study or are issued an iPhone app called Heartline which also connects to Medicare’s Blue Button API that provides the patients access to their Medicare billing and claims data. 

This unique study is one of the largest randomized digital health trials in history, at a minimum, the goal is to recruit 150,000 people.

Collaborating Technology, Clinical and Retail Partners

Its working model is unique in that it represents a partnership between a technology company (Apple, NASDAQ: AAPL), a global healthcare conglomerate (Johnnson & Johnson, NYSE: JNJ) and a retailer (Best Buy, NYSE: BBY) to facilitate the study program.


LUNDBECK'S NEW MIGRAINE DRUG VYEPTI APPROVED BY FDA

by John G. Baresky on 02/23/20

Vyepti: Lundbeck new product launch expected in April 2020 for Lundbeck

Lundbeck (OTCMKTS: HLUYY) has received FDA approval for its migraine therapy product Vyepti (eptinezumab-jjmr). Vyepti is indicated for the preventive treatment of migraine in adults. Vyepti is an infused pharmaceutical therapy. Lundbeck anticipates the product being available to prescribers and patients in April 2020.

Vyepti is an early result of Lundbeck’s purchase of Alder

The product originated from the product pipeline of Alder Pharmaceuticals. Lundbeck acquired Alder for about $2 billion in 2019.

Vyepti is an intravenous (IV) mAb therapy

The recommended dose of Vyepti is 100 mg every 3 months and it is noted some patients may benefit from a dose of 300 mg. Vyepti is a humanized monoclonal antibody (mAb) that binds to calcitonin gene-related peptide (CGRP) ligand and blocks its binding to the receptor.

Vyepti will be up against strong competition from Aimovig (Amgen and Novartis), Ajovy (Teva), Emgality (Eli Lilly) and other migraine products.

Lundbeck is a global pharmaceutical company

Headquartered in Copenhagen, Denmark with a U.S. base located in Deerfield, Illinois (a Chicago suburb) Lundbeck is centered on brain and psychiatric pharmaceutical therapies.

Some of Lundbeck's best-known products include:

·         Abilify (aripiprazole)

·         Northera (droxidopa)_

·         Onfi (clobazam)

·         Rexulti (brexpiprazole)

·         Sabril (vigabatrin)

·         Trintellix (vortioxetine)

·         Xenazine (tetrabenazine)

FDA APPROVES 3 PRESCRIPTION DRUGS FOR OVER-THE-COUNTER STATUS

by John G. Baresky on 02/21/20

Three FDA Rx to OTC Switches Approved

The U.S. Food and Drug Administration (FDA) has approved these 3 products presently available only by prescription to be purchased without one:

  • Pataday Twice Daily Relief (olopatadine HCl ophthalmic solution/drops, 0.1%)
  • Approved for itching, redness of eyes triggered by allergies
  • Manufactured by Alcon (NYSE: ALC)
  • Pataday Once Daily Relief (olopatadine HCl ophthalmic solution/drops, 0.2%)
  • Approved for itching, redness of eyes triggered by allergies
  • Manufactured by Alcon (NYSE: ALC)
  • Voltaren Arthritis Pain (diclofenac sodium topical gel, 1%)
  • Approved for arthritis pain
  • Manufactured by GlaxoSmithKline (NYSE: GSK)
Now available without a prescription

The FDA has specific approval processes in place to orchestrate the conversion of a prescription drug to over-the-counter (OTC)  status which are rigorous and require substantial data.

A drug's safety record as a prescription therapy is heavily documented and weighs heavily in the decision of its conversion to an OTC product. It also must demonstrate its purpose and its administration can be safely followed via its label. 

OTC medication not typically covered by pharmacy benefit plans

From a consumer/patient viewpoint, the switch from Rx to OTC is welcomed based on having access to the product without having to consult a medical professional for a prescription. In some cases, financial issues are triggered as the OTC formulations are typically not covered by prescription benefits and the purchaser may incur higher out-of-pocket costs. 



 

AMAZON LAUNCHES EMPLOYEE HEALTHCARE PROGRAM "AMAZON CARE"

by John G. Baresky on 02/19/20

Amazon's telehealth / telemedicine employee healthcare program, Amazon Care, is now fully activated

The program is available only to Amazon corporate headquarters (Seattle, WA) employees and their dependents. The success of its launch plus care and cost effectiveness may predicate whether or not Amazon roles the wellness and care concept and technical platform out to its other major locations.

Amazon has made significant investments in the program for its success

The clinic component features a combination of telemedicine and in-person services including an in-app video visit with a doctor, nurse practitioner or registered nurse for consultation, diagnosis, treatment, referrals and other patient care support. In-clinic, face-to-face appointments are available and Amazon Care can arrange for a nurse to follow up with a home visit if required.

Amazon Care features a preferred retail pharmacy network

Prescription benefits are part of the program. Amazon Care clinicians will be able to prescribe medications and the patient may have them delivered to their homes or pick them up at a preferred pharmacy. It is not certain if PillPack, Amazon’s mail order pharmacy unit, has a role in the program due to HIPAA and PHI concerns.

Oasis Medical Group is contracted with Amazon

To administer the program, Amazon has an agreement with Oasis Medical, a family practice medical group based in Seattle. Oasis Medical is not owned or operated by Amazon, it is a contracted provider organization. Conceivably, Amazon may add other specialties and providers (allergy, dermatology, OB/GYN, internal medicine,etc.) as they gain more experience with the Amazon Care model, gauge employee satisfaction and weigh economic benefits.

Amazon is a partner in Haven Health, a joint venture founded to explore how to provide employee patient populations with higher levels of care at less cost

It will be interesting to see if Amazon’s Haven Health joint venture partners Berkshire Hathaway and JPMorgan Chase introduce similar programs for their employees and dependents. 

Key Performance Indicators for Amazon Care

 

  • Is the program saving Amazon corporate money and are employees more productive from using it?
  • Are employees receiving better care and saving money?
  • Are the employee dependents using Amazon Care satisfied with the program?
  • Can the program be expanded to other Amazon facilities?
  • How can the Amazon Care concept and program be commercialized and marketed to other companies?

 

Learn how Amazon Care was launched and what its goals are

Review this detailed feature-length story to see how Amazon Care went from concept to reality.





WHO GIVES CORONAVIRUS 2019-nCoV A NAME: COVID-19

by John G. Baresky on 02/11/20

Published on 2/11/20, updated 2/23/20

A well-known disease gets a meaningful name

The World Health Organization has established a formal name for Coronaviridae - Coronavirus 2019-nCoV which is easy to communicate and encapsulates some of its key elements.

COVID-19 is the new name and the succinct but descriptive abbreviation is no doubt appreciated by medical professionals, healthcare IT and EHR / EMR companies, payers, government officials, patients and consumers. 

COVID-19 stands for:
  • CO: Coronavirus
  • VI: Virus
  • D: Disease
  • 19: Viral pathogen's year of being found 
COVID-19 continues to earn its PHEIC status by its ability to spread and generate serious illness:
  • Over 1,000 COVID-19 patients have become fatalities
  • More than 43,000 COVID-19 patients have been diagnosed with the viral pathogen's illness
  • The early discoverer of COVID-19, Dr. Li Wenliang, has died as a result of contracting the disease 


SUPER BOWL 54 TV ADS: Can Any Healthcare Company Exceed The Success Of A Family-Owned Business Ad From Super Bowl 51?

by John G. Baresky on 02/01/20

The Super Bowl is a global event; marketers and advertisers invest millions in audience research and testing plus media ad spending to air the best television commercials money can buy


Numerous healthcare, pharmaceutical, business services, consumer product, technology, automobile, fast food and insurance companies will be vying for audience attention and audience recall with big budget ads. How well will they succeed in achieving their KPI metrics and ROI goals?

Amazingly, a nondescript family-owned business achieved global notoriety and greatly exceeded their KPI and ROI goals with one ad during Super Bowl 51

This is how a humble, regional building material supply company with a modest budget outperformed global Fortune 500 companies in marketing strategy, execution and return on investment:
  • Quality story line with clear and meaningful messaging
  • Strong brand and company identification elements
  • A unique campaign strategy that aligned network television, website and social media venues to effectively engage audiences worldwide
Learn how to apply their insights, strategies and tactics to develop more effective marketing and advertising campaigns in 2020

Read this how-to case study article and then ask yourself why more healthcare, pharmaceutical and other businesses are not following this example to increase the effectiveness of their television, digital and social media marketing programs.

HORIZON THERAPEUTICS EARNS FDA APPROVAL FOR TEPEZZA - John G. Baresky

by John G. Baresky on 01/26/20

A first for Thyroid Eye Disease

Horizon's recently FDA approved Tepezza is indicated for the treatment of Thyroid Eye Disease (TED). TED is a healthcare condition associated with the inflammation of the eyes, eye muscles, eyelids, tear glands and fatty tissues behind the eye.

Tepezza (teprotumumab-trbw) can be described as a biologic or biotherapy agent as it is a fully human monoclonal antibody (mAb) and a targeted inhibitor of the insulin-like growth factor 1 receptor (IGF-1R).

Medical issues associated with TED

TED is also known as Graves’ Orbitopathy or Ophthalmopathy and is an autoimmune condition. TED’s symptoms include outward bulging of the eye which may cause a series of problems such as double vision, eye pain, light sensitivity or issues with closing the eye. Tepezza may help some patients prevent more serious challenges with their eyes as a result of TED including the potential need for surgical procedures. Tepezza is an injectable product administered via infusion; once every 3 weeks for a total of 8 infusions.

FDA Director of The Division of Transplant and Ophthalmology Weighs In On Tepezza:

Wiley Chambers, M.D., deputy director of the Division of Transplant and Ophthalmology Products in the FDA’s Center for Drug Evaluation and Research shares these comments about Tepezza:

“Currently, there are very limited treatment options for this potentially debilitating disease. This treatment has the potential to alter the course of the disease, potentially sparing patients from needing multiple invasive surgeries by providing an alternative, non surgical treatment option. Additionally, thyroid eye disease is a rare disease that impacts a small percentage of the population, and for a variety of reasons, treatments for rare diseases are often unavailable. This approval represents important progress in the approval of effective treatments for rare diseases, such as thyroid eye disease.”

FDA requires Horizon to conduct a post-approval study for Tepezza

As part of the FDA's approval of Tepezza, Horizon will continue monitoring Tepezza’s performance in a post marketing study. The study will assess the product's safety profile in a larger patient population. 

About Horizon Therapeutics 

Horizon Therapeutics (the recently renamed Horizon Pharma) is based in Dublin, Ireland with a U.S.  headquarters located in the Chicago suburb of Lake Forest, Illinois. Founded in 2005, Horizon's annual revenues are about $1.25 billion.

FRIDAY FEBRUARY 14th IS NATIONAL DONOR DAY ***ORGAN DONOR***

by John G. Baresky on 01/24/20

Organ donation saves lives


National Donor Day is dedicated to organ donors plus the patients and medical professionals needing their help. Advancements in medicine have made incredible progress in organ transplant success but this record of achievement cannot continue without more donors. While more transplant procedures are being conducted each year, many never happen because there were not enough donors.


Organ transplants are more common but still challenging 

Since each patient and donor is different, no two transplants are the same. With each transplant, medical professionals, clinical researchers and other transplant science stakeholders learn more. For each transplant, medical professionals conduct an intense and time sensitive assessment of the organ recipient and the organ donor to determine the best match that will help increase the chances of success and survival. 


Organ transplant patients require considerable care after the procedures are completed

Following the transplant procedure, transplant patients are still at risk for complications as a result of the transplant including organ rejection. 
Even with highly effective immunosuppressive drugs and other therapies plus the care and support of healthcare professionals, organ rejection can occur years after a transplant is performed. In some cases the person is added to the transplant waiting list again. Based on new patients and transplant patients needing a replacement for their transplanted organ, there is an ongoing demand for more organ donors.

 

Ten facts about organ donation and organ transplantation:

Over 120,000 persons in the United States are in need of an organ transplant; for many of them their very life depends on it


Almost 
40,000 organ transplants were conducted in 2019

One organ donor can save the lives of or tremendously improve the quality of life for 8 people or even more


In the United States more than 700,000 organ transplants have been conducted since 1988


These are the most common organ transplants:

  • Heart
  • Intestine
  • Kidney
  • Liver
  • Lung
  • Pancreas
    These body components are transplanted as      well:
  • Blood Vessels
  • Bones
  • Corneas
  • Heart Valves
  • Ligaments
  • Skin Tendons

Survival rates vary depending upon the patient and post-transplant recovery challenges including organ rejection

A new person is added to the organ transplant list in the United States every ten minutes

In the United States it is estimated 20 persons die each day that were waiting for transplants

Organ donation is free and there are no costs to register as an organ donor

Sign up to be an organ donor or share this information with someone else so they can be an organ donor, too 

You can help over 120,000 persons currently waiting for an organ transplant!

Visit this resource to learn how to sign up; if you are already registered, please share it with those who would like to join yourself and others as life saving organ donors:

 OrganDonor.Gov - U.S. Government Information on Organ Donation and Transplantation

Spread the word: Friday February 14th is National Donor Day!



AMAZON EXPANDS HEALTHCARE TEAM WITH LATEST HIRE: DR. VIN GUPTA

by John G. Baresky on 01/09/20

Published on 1/22/2020; updated 2/23/2020

Amazon hires Dr. Vin Gupta

Amazon continues to fortify itself with healthcare talent and technology assets. It has ramped up its online pharmacy unit Amazon Pharmacy / PillPack, acquired healthcare software and technology startup Health Navigator plus launched Amazon Comprehend Medical and Amazon Transcribe Medical. Amazon is also involved in a collaboration with the Pittsburgh Health Data Alliance.

Its latest addition is the reported hiring of Dr. Vin Gupta for its Amazon Care unit. Amazon Care (formed in 2019) is dedicated to serving the headquarters staff of Amazon and provides an array of healthcare services to employees and their dependents. Its programs include conventional patient and clinician care visits, telemedicine access plus other medical support and pharmacy services.

Dr. Gupta has a distinguished clinical, commercial and government background

Vin's experience spans these and other organizations in full time and advisory roles:

  • Institute of Health Metrics and Evaluation
  • Council on Foreign Relations
  • U.S. Air Force
  • U.S. State Department
  • MIT
  • NBC News
  • Apple
  • World Bank Group
  • Brigham & Women’s Hospital

He has extensive academic credentials including:

  • MPA; Public Administration, Harvard University
  • USAF United States Air Command and Staff College
  • MSc; International Relations and Affairs, University of Cambridge
  • MD; Columbia University College of Physicians and Surgeons
  • BA; Chemistry, Princeton University
Dr. Gupta's experience in medicine, public health, business and leadership will be a valuable resource for Amazon

 Amazon ( NASDAQ: AMZN ) is enriching its capabilities in and revenue from healthcare. Dr. Gupta's involvement could extend beyond the internal Amazon Care program managed through Oasis Health to Amazon's commercial ventures such as Amazon Cloud / AWS, Amazon Pharmacy / PillPack, Amazon Comprehend Medical, Amazon Transcribe Medical or its partnership in Haven Healthcare that includes JPMorgan Chase and Berkshire Hathaway.


 

UNITED STATES FLU SEASON 2019-2020 UPDATE Q & A

by John G. Baresky on 12/28/19

Initially published 1/06/20, updated 2/23/20

The 2019-2020 Flu season is well underway across the United States

The Centers for Disease Control ( CDC ) plus other government healthcare agencies and medical professionals are closely monitoring what is shaping up to be a formidable Flu season. 

Who is most at risk for Flu?

Individuals spanning infant to elderly are susceptible to the Flu virus. Expectant mothers, seniors and persons with chronic conditions such as asthma, an airway abnormality or other respiratory issues, diabetes, hypertension, heart disease, neurological or neurodevelopmental disease, kidney, liver or blood disease could be more vulnerable to Flu and severe Flu symptoms.  

Who are some of the leading healthcare companies developing and marketing vaccine products to help protect against the Flu?

The largest Flu vaccine manufacturers include:

  • AstraZeneca ( NYSE: AZN ) 
  • GlaxoSmithKline ( NYSE: GSK )
  • Sanofi ( NASDAQ: SNY )
  • Seqirus / CSL ( ASX: CSL )

Most Flu vaccine formulations are administered via a single injection although an inhaled nasal mist Flu vaccine is available ( FluMist Quadrivalent manufactured by AstraZeneca ). Healthcare professionals determine and prescribe which Flu immunization option, injection or inhaled formulation, is most appropriate for each patient.  

What products are available to treat the Flu for those diagnosed with it?

Depending on the consumer or patient there is an array of over-the-counter medications available which treat Flu symptoms that do not require a prescription.

There are several companies manufacturing Flu antiviral drugs which can be administered to patients with confirmed Flu diagnosis that require a prescription including:

  • Rapivab ( peramivir; injection ) - manufactured by CSL 
  • Relenza ( zanamivir; dry powder for inhalation ) -  manufactured by GSK  
  • Tamiflu ( oseltamivir phosphate; oral ) - manufactured by Roche but also available as as a generic 
  • Xofluza (baloxavir marboxil; oral) - manufactured by Genentech / Roche ( OTCMKTS: RHHBY ) 

How is the Flu season unfolding so far?

  • The predominant Flu virus strain varies by region
  • Age groups are another variable in profiling specific Flu virus strains
  • Nationwide, influenza B/Victoria virus has been the most frequently reported Flu strain thus far; the second most frequently occurring is A(H1N1)
  • Influenza B/Victoria viruses are most commonly reported in children age 0-4 years ( 46% of reported viruses) and persons age 5-24 years ( 57% of reported viruses)
  • A(H1N1) pdm09 viruses are most commonly identified in persons age 25-64 years (41% of reported viruses)
  • For adults 65 years of age and older almost equal proportions of influenza A(H1N1) pdm09 ( 38% ) and A(H3N2) viruses ( 37% ) have been reported
  • Current hospitalization rate has been 6.6 cases per 100,000 ( similar to previous Flu season trends at this calendar interval but on the increase )
  • Overall the CDC estimates there have been 4.6 million Flu cases  so far this year resulting in about 39,000 hospitalizations and over 2,100 fatalities

What are some ways I can protect myself and others from the Flu?

  • It is not too late to get the Flu shot ( or FluMist if appropriate ); there are ample supplies presently available
  • Take precautions to avoid contracting and spreading Flu virus:
    • Avoid persons who are sick
    • Avoid directly touching eyes, nose, mouth; cover nose and mouth with a tissue when coughing or sneezing; properly dispose of the tissue quickly
    • Wash hands with soap and water frequently and clean / disinfect surfaces where hand contact is frequent ( desks, counters, table tops, cell phones, keyboards, tablets, door handles, remote controls, appliance handles, etc. )
    • If diagnosed with the Flu and prescribed Flu antivirus medication, patients should be certain to complete the entire course of therapy and limit close contact with others
What is the economic impact of the Flu season in the U.S.?

CDC sources estimate Flu annually burdens the U.S. with just over $10.4 billion in expenses for hospitalizations and outpatient visits for grownups.

How long does Flu season last?

In the United States, the Flu season typically begins in October. Over the last 3 decades, it has peaked at various times and depending on the trajectory of regional outbreaks, it can steeply ramp up in October or steadily climb through February. Following February Flu season usually tapers out by April with some cases still being reported in May.


ASTELLAS ACQUIRING XYPHOS BIOSCIENCES TO BUILD OUT ONCOLOGY UNIT

by John G. Baresky on 12/27/19

Tokyo-based Astellas buys second California biotech company in less than a month

Astellas Pharma ( OTCMKTS: ALPMY ) is acquiring Xyphos Biosciences in a deal worth up to $665 million. Astellas is seeking to build out its  immuno-oncology business capabilities. This is the second acquisition Astellas has made in a month. Historically the company has made few buyouts since it was formed in 2005 from the merger of Yamanouchi Pharmaceutical and Fujisawa Pharmaceutical.

Xyphos is centered on advanced oncology treatment science

Astellas covets Xyphos’ proprietary molecules which can be delivered to natural immune cells or to engineered Chimeric Antigen Receptor (CAR) cells to generate immunotherapies for oncology treatment. The deal provides Astellas with additional clinical talent plus proprietary processes and technology focused in novel cancer treatment research and development. Xyphos’ first CAR cell product investigational agent is in preclinical development and scheduled to be tested in a first-in-human clinical study in 2021.

Astellas announced a multi-billion dollar deal earlier this month 

Earlier in December, 2019 Astellas bought Audentes Therapeutics for $3 billion. Audentes is a biotech firm focused on gene therapy. Xyphos and Audentes are each based in South San Francisco.

Astellas is a worldwide pharmaceutical leader

Based in Tokyo, Japan with a U.S. headquarters in Northbrook, Illinois, Astellas is Japan’s second largest pharmaceutical company ( Takeda is ranked number one). Astellas has over 17,000 employees and generally speaking is aligned with 5 disease categories:

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

Xyphos is an ideal element that fits well with Astellas’ corporate strategy. With annual sales of approximately $12 billion and a market capitalization estimated at $33 billion, Astellas has made assertive moves in 2019 to accelerate its clinical and financial future success from the start in 2020.

John G. Baresky

GENE THERAPY: ROCHE COMMITS OVER $1 BILLION IN SAREPTA THERAPEUTICS DEAL

by John G. Baresky on 12/26/19

Gene therapy continues to draw multi-billion dollar investments from biotech and pharmaceutical companies worldwide

Roche ( OTCMKTS: RHHBY ) is committing over $1 billion dollars up front to Sarepta Therapeutics ( NASDAQ: SRPT )  in a licensing deal with substantially more to follow depending upon the progress of SRP-9001, an investigational gene therapy targeting Duchenne muscular dystrophy.

Roche and Sarepta develop a product development and licensing deal

Based on its $1.15 billion deal with Sarepta, Roche will have global rights to launch and market SRP-9001 except for the United States:

  • Sarepta received $750 million in cash from Roche
  • Roche purchased about $400 million of Sarepta stock at $158. 59 per share

For now Sarepta, based in Cambridge, Massachusetts, has decided to retain the U.S. market sector for its own commercial ventures.  Sarepta will continue to manage clinical development and production manufacturing of SRP-9001; Roche has agreed to cover half of the global clinical development costs. If the drug meets unspecified regulatory and sales milestones, Sarepta could receive up to $1.7 billion more in funds from Roche, as well as royalties on any net sales, if SRP-9001 achieves certain regulatory approval requirements as well as sales revenue targets.

The patient care science of SRP-9001

SRP-9001 has the potential to be a breakthrough therapy in a challenging patient care sector. SRP-9001 is presently in Phase II clinical development. The agent is designed to deliver the micro-dystrophin-encoding gene directly to the muscle tissue for the targeted production of the micro-dystrophin protein.

Sarepta's strategy to fund clinical trials for SRP-9001

With Roche’s investment, Sarepta can continue to invest in the development of the product and conduct clinical trials. They are selecting patients for the two-part Phase II SRP-9001-102; a 40-patient study focused on safety and efficacy of SRP-9001 in a 48-week randomized, double-blinded, placebo-controlled timeframe plus a 96-week, double-blinded extension period. This clinical study program has an anticipated wrap up targeting the 4th quarter of 2022.

Based on positive results, Sarepta and Roche will pursue marketing opportunities worldwide

If the product is approved, Sarepta will have funds to orchestrate commercialization initiatives to launch the product in the United States. Roche, headquartered in Basel, Switzerland, has the global expertise and commercial resources that will enable it to move forward in other markets around the world. Roche, which just completed a $4.3 billion acquisition of gene therapy company Spark Therapeutics, will be a lucrative partner for Sarepta to market other gene therapy pipeline products with in the future or perhaps be wholly-acquired by Roche.

Partnerships and licensing agreements are popular options for large and mid-sized biotech and pharmaceutical companies to explore gene therapy commercial opportunities while avoiding risk

Gene therapy and other highly-focused clinical research or product development firms do not always have the financial resources or business structure to orchestrate a complete commercial lifecycle of their work. Established, publicly-held drug companies frequently collaborate with gene therapy and other smaller, highly advanced biotherapeutic concerns. As pipeline candidates move through the clinical trials process, it is easier to gauge the likelihood of their chances for approval by regulators. They provide financial support to these activities and when it appears their success is almost imminent, larger investments and commitments are made to assure trial completion, approval and subsequent clinical / commercial launch traction. 

The high cost and high risk involved with gene therapy research is a barrier to entry; less firms and highly focused therapies reduce competition in the sector

As an advanced area of life sciences with potential to cure diseases by replacing missing or mutated versions of a gene found in a patient’s cells with healthy copies gene therapy is not a sector many companies can participate in based on time, clinical and financial commitments. Depending on the patient and the genetic-based issue involved, gene therapy in has been proven to significantly reduce or eliminate complex, life threatening conditions. Success in the gene therapy sector also enriches the clinical insights and manufacturing attributes of their organizations which can be applied in other product development ventures outside of the gene therapy realm.

LinkedIn: John G. Baresky

Twitter: Healthcare & Content Marketing Guy


DANAHER: $21.4 BILLION GE BIOPHARMA DEAL MOVES FORWARD WHILE ENVISTA DIVESTITURE IS COMPLETED

by John G. Baresky on 12/19/19

Published on 12/19/19, updated 2/23/20

Danaher achieves critical European regulatory approval milestone in acquisition of GE biopharma business unit

Danaher (  NYSE: DHW.WD ) is closing out 2019 at full speed with its attention squarely centered on 2020. The European Union has approved their acquisition of GE Biopharma which completes a pivotal stage of their quest to buy one of GE's most prestigious and profitable corporate divisions. To satisfy the European Commission and other government regulatory requirements, Danaher will sell off these operating groups:

  • MolDev FortéBio molecular characterization business located in Fremont, California and Shanghai, China
  • Pall Biotech chromatography hardware unit operating from Portsmouth, United Kingdom and Westborough, Massachusetts
  • Pall Biotech chromatography resins company operating out of Cergy, France
  • Pall Biotech Single-Use Tangential Flow Filtration ("SUT TFF") systems located in Portsmouth, United Kingdom and Westborough, Massachusetts plus its stainless-steel Hollow-Fibre TFF (“SS HF TFF”) systems operations in Shanghai, China
  • Pall Biotech SoloHill microcarriers and particle validation standards unit based in Farmington Hills, Michigan

With addition of GE biopharma assets, Danaher's business will engage multiple bioprocessing industry sectors

As a combined organization, Danaher and the acquired assets of GE Biopharma Business will be a worldwide leader in products and services aligned with bioprocessing including consumable single-use technology products such as bioreactors, mixers or connectors plus cell culture media and sera, microcarriers, bioprocessing filtration, molecular characterization, microscopy, high-content screening and laboratory filtration. Its enormous portfolio will enable it to embrace the needs of multiple customer stakeholders. 

These include academic institutions and commercial research organizations plus an array of companies involved with research, development, manufacturing, and commercialization of products prepared from or used by biological systems such as biopharmaceutical developers and manufacturers, cosmetics, food, fuel, livestock feed and other biochemical product and service providers.

Danaher corporate profile 

Headquartered in Washington, D.C., the Danaher organization is generally defined through three business groups: 

  • Environmental & applied solutions
  • Diagnostics
  • Life sciences

With the addition of the GE biopharma assets, Danaher’s abilities in each of the 3 will be significantly multiplied and likely reach into new business sectors as well. Excluding the addition of the GE biopharma assets and their revenue potential, Danaher already generates just under $20 billion in annual sales.

Danaher will be disrupting the competitive balance in their business sectors

These top 10 Danaher rivals plus other firms will be sizing up the new competitive threats Danaher is formulating:

  • Agilent Technologies ( NYSE: A ) 
  • Bruker Corporation ( NASDAQ: BRKR )
  • Harvard Bioscience ( NASDAQ: HBIO ) 
  • Illumina ( NASDAQ: ILMN )
  • Lonza Group ( OTCMKTS: LZAGF )
  • PerkinElmer ( NYSE: PKI )
  • Roche ( OTCMKTS: RHHBY )
  • Thermo Fisher Scientific ( NYSE: TMO )
  • VWR / Avantor ( privately held ) 
  • Waters Corporation ( NYSE: WAT )

Danaher completes its divestiture of Envista including stock ownership and voting rights

Another strategic corporate development milestone at Danaher is the completion of its dental product assets into a fully independent spinoff  known as Envista Holding Corporation which was launched in 2018.  Danaher recently accepted an aggregate of 22,921,984 shares of Danaher common stock in exchange for all of its 127,868,000 shares of Envista common stock. Danaher is now completely separated from Envista as it no longer possesses any voting rights or economic interest in the newly formed company.

Danaher spinoff formed a global professional dental product leader 

Overlooked in the broader sense of the investor and dental healthcare communities, through spinning off its dental assets to form Envista ( NYSE: NVST ) Danaher launched a professional dental products giant comprised of: 

  • 3 primary business units: KaVo Kerr, Nobel Biocare, Ormco
  • Over 12,000 employees
  • More than 30 dental brands and product franchises
  • $2.8 billion in annual sales generated from over 150 nations

Danaher's organizational and revenue goal plans for 2020

Moving forward, Danaher will be busy with the arrangements to integrate its new assets and aligning their revenue producing capabilities according to their annual business plan. At the same time, they will be shopping the 4 Pall business units and MolDev FortéBio to interested parties. 2020 will unveil a significantly larger and somewhat redefined Danaher that customers, competitors and investors will be paying much more attention to in the future.


WALGREENS 4 POWER PARTNER PROFILES: KROGER, MCKESSON, MICROSOFT, PRIME THERAPEUTICS

by John G. Baresky on 12/13/19

Commercial synergy, market access and profit in strategic partnerships

Walgreens Boots Alliance (NASDAQ: WBA ) ranks at number 17 on the Fortune 500 list of largest firms. Reportedly they are exploring options to take the company private which may also be a strong signal to other industry leaders that it is open to takeover offers. Regardless of what their ultimate goals are, they remain a global force in retail, pharmacy, wholesaler and other sectors. The company’s CEO, Stefano Pessina, has communicated Walgreens is actively pursuing more partnerships as a business strategy that enable it to generate revenue by asserting its corporate, financial, clinical and operations resources to build market access and revenue while disrupting competitors --without having to deploy excessive funding for complete acquisitions that contribute further to debt loads.

Walgreens Boots Alliance ( WBA ) financial profile based on the formation of its present corporate structure

For many, Walgreens is a widely recognized retail drugstore chain that competes against consumer and pharmacy players such as CVS Health, Target, Walmart, grocery store pharmacies and online juggernaut Amazon's consumer and pharmacy businesses. In 2014, Walgreens completed an acquisition exercise valued at $4.9 billion cash plus 144.3 million common shares valued at $10.7 billion to acquire UK and Swiss-based Alliance Boots ( Walgreens had earlier committed $4 billion cash and 83.4 million common shares to get the deal underway ). Based in Deerfield, Illinois, ( a Chicago suburb ), the new organization, which deems itself as a holding company, immediately transformed into a global, multi-sector competitor. 

Primary elements of Walgreens Boots Alliance financial position

  • Market capitalization of $50 billion
  • Annual sales: $136.86 billion ( 2019 figures which represented a 5.8% increase over 2018 )
  • Earnings: $3.982 billion
  • Debt: $15 billion
  • Ownership stake of 16% held by CEO Stefano Pessina
Strategic global attributes of WBA
  • Business operations in more than 25 nations
  • Over 415,000 employees
  • More than 18,500 stores located in 11 countries
  • Over 390 distribution centers servicing pharmacies ( including pharmacies not owned by WBA ), physician offices and healthcare provider organizations
  • Ownership stake of 26% in AmerisourceBergen, a global leader in healthcare wholesaler operations ranked at number 12 on the Fortune 500 list; annual sales of $153 billion
A formidable global commercial enterprise in consumer, healthcare and supply chain sectors; Walgreens is a coveted partner and respected competitor

Based on its success and expertise dating back to 1901, Walgreens is acknowledged as an industry leader in consumer, pharmacy, wholesale and other business sectors. While it has various collaborations in place with a number of entities, it has 4 partnerships with established industry leaders equal to its own scope and scale. They demonstrate how attractive Walgreens is as an ally and business opportunity. Their relationships with Walgreens underscores Walgreens' ability to innovate and operate outside of conventional business model structures to share knowledge and resources which benefits both partners while increasing sales.

U.S. grocery store giant Kroger Co.

Walgreens has been collaborating with grocery store giant Kroger ( NYSE: KR )  in several marketing initiatives and late in 2019 announced the formation of their own GPO, Retail Procurement Alliance. By combining their orders, Kroger and Walgreens seek to lower costs and boost operational efficiencies. The two companies are already selectively marketing each other’s private label brand products in test market stores across the nation.

Cincinnati, Ohio based Kroger operates over 2,800 stores under 17 different names in 35 states with annual sales exceeding $122 billion. By working together, Kroger and Walgreens are developing wider market access for each of their product portfolios while developing synergies to more effectively operate and compete against Amazon, Walmart, Target, CVS Health, Albertsons, Costco plus other grocery and pharmacy rivals.

The global leader in healthcare wholesale operations McKesson Corporation

Late in 2019, Walgreens entered into a collaboration with McKesson, the world’s largest wholesaler. The two companies formed a joint venture to combine each of their drug wholesale units ( Alliance Healthcare Deutschland and GEHE Pharma Handel ) in Germany. McKesson ( NYSE: MCK ) has a 30% stake int the venture and WBA owns the remaining 70%. The organization will optimize efficiencies and strengthen a competitive position in Germany. The joint venture ( yet to be named and still requiring approval by regulators) is exclusively deployed within Germany's borders and does not extend into other nations. 

This arrangement is particularly interesting relative to Walgreens 26% ownership in AmerisourceBergen, one of McKesson’s primary competitors. McKesson, headquartered in San Francisco, ranks at number 7 on the Fortune 500 list by producing over $208 billion in yearly sales.

Technology champion and innovator Microsoft Corporation

Early in 2019 Walgreens Boots Alliance entered into a deal with Microsoft to enroll over 380,000 employees in Microsoft 365 cloud apps which encompass mobile, Office 365, security features and other applications. Walgreens will also transition the majority of its IT workload to Azure and Microsoft’s cloud platform. The two organizations are further working on solutions to optimize data workflow throughout WBA including administrative, pharmacy, operations and other areas through artificial intelligence ( AI ) and other technology. Microsoft has deep AI capabilities spanning, voice, advanced machine learning, data science, Internet Of Things ( IoT ) / Interoperability applications and robotics.

This arrangement benefits Walgreens as it gives them access to Microsoft’s technology resources and IT savvy while Microsoft gains a wider presence in the consumer / patient data management, retail, pharmacy, operations and other sectors ripe for advanced technology development. Through the partnership, both are staking a competitive position against a mutual consumer, healthcare and commercial technology rival, Amazon. Ranked at number 24 in the Fortune 500, Seattle based Microsoft churns out more than $110 billion in annual sales.

Blue Cross Blue Shield Pharmacy Benefit Manager Leader Prime Therapeutics

In 2017 Walgreens entered into a partnership arrangement with Prime Therapeutics, one of the largest pharmacy benefit management companies in the United States. The venture, called AllianceRx Walgreens Prime, is a ten year commitment for the 2 partners. Walgreens is the central ( but not exclusive ) retail pharmacy provider for Prime Therapeutics and the two jointly operate a specialty pharmacy plus mail order pharmacy services. AllianceRx Walgreens Prime benefits WBA with enhanced market access to the membership of 14 BCBS plans plus other customer groups. 

Prime Therapeutics realizes the benefit of being aligned with a leader in retail, mail and specialty pharmacy services and operations. Prime Therapeutics, based in Eagan, Minnesota, was founded in 1998. It services more than 28 million members and patients. Their cooperative ownership structure is comprised of 14 Blue Cross Blue Shield plans across the United States.

Walgreens building its future through clinical, operations, and technical transformation plus strategic alliances

Through the company it keeps in strategic partnerships and willingness to reinvent itself; Walgreens fortifies its ability to profitably grow and compete. Maximizing its assets and attributes with equally adept and equipped partners, Walgreens cultivates and improves its organizational effectiveness. Moving forward, Walgreens has numerous options to satisfy the demands of consumers, patients, payers and shareholders while continuing to be a preferred strategic ally for existing and future partners.  

LinkedIn: John G. Baresky

Twitter: Healthcare & Content Marketing Guy

FIRST TIME: WOMEN COMPRISE MAJORITY OF MEDICAL STUDENTS IN THE U.S.

by John G. Baresky on 12/10/19

Medical school applicants and medical school enrollees transforming based on gender, ethnicity, race

The Association of American Medical Colleges ( AAMC ) reports that based on its data, more females than males are enrolled as medical students throughout the nation. The margin is narrow but reflects an ongoing trend that has been building over the last several years. This is a breakthrough for women, the medical community, academia and the nation.

AAMC is a champion for better patient care and healthcare academics

Based in Washington, D.C., AAMC was founded in 1876. AAMC is a non-profit organization. Its members comprise all 154 accredited United States and 17 accredited Canadian medical schools encompassing almost 400 teaching hospitals and health systems, 51 Department of Veterans Affairs ( VA ) medical centers plus over 80 academic medical societies. The AAMC is a healthcare leader dedicated to improving medication education and patient care while driving breakthrough medical research and healthcare innovation. 

A positive and growing trend that cleared a medical school enrollment milestone in 2017

Presently, 50.5% of all enrolled medical students are women. This number is built from crossing an earlier landmark threshold from 2017 when for the first time females outnumbered males as first-year medical students.

Kaiser Family Foundation Data

According to the Kaiser Family Foundation ( KFF ) there were 25,955 medical school graduates in 2018. This number includes allopathic medical school graduates and osteopathic medical school graduates. The top 10 states of combined allopathic and osteopathic graduates were:

  • California: 1,477
  • Florida: 1,316
  • Illinois: 1,315
  • Michigan: 1,143
  • Missouri: 922
  • New York: 2,402
  • Ohio: 1,122
  • Pennsylvania: 1,910
  • Texas: 1,735
  • Virginia: 858

Based in San Francisco and founded in 1948, the Kaiser Family Foundation is a commercially and clinically recognized and respected non-profit organization dedicated to the major healthcare issues of the United States and the role of the nation as an influential global healthcare policy leader.

As an industry, healthcare is becoming more diverse

The medical school academic sector is changing in many other ways. A greater number of minorities are applying and the percentage of them being accepted is on the rise as well.

Data from AAMC reveals a small and steady transformation in healthcare academics and the future healthcare workforce:

  • Native American or Alaska Native applicants increased by 4.8% and their acceptance levels increased by 5.5%
  • Hispanic or Latino applicants grew by 5.1% and those accepted grew 6.3%
  • African American or black applicants rose by 0.6% and those accepted increased by 3.2%
  • For African American or black males, their applicant count grew by .5% and those accepted increased by 3.7%

If current trends continue, the physician workforce of the future will be significantly changed

While women and minorities are presently outnumbered in the physician ranks, the current trends mark an important change from the past norms which is favorable for patients and clinicians moving forward. For persons early in their education and forming ideas about their career aspirations or for those people seeking a change in their existing careers, the prospects of gaining entry into the healthcare industry is greater than ever --including the opportunities for medical doctor roles as long as they can meet the academic rigor ( average GPA of undergraduates admitted to medical school is above 3.7 ) and take on the economic burden involved.

Medical school expense is a daunting challenge but interest in the healthcare profession and physician careers is robust

Based on data from the American Medical Student Association ( AMSA ), the annual cost of attending  a public medical school ( complete with tuition, fees, and health insurance included ) is approximately $34,592 for in-state students and $58,668 for out-of-state students. This cost rises considerably for those attending private institutions. Private medical school tuition, fees and health insurance average over $50,000 annually for in-state or out-of-state enrollees. These figures are based on statistics from 2016-2017; for public and private universities these costs continue to increase. Founded in 1950, AMSA is a student governed non-profit organization with over 30,000 members that is based in Washington, D.C. which cultivates healthcare academic and student advocacy while providing a framework for educational and clinical communication and networking. 

The sustained and growing interest in healthcare as a career and physician-centered roles is encouraging. 20 new medical schools have opened in the last ten years and class sizes have been expanded which has resulted in a 33% growth trend that dates back to 2002. 

Americans are living longer; will there be enough physicians to care for us?

Amazingly, the expansion may not be sufficient to meet the healthcare needs of the nation. Thanks to rapidly evolving healthcare knowledge, better techniques and advanced healthcare products as well as a decline in tobacco use, U.S. citizens are living longer. To meet the needs of today and those of future generations, the number of physicians needs to increase as present data indicates a drastic shortfall by up to 122,000 doctors is approaching by the year 2032.

LinkedIn: John G. Baresky

Twitter: Healthcare & Content Marketing Guy

SANOFI ACQUIRES SYNTHORX FOR $2.5 BILLION TO EXPAND ONCOLOGY PORTFOLIO

by John G. Baresky on 12/10/19

Synthorx: a fourth multi-billion dollar acquisition for Sanofi in less than 10 years

Sanofi is expanding its oncology therapeutics business through acquiring Synthorx for approximately $2.5 billion. Based in La Jolla, California, Synthorx has a primary focus in immuno-oncology. Synthorx's most current primary development project is THOR-707, a form of interleukin-2 (IL-2) which, if approved and launched, can be deployed to treat multiple solid tumor types as a monotherapy and potentially in combination with checkpoint inhibitors. The agent is intended to increase effector T-cells and natural killer cells that eliminate cancerous cells in patients.

Synthorx has value-added biotech research & development attributes for Sanofi to build on

An added asset for Sanofi in the deal is Synthorx’s Expanded Genetic Alphabet platform. It can be integrated with Sanofi’s existing initiatives in nanobody research and development. This will support Sanofi’s ventures in advanced patient care and healthcare product sectors such as:

  • Biologics
  • Conjugates
  • Protein Fusions

$2.5 billion deal a mega win for Synthorx investors

Synthorx had gone public in 2018. These three initial backers will realize an enormous windfall from their investments in it:

  • Avalon Ventures
  • OrbiMed
  • RA Capital

Sanofi expanding its ability to compete in advanced pharmaceutical product sectors while stacking on debt

Sanofi, which has been reported to be shopping its consumer healthcare products unit as a spinoff or joint venture that could be worth up to $30 billion, has made three sizable acquisitions since 2011 that, combined with the Synthorx deal, will push up its $28 billion debt load:

  • Synthorx: bought for $2.5 billion in 2019
  • Bioverativ: acquired for $11.5 billion in 2018 ( a spinoff from Biogen)
  • Ablynx purchased for $2.4 billion in 2018
  • Genzyme bought for $20 billion in 2011 

 Based in Paris, France, Sanofi ( NASDAQ: SNY ) is a global contender ranked within the top 10 of pharmaceutical manufacturers. It generates over $42 billion in annual sales and has over 100,000 employees.

Sanofi transforming its corporate organization and clinical focus

The Synthorx deal is part of a newly emerging change in strategy at Sanofi. They are not only seeking to further monetize their consumer healthcare products unit through a spinoff, partnership or outright sale but also to channel more focus into global healthcare opportunities based on clinically complex medicines. Their senior leadership team has communicated they are going to be significantly reducing their clinical and financial investments in the cardiovascular / hypertension and diabetes / endocrinology patient care sectors in favor of more challenging life science commercial opportunities.

LinkedIn: John G. Baresky

Twitter: Healthcare & Content Marketing Guy

3M EXPLORING SALE OF DRUG DELIVERY SYSTEMS PRODUCT GROUP VALUED AT $1 BILLION

by John G. Baresky on 12/10/19

Could 3M be seeking to boost revenue or pay down long term debt?

3M ( NYSE: MMM ) is reportedly exploring it options to sell or spinoff its drug delivery systems unit. Based in Maplewood, Minnesota ( a suburb of St. Paul ), 3M ( formerly known as the Minnesota Mining and Manufacturing Company ) is a global conglomerate with long established business enterprises in consumer goods, healthcare, industrial products and worker safety.

3M has a robust presence in the healthcare sector

While 3M generates about $33 billion in sales annually, the drug delivery portfolio of products is a smaller part of a substantially large healthcare products unit. It is estimated drug delivery product revenue accounts for less than 2% of 3M’s total annual sales. Medical device manufacturers, brand and generic pharmaceutical manufacturers as well private equity investors can be considered as likely buyers if 3M does move forward with the sale of the business unit.

 3M drug delivery has 5 primary product groups:

  • Inhalation
  • Microneedle
  • Nasal
  • Packaging
  • Transdermal
Medical device, pharmaceutical or private equity buyers could maintain such an acquisition as a wholly-intact group or choose to keep only select product franchises and sell the remaining categories to another interested party. 

A spinoff of the drug delivery unit to form a separate operating company would be a more complex and lengthy process and may not be feasible based on 3M's goals and timeframe plans.

Possible plans for proceeds from sale of the drug delivery business unit

If 3M were to spinoff or sell the drug delivery unit, it could be marketed for around $1 billion. 3M may have plans to drop the proceeds of the drug delivery unit into the bottom line of its annual revenue totals or could apply it to pay down some of its long term debt which is approximately $19.4 billion.

LinkedIn: John G. Baresky

Twitter: Healthcare Marketing Guy


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

by John G. Baresky on 12/03/19

Astellas Expands Therapeutic Portfolio With Gene Therapy Deal

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

Astellas is a global pharmaceutical leader 

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

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

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

Audentes has developed a robust pipeline of advanced gene therapies

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

  • Gene Replacement
  • Vectorized Exon Skipping
  • Vectorized RNA Knockdown

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

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

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

Astellas began exploring gene therapy marketplace in 2018

Astellas began exploring gene therapy marketplace in 2018

Astellas has already licensed a gene therapy candidate. In 2018 Astellas entered into a licensing agreement with Juventas Therapeutics for JVS-100. JVS-100 is a non-viral gene therapy expressed from stromal cell-derived factor -1 ( SDF-1 ) which is a naturally occurring signaling protein activating the endogenous tissue repair pathways. Founded in 2007 and based in Cleveland, Ohio, Juventas is a private, clinical stage biotechnology company developing novel non-viral gene therapies which activate natural processes. Their clinical indication specialties encompass dermal scar prevention, heart failure, peripheral artery disease and other areas of investigational research and development.

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

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

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

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

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

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

Astellas is highly selective in its acquisition strategy

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

Astellas versus the competition in the gene therapy marketplace

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

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

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

Potential gene therapy giants or acquisition targets

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

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

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

Drug manufacturers seek to avoid large financial outlays and risk involved with gene therapy and other biotherapy product development

Many large and mid-sized companies owned by the investment community prefer to have smaller, highly-focused companies develop products like gene therapies first. As they progress through the approval process, the pharma companies either license or buy outright the product or the firm when approval by regulators seems imminent. In advance, these companies may partially fund the research necessary to develop the products. Audentes provides Astellas with a solid candidate to enter the gene therapy market with and hopefully generate other products in the future.

Astellas and Audentes deal approval and product approval timelines

Even before the Astellas and Audentes deal is approved by regulators, the approval of AT132 X-linked Myotubular Myopathy MTM1 ( Gene Replacement ) will be highly anticipated by investors, company staff members and the medical community. Depending when the deal is approved and AT132 is approved, a combined torrent of activity will follow. Astellas and Audentes could be working to integrate their organizational structures and launching a strategic product venture at the same time. As 2020 rapidly approaches, each company has much to accomplish and look forward to.




AMAZON LAUNCHES ADVANCED HEALTHCARE DATA APPLICATION: AMAZON TRANSCRIBE MEDICAL

by John G. Baresky on 12/02/19

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

Conversation Converted To Digital Text Technology

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

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

Healthcare Clinical And Cost Advantages

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

Amazon Technology In Partnership With Cerner and Suki

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

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

Patient Information HIPAA Compliance And Data Accuracy

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

Microsoft, Google, Other Competitors

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

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

 

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

 

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

Voice Recognition Technology ( VRT ) And Transcription Technology

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

Demands Of Clinicians And Healthcare Provider Organizations

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

Patient Information Data Companies

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

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

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

LinkedIn: John G. Baresky

Twitter: Healthcare Marketing Guy

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


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


Verify Technical Attributes Are In Place And Functioning Properly

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


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


Revisit Keyword Selection


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

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


Consult Your Repurposing Strategy

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

Paid Search

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


Redefine Your Topic

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


Strategically Utilize Social Media

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

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


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


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

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

Security / Privacy

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

Key Performance Indicators ( KPIs ) / Sales Goals Attainment

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

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

Sharpen Segmentation

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

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


Automation


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

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


Benefit From Opt-outs


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

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

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


Double Up On Focusing Content And Offerings


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

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

Change Up Your Approach

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

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

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

Mobile

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

Moving Forward

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



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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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


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

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

Healthcare And Technology Compete Against Themselves Everyday…

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

Commit Your Content To The Audience

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

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

Help Google Help You

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

…Spinning Out Of The Curve…

Practice Good Form

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

….Based on research from Wolters Kluwer Health…

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

Be Time Sensitive

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

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

Spur Your Content To Stay On The Move

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

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

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

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

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

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

Eight Fast Facts…

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

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

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

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

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

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

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

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

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

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

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

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

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


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

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

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

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

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

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

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

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


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

Mobilize Healthcare Marketing And Sales ROI…

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

…According To Google…

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

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

Start With Regulatory, Legal, IT…

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

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

KPIs, Goals / Objectives…

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

Define, Target The Right Audience…

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

Critically Assess Your Website…

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

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

Consult Customers…

….Based on research from Wolters Kluwer Health…

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

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


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

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

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

Evaluate Mobile Marketing Initiatives In Other Industries…

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

….Results Of An Indegene Physician Marketing Study Reveal…

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

Interactive Calls-To-Action…

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

To App Or Not To App…

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

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


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

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

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

Mobile-Friendly Email Marketing…

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

SMS/MMS Text Subscription Options…

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

Video Growing In Popularity…

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

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

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

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

Voice is coming on strong as well…

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

Technical Alignment…

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

Be Certain You Deliver What You Promise…

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

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

Continually Evaluate And Refine…

Keep your healthcare mobile marketing initiatives on the move:

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

Don’t Stand Still…

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


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

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

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

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

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

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

Check your bearings…

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

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

Chart Your Course…

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

Digital / Social Media Marketing Elements

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

Brand Elements

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

Marketplace Channel Elements

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

Managed Care / Market Access Elements

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

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

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

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

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

Sailing Ahead…

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

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

Over $40 billion in annual sales…

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

Specialized markets, services and plans…

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

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

Significant risk management business challenges…

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

A growing organization...

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

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

Moving ahead…

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

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


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

IngenioRx — A Business Climate Changer…

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

Express Scripts Explores A Different Path…

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

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

AllianceRx Walgreens Prime…

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

United HealthCare / OptumRx And Catamaran…

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

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

Forging Ahead…

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

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

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

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

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

A Wilderness Of Exhaustive Complexity

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

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

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

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

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

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

A Gold Rush Of Controversy

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

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

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

Pharmaceutical Manufacturers Stake Their Claim

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

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

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

Will More Regulation Provide A Positive Payout?

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


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

Largest Private For Profit Health System In The United States…

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

Expansive Organizational Reach…

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

Business Impact…

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

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

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

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

Giddy Up For A Deal

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

Margins

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

Diminishing Returns / Damaging Effects Of Continual Cost Cutting

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

Plug The Revenue Leak

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

Growth By Acquisition Strategy

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

Come Buy Me ( CBM )

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

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

Competitive Threats

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

Private Equity

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

Favorable Financing

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

Technology

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

Saddle Up

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


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

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

Understand Two-Screening Behavior…

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

Understand Two-Screening Technical Enablement…

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

A Contributing Driver Of Two-Screening Behavior…

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

Profile Of 84 Lumber And Their Ad Agency, Brunner…

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

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

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

Impact…

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

Get More From Broadcast Television Advertising And Digital Marketing…

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

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

Considerations…

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

Know your audience…

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

Two-Screening Advantages…

Healthcare marketers can effectively span broadcast and digital venues

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

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

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

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

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

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

How To Plan A Two-Screening Initiative…

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

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

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

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

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

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

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

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

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

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

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

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

An Innovative Healthcare Broadcast And Digital Marketing Strategy…

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

Follow the customer / patient journey map…

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

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

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

Leadership Commitment

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

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

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

Customer Connection

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

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

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

Integrated Marketing / Brand And Digital

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

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

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

Technical Resources

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

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

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

Partnership With Sales

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

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

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

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