Results of research analysis to assess the impact of CARE Media Holding’s KidCARE TV program; evaluated on Product X on prescribing behavior of participating physicians using a nine month test/post-test period.
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KidCARE TV Promotional Evaluation
1. KidCARE TV Promotional Evaluation
NINE MONTH TEST/POST-TEST ASSESSMENT
Presentation by: IMS Health Consulting & CARE Media Holdings Corp.
2. Agenda
• Objective
• Research Methodology
• Methodology Assumptions
• Study Results
• Conclusions
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3. Objective
• To assess the impact of CARE Media Holding’s KidCARE TV
program that is being evaluated on Product X on prescribing
behavior of participating physicians using a nine month
test/post-test period
Product X
KidCARE TV
Incremental
for
NRx?
• This analysis is limited to participants who began exposure
during April 2010
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4. Agenda
• Objective
• Research Methodology
• Methodology Assumptions
• Study Results
• Conclusions
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5. Research Methodology
• Impact of KidCARE TV programming for Product X is assessed
using IMS Consulting’s Promotion EvaluationSM methodology
− Paired comparison analysis to measure changes in the product of
new prescription writing behavior of a Test group relative to a
similar group of Control physicians
− Utilizes physician-level new prescription data* that is “raw,” or
not projected, which removes any potential bias that might be
introduced by projection
*Data source: IMS Health’s prescriber prescription database
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6. Agenda
• Objectives
• Research Methodology
• Methodology Assumptions
• Study Results
• Conclusions
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7. Research Methodology
• Impact of CARE Media’s KidCARE TV for Product X is assessed
using IMS Consulting’s Promotion EvaluationSM methodology
– Paired comparison analysis to measure changes in Product X new
prescription writing behavior of a Test group relative to a similar group
of Control physicians
– Utilizes physician-level new prescription data* that is “raw,” or not
projected, which removes any potential bias that might be introduced
by projection
*Data source: IMS Health’s prescriber prescription database
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8. Study Time Periods
• Test physicians were initially exposed to the KidCARE TV promotion
during April 2010
• NRx data for the same nine months during the previous year (as
compared to the post-test period during the current year) is used as
the pre-test period
• NRx data for the test month and following eight months of exposure
(test/post-test period) reflects prescribing behavior influenced by the
KidCARE TV promotion
Pre-Test Period Test/Post-Test Period
9 Months 9 Months
Apr – Dec 2009 Apr – Dec 2010
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9. Test Group
2,264 Physicians participated in
the KidCARE TV program for
1,888 Physicians qualified as potential Test
physicians (successfully matched to the IMS
Health prescriber universe)
1,831 Physicians had a matched Control
1,548 Physicians 283 Physicians
were Specialists were All Other
Specialties
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10. Statistical Approaches
• ANCOVA was used to measure statistical significance of the
difference between the post-test NRx volume generated by
the Test and Control physicians
– Adjustments were made in the post-test period to eliminate any pre-
test period differences between the Test and Control groups
– Program success was determined by looking for an Index of Adjusted
Means (IAM) above “1” with a p-value <0.10, i.e., a confidence level
>90% showing that the result is not due to chance
• Z-tests were performed to determine the effectiveness of the
program on
– Product X NRx share, defined as the ratio of Product X NRx over
market NRx, and
– Product X physician penetration, defined as the number of physicians
writing at least one prescription for Product X
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11. Control Group Selection
• 1,888 potential Test physicians were matched to the IMS
Health prescriber universe to identify potential Control
physicians based on the following criteria:
− Product X NRx during the pre-test period;
− Product X’s competitors NRx in the pre-test period;
− Sales force promotion;
− MD geography; and
− MD specialty
• 1,831 Test physicians were successfully matched to a Control
physician
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12. Methodology Assumptions
• Test and Control group physicians are assumed to have
similar levels of exposure to promotional activity for the
duration of the study time period
− Cannot control for disproportionate changes in promotional levels
in the post-program exposure time period
• Managed care influences are also assumed to be similar
between the Test and Control physicians
− Cannot control for disproportionate changes in patient flow or
patient health care plans at any time of the study time period
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13. Quality Control Procedures
• Two different quality control procedures were utilized as
necessary to ensure that sporadic reporters do not bias the
results
− Constant Store Panel – a pharmacy must report prescription
activity in each study period month to be included in the analysis
− Active Writers – a physician must generate at least one
prescription during the most current three months to be included
in the analysis
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14. Agenda
• Objective
• Research Methodology
• Methodology Assumptions
• Study Results
• Conclusions
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15. Product X NRx Comparison
During the nine month post period, Test physicians prescribed 3.0% more Product X NRx
compared to Control physicians. This change in prescribing behavior is statistically
significant (cl=89.96%).
12000
10000
Product X NRx
8000
6000
4000
2000
0
Test Product X Control Product X
Note: cl = Confidence level; if cl >= 90% the program impact is significant, cl=80-90% is directional,
else it is non-significant. Analysis conducted : ANCOVA.
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16. Competitor NRx Comparison
Test physicians prescribed 1.1% more Competitor NRx compared to Control
physicians. This change in prescribing behavior is not statistically significant
(cl=58.37%).
40000
35000
30000
Competitor NRx
25000
20000
15000
10000
5000
0
Test Competitor Control Competitor
Note: cl = Confidence level; if cl >= 90% the program impact is significant, cl=80-90% is directional,
else it is non-significant. Analysis conducted : ANCOVA.
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17. Market NRx Comparison
Test physicians prescribed 1.5% more Market NRx compared to Control physicians.
This change in prescribing behavior is directional (cl=79.59%).
50000
45000
40000
35000
Market NRx
30000
25000
20000
15000
10000
5000
0
Test Market Control Market
Note: cl = Confidence level; if cl >= 90% the program impact is significant, cl=80-90% is directional,
else it is non-significant. Analysis conducted : ANCOVA.
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18. Product X NRx Share Comparison
During the nine month test/post-test period, Product X NRx share decreased to a
greater extent among Control physicians than Test physicians, resulting in a statistically
significant difference in share change of +0.4 share points (cl=97.71%).
0.3 point 0.6 point
decrease decrease
25.3%
25.2% 25.2% 25.2%
25.1%
Product X NRx Share
25.0%
24.9%
24.9%
24.8%
24.7%
24.6% 24.5%
24.5%
24.4%
24.3%
24.2%
Test Group Control Group
Pre-Test Test/Post-Test
Note: Analysis conducted : Z-test.
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19. Product X Physician Penetration Report
Physician penetration decreased to a lesser extent among Test than Control, resulting in
a net increase of 0.7 points. The results are not statistically significant (cl=34.98%).
0.8 point
1.4 point
decrease
90.0% decrease
89.8% 89.8%
89.5%
MD Penetration
89.1%
89.0%
88.5% 88.4%
88.0%
87.5%
Test Group Control Group
Pre-Test Test/Post-Test
Note: Physician Penetration is defined as the ratio of MDs writing / MDs in program. Analysis
conducted : Z-test
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20. Comparison of the Impact of KidCARE TV on
Physicians by Specialty
Specialists n = 1,548
All Other Specialties n = 283
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21. Participants Breakout by Specialty
Physician
Specialty % of Total
Count
Specialists 1,548 85%
All Others 283 15%
Total 1,831 100%
Physician % of Total Physicians
All Other Specialties
Count with Patients Enrolled
Specialty C 117 41%
Specialty D 39 14%
Specialty E 14 5%
All Others (individual specialties
113 40%
comprising of less than 7%)
Total 283 100%
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22. Product X NRx Volume Comparison by Specialty
Test Specialists prescribed 2.5% (cl=80.80%) more Product X NRx compared to Control
physicians, as All Other Test physicians prescribed 8.7% (cl=87.00%) more NRx. These
changes in prescribing behavior are directional.
12000
10000
Product X NRx
8000
6000
4000
2000
0
Specialists Test Product X Specialists Control Product X
All Others Test Product X All Others Control Product X
Note: cl = Confidence level; if cl >= 90% the program impact is significant, cl=80-90% is directional,
else it is non-significant. Analysis conducted : ANCOVA.
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23. Competitor NRx Volume Comparison by Specialty
Test Specialists prescribed 1.5% (cl=72.70%) more Competitor NRx compared to
Control physicians, as All Other Test physicians prescribed 2.2% (cl=49.33%) fewer
Competitor NRx. However, these changes in prescribing behavior are not statistically
significant.
35000
30000
25000
Competitor NRx
20000
15000
10000
5000
0
Specialists Test Competitor Specialtists Control Competitor Competitor
All Others Test Competitor All Others Control Competitor
Note: cl = Confidence level; if cl >= 90% the program impact is significant, cl=80-90% is directional,
else it is non-significant. Analysis conducted : ANCOVA.
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24. Market NRx Volume Comparison by Specialty
Test Specialists prescribed 1.8% (cl=83.25%) more Market NRx compared to Control
physicians, as All Other Test physicians prescribed 0.3% (cl=6.98%) fewer Market NRx.
Specialist changes in prescribing behavior are directional, All Others are not statistically
significant.
45000
40000
35000
30000
Market NRx
25000
20000
15000
10000
5000
0
Specialists Test Market Specialists Control Market
All Others Test Market All Others Control Market
Note: cl = Confidence level; if cl >= 90% the program impact is significant, cl=80-90% is directional,
else it is non-significant. Analysis conducted : ANCOVA.
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25. Product X NRx Share Comparison by Specialty
The program increased Product X NRx share among All Others with statistical
significance. Specialists increased share to a lesser extent, and without statistical
significance.
Specialists All Others
A non-significant net increase among A significant net increase among Test
Test of 0.2 share points (cl=75.75%) of 1.6 share points (cl=99.97%)
30%
25.7% 25.4% 25.9% 25.3%
25%
Specialists NRx Share
20.3% 20.7%
20% 19.0%
17.7%
15%
10%
5%
0%
Test Group Control Group Test Group Control Group
Pre-Test Test/Post-Test
Note: Analysis conducted : Z-test.
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26. Physician Penetration Comparison by Specialty
Physician penetration increased among All Others to a greater extent than among Specialists.
However, results are not statistically significant.
Specialists All Others
A non-significant net increase of 0.4 A non-significant net increase of 2.1
points (cl=26.29%) points (cl=28.49%)
100% 94.9% 94.4% 94.9% 94.0%
90%
80%
% Physician Penetration
70%
62.2% 60.1% 62.2%
58.0%
60%
50%
40%
30%
20%
10%
0%
Test Group Control Group Test Group Control Group
Pre-Test Test/Post-Test
Note: Physician Penetration is defined as the ratio of MDs writing / MDs in program. Analysis
conducted : Z-test
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27. ROI Analysis – Methodology
• Calculate Average Product TRx (average retail price for a
Step I prescription) = TRx sales/ 9 month study period (for ) is
$148.30 (source: IMS NPA Plus – TRx retail price)
• Calculate Revenue Associated with Test Physicians =
Step II Projected Product X TRx x Average Product Price
350,703 x $148.30 = $52,008,378
• Calculate Revenue Associated with Control Physicians =
Projected Product X TRx for Control Physicians* x Average
Step III Product Price
340,488 x $148.30 = $50,493,519
• Incremental Revenue due to the program = Revenue
Associated with Test Physicians – Revenue Associated with
Step IV Control Physicians
$52,008,378 - $50,493,519 = $1,514,859
• Return on Investment = Incremental Revenue from program/
Step V Cost of the program
$1,514,859/$236,460 = 6.4:1 or $1,278,399
Note: Projected Product TRx for Control physicians calculated using Index of Adjusted Means (1.03) from ANCOVA, which
means Test physicians wrote 3.0% more NRx than Control physicians during a 9 month post-test period.
Promo.Return CARE Media Holdings KidCARE TV Final Report • February 2011
28. Agenda
• Objective
• Research Methodology
• Methodology Assumptions
• Study Results
• Conclusions
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29. Conclusions
• The KidCARE TV promotion for Product X was successful at
increasing Product X NRx volume and share with statistical
significance. During the latter months of the post-test
period, Test group appears to be outperforming the Control
group as evidenced by the separation in trend lines. The
program also retained writers as indicated by the positive
result for physician penetration, however results are not
statistically significant.
− Among the specialties, Specialists increased Product X NRx
directionally, with a non-significant increase in share. All Others
showed a directional increase in NRx volume, with a significant
increase in share.
− Both specialty groups showed non-significant increases in
physician penetration.
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30. Conclusions
• The KidCARE TV promotion for was successful at increasing
Product X NRx volume and share with statistical significance.
During the latter months of the post-test period, Test group
appears to be outperforming the Control group as evidenced
by the separation in trend lines. The program also retained
writers as indicated by the positive result for physician
penetration, however results are not statistically significant.
− Among the specialties, Specialists increased NRx
directionally, with a non-significant increase in share. All Others
showed a directional increase in NRx volume, with a significant
increase in share.
− Both specialty groups showed non-significant increases in
physician penetration.
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