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Non-physician prescribers–the new marketing frontier

Published by Brenda Rizzo on January 9, 2012.

We seem to forget about this very influential group of prescribers who make independent decisions based on their assessment about how to treat a condition. Across all 50 states nurse practitioners (NP) and physician’s assistants (PA) are able to prescribe. Each state has their own specific rules that can limit or expand those roles, but they are all able to prescribe. So now that you have considered this audience, how do they want to be marketed to?

That depends on their specific specialty. An NP who works in long term care may be more focused on reimbursement channels and routes of administration, given the population they serve. NP’s who work in family practice may be looking for educational support for a busy and varied practice. NP’s who work in women’s health may be looking for assessment tools as they manage health concerns of women in transition to menopause. We don’t know until we have asked.

Here at GSW we have assembled a group of NPs and PAs to consult with a variety of specializations that we can contact to get their opinion. Sometimes it can be as easy as a phone call, or we can survey them as a whole. We can even get them together on a chat room online or do a focus group. This has become a very valuable tool. We have found insight into the way they practice, how they make prescribing decisions and how they would like to get information on new drugs. We have asked them to suggest tools that would be helpful to their practice and evaluate tools along the way as we develop them. We had nurses involved in advising us about an online educational tool that has been valued by several of our clients, and adapted for their use.

Our panel includes NPs and PAs from all across the country with areas of specialization from neonates to geriatrics, from inpatient settings to outpatient clinics, from doctor’s offices to operating rooms. It is a temptation to guess what they need or want from a pharmaceutical company, but when we ask them we are often surprised at what they really value. This has helped us to stay focused on creating value added materials/benefits that help them to serve their patients as well as see the value of what we are trying to sell.

Some overall themes that I have observed in working with NPs and PAs are:
 • They are very passionate about the patients they serve. It is not enough to put a patient on birth control; they also have to talk with her about how to avoid sexually transmitted diseases. It is not enough to put someone on an anti-hypertensive, they also educate on how to change their lifestyle to improve their blood pressure. It is not enough to treat their acne; they want to know how their breakouts are affecting their self-esteem. They tend to consider the whole patient, not just the disease state they are treating.
• Affordability is a big issue. If the benefits of the drug outweigh the additional expense then they will help the patients to understand this. But if their perception is that there is an alternative that is more affordable then they probably will not consider the more expensive option. Giving a patient a more expensive drug that they can’t fill, due to the cost, when there is an alternative that is generic does not fit well with their point of view.
• Patient Education is an aspect of patient care that they “own.” Tools to help them be more effective are an added value to their practice. They don’t mind if it has a brand name on it or is specifically about a particular product as long as it is not trying to tear down or bring a bad light to competing products/points of view. They do not expect all educational tools and support to be unbranded.
• They value being viewed as experts in their area of specialization. Anything that can promote acknowledgement of that expertise is desired. Train the trainer, speaking engagements, certifications, or awards are valued. They feel a lack of recognition in general and when they obtain recognition it elevates their visibility in their community.

Finally each area of specialization utilizes NPs and PAs in a very unique way. You don’t gain insight in asking a NP that works with adults what a NP in pediatrics would need. Asking a PA that works in palliative care would not know what a PA in the operating room needs. So seek out insight from NPs or PAs that actually work in the area where you are interested in influencing.

NPs and PAs are organized; they belong to professional groups, both locally and regionally. Many participate in online chat rooms, or visit educational websites. But ask them, “where do you get your information?” Then you know what they want or need and where they will look for it.
Have you created any programs for non-physician prescribers? How did you develop it? Any insights from your programs that you would be willing to share? This is a rich area that needs to be explored for effective communication.

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Rethinking ROI for programs targeting nurse practitioners and physician’s assistants

Published by Brenda Rizzo on May 26, 2010.

The success of any marketing program can often be based on measuring return on investment (ROI). Many different measures of ROI have been developed, but the traditional one that most pharma companies use is increase in new Rx. When creating a program for nurse practitioners or physician’s assistants tracking prescribing behavior as a result of your initiative can be a bit more complex.

Third party companies that track prescribing behaviors typically use an identifying number that is unique, only to physicians, to track which medications are most frequently prescribed, providing insight for pharmaceutical companies and drug representatives. However in some states NP’s and PA’s do not have a number that is tracked. Their prescriptions are attributed to the physician that they work with or that oversees their practice. NPs and PA’s have a prescriptive authority number provided by the state in which they are licensed, however, pharmacy software programs are not typically set up to use these numbers when filling prescriptions. Consequently the pharmacist may assign the prescription they are filling to the collaborating physician’s identifying  number.

Brand managers and drug representatives must recognize that relying exclusively on the prescription tracking reports available today may not provide an accurate impression of the ROI from their initiative. If their sole measure of success is tracking new Rx, they need to identify the collaborating physician and watch their prescribing behavior, even though they may have not been the target of their marketing program. Creating a program to measure ROI that directly assesses the NP/ PA response to the initiative is ideal, to determine the success of a program.

Categories: New ideas and approaches
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Liberating a brand by redefining the target audience

Published by Brenda Rizzo on April 28, 2010.

When marketing a healthcare brand to a professional audience typically the physician is considered to be the only intended audience. But there are many non-physician healthcare professionals that also make independent prescribing decisions, and are often overlooked. Identifying those targets can be confusing and the laws that regulate their prescribing behaviors differ from state to state. But there are many similarities once the different roles are understood.

Types of prescribers.

Non-physician prescribers include:

  • Nurse Practitioners (NP)
  • Clinical Nurse Specialists (CNS)
  • Advance Practice Nurses (APN)
  • Certified Registered Nurse Anesthetists(CRNA)
  • Certified Nurse Midwives (CNM)
  • Physicians Assistants(PA)

NPs typically specialize in an area like primary care, pediatrics, women’s health, cardiac, oncology, etc. Depending on the state they practice in, they can either be independent providers of care or are in a practice arrangement with an attending physician.

Clinical Nurse Specialists are masters prepared nurses that in some states (not all) have prescriptive privileges. Typically they work in hospital and/or inpatient medical care organizations, but when they are in private practice it is most commonly in the area of mental health.  APN is an umbrella term that describes nurses that have gone into advanced practice. Not every state uses this term but when it is used it can include NPs, CNS, CRNAs and CNMs in their category. Physician’s assistants also have prescriptive authority. They are licensed to practice medicine only with physician supervision.  The level of supervision required varies from state to state.

How to connect with them.

When considering marketing to these non physician prescribers what should be different about the way you convey your message? The level of sophistication of evidence needs to be the same as it would be for a physician. Making separate marketing messages about the clinical features of a drug or device for this audience would be a mistake. However, providing collateral materials that help them to function in their role would be valued. For example; patient education materials that would support their role in counseling, or assessment tools that would help them to identify problem/needs more readily. These materials cannot be created for the express purpose of selling the product, or educating the patient about a condition that can only be treated by your solution. It must be as unbiased as possible and the intent must be about supporting their role as a non-physician prescriber and to improve patient care.

Non physician prescribers can also be reached through professional organizations, at national and regional meetings, through journals and webinars. They also have the need to obtain continuing education hours to maintain licensure, so pharmaceutical and/or medical device companies can support this effort through unrestricted educational grants, just like they do with continuing medical education.

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