Biomedical Engineering Reference
In-Depth Information
875
840
785
740
692
647
603
561
2003
2004
2005
2006
2007
2008
2009
2010
Total World Market, Constant $ using Q410 average exchange rates
Fig. 14.3
Global pharmaceutical market (in US$ billions).
Source
: IMS Health Market Prognosis,
March 2011, includes IMS audited and unaudited markets; information from March 2011:
http://
Market_2003- 2010.pdf
,
last accessed on October 12th, 2011
expenditures, today DTCA still represents only 14.2 % of total industry expenditures
in the promotion of prescription drugs in the United States, and direct-to-physician
efforts represented the bulk of pharmaceutical marketing expenditures (Donohue
et al.
2007
). In most countries, in which DTCA is typically not allowed, the propor-
tion of marketing resources allocated to direct-to-physician efforts is even greater.
The trends towards patient empowerment suggest that the relatively low share of
marketing spending devoted to direct-to-patient marketing needs to be reconsid-
ered. In addition, increased spending on pharmaceutical drugs, which, according to
IMS Health, reached $875 billion in 2010 (see Fig.
14.3
), led payers and regulators
to increase the pressure on pharmaceutical firms to demonstrate the value per dollar
of the therapies they launch (Hilsenrath
2011
). Such a context requires more direct
collaboration between firms and patients.
Moreover, physician responsiveness to sales reps seems to be rapidly declining
(Weintraub
2007
). According to recent reports by the consulting firm, ZS Associates,
the number of physicians classified as “rep-accessible,” those who meet with at least
70 % of the sales representatives who called them, fell nearly 20 % between 2009
and 2010, and the number of “rep-inaccessible” prescribers, those who saw fewer
than 30 % of the reps who called them, increased by 50 % (Wright
2010
). Finally,
existing research seems to indicate that return on investment of direct-to-physician
marketing efforts is modest, with elasticities clearly below 1.0 (see Kremer et al.
2008
; Manchanda et al.
2005
). Unfortunately, DTCA does not seem to be the solu-
tion as sales elasticities are even lower. More precisely, in a large meta-analysis of
58 studies on the effectiveness of pharmaceutical promotional investments across
several therapeutic categories, Kremer et al. (
2008
) found an average elasticity of
0.326 for detailing, 0.123 for direct-to-physician advertising, and only 0.073 for
DTCA. Apart from their direct effect on sales, promotional efforts, such as DTCA,
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