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Healthcare Dynamics Model “Go with the (patient) flow”

© 2009, Ipsos

The twists and turns that patients pass through as they negotiate their way to solving their health problem are critical points to be understood and evaluated as potential leverage points for marketing. Within healthcare. for marketing research to be an effective partner in the marketing process. The experiences of a person who perceives that they have a health problem and then enters the healthcare system should be focused on as the fundamental building blocks of a buying process analysis. it may be appropriate to start with research delving into the patient’s perspective and the physician’s perspective on the buying process. for many patients. Since our design architecture is in place prior to the initiation of a program of research. analysis and recommendations. It is common for marketers to believe. and governmental policies. To conduct research on the “buying process” broadly refers to building an understanding of the steps which occur. pharmacists’ influence. They subsequently “originate” or enter the healthcare system and proceed to be evaluated. Through the use of several questionnaires based on an integrated design. Ipsos . The Ipsos Healthcare Dynamics Model (HDM) is. their physicians are no longer the sole influencers of brand choices. a primary research methodology that seeks to build an understanding of each of the important stakeholders in a therapeutic area. comprehensive analysis that is reflective of the sequence of steps through which healthcare is actually delivered. at the outset. 3) Detailed analysis of process steps specific to the therapeutic category being studied and 4) Assessment of the relative impact of each of the various stakeholders. The idea of following the progress of a process over the course of time is. we can achieve a flexible approach for clients. HDM research often identifies patient experiences that can be categorized as is illustrated in Figure 1. a “case study analysis” is typically reported in terms of the sequence of events that have occurred for a single patient. Research with a patient and a physician cohort will have points of integration in terms of data collection. From an investigative standpoint. “treatment algorithms” and “market flow modeling” have been used to ” describe a similar concept. A high level research approach that is well suited to achieve the goal of integrating the attitudes. The Ipsos Healthcare Dynamics Model is a systematic enhancement of these fundamental approaches to healthcare marketing research. but in the current environment. it only becomes apparent after initiating the research with a few stakeholder groups that other stakeholders are important as well. phrases such as “patient dynamics. Pharmaceutical marketing has broadened in its scope so that efforts are made to achieve effective marketing across all relevant stakeholders. Physicians may wield considerable influence. In any therapeutic category. Similarly “chart audits” while often focusing on a singe point in time. The patient perceives they have a health issue. Subsequent –2– © 2009. research tools need to provide an understanding of the relevant stakeholders and how their perspectives interact to result in the choices of brands. From a healthcare perspective. over time. health plan decisions. In the evolution of healthcare systems. to result in the selection of a brand. that several stakeholder groups are impacting the treatment and brand decision process.I P S O S H E A L T H Historically. the decisional role of physicians is often combined with: patients’ perspectives. they are rarely making unilateral decisions. not novel. can be implemented in order to identify how a cohort of patients progresses through the healthcare system. Core elements in the HDM approach are the: 1) Patient’s experience as the organizing principle. in the current environment. diagnosed and treated. 2) High level process steps that are frequently found in research across a range of therapeutic categories and situations. in and of itself. The HDM approach allows for multiple stakeholders to be included in the research design and for follow-up studies to be implemented so that additional stakeholders can be merged seamlessly into the original research with additional findings and recommendations developed in a consistent context. beliefs and choices of healthcare stakeholders is to construct an understanding of the buying process that is in place for a therapeutic category. the focus on understanding healthcare choices through research with physicians and other healthcare professionals was a strong approach to healthcare marketing research. caregiver concerns. Occasionally. we achieve a multi-stakeholder. By way of example. at its core.

and sequentially tracing through the experiences of patients throughout their experience to a solution (which may be the control of symptoms. in and of itself.I P S O S H E A L T H steps include the delivery of a healthcare solution.g. checking the internet. Using the HDM approach. compliance with treatment recommendations and follow-up activities. a cure of a condition. but not on the reasons for origination nor the extent of compliance). the perspectives of other stakeholder groups are gathered with questionnaires that focus on the elements of the patient’s experience that are known to those stakeholders (e. Ipsos . We have represented the potential for different stakeholders to have input to selected steps in the buying process in Figure 1 with the icons for each of the commonly recognized shareholders. but does not produce a questionnaire or discussion guide. beginning with a focus on what occurs prior to officially entering the healthcare system (sensing a problem. Figure 1– Common Healthcare Buying Process Steps –3– © 2009. prior to seeing a healthcare professional). Careful inquiry. physicians can provide strong detail on office visits. Keeping these steps in mind while evaluating patients’ experiences provides strong guidance. etc. or leaving the healthcare system with less than what was originally sought).

080.600. Figure 3 illustrates the approach for integrating the findings from multiple stakeholders.000 1.040. family members /caregivers.000 3.000 960. The extent of drop-out is identified quantitatively.000 4. Ipsos . we show a fundamental analysis resulting from an HDM approach to the buying process.000 11.000 600.000 1. findings and recommendations are focused on the key leverage points in the buying process and the stakeholders who are most important for each of them.240. This adaptation of an actual study shows that for a particular pharmaceutical company offering a pharmaceutical solution to a condition.000 3. With a research design that begins with the recognition of the need for integration.200.000 3.000) Actual Patients Lost (. The analysis is exemplified in Figure 2 and Figure 3.680. managed care decision makers. non-physician practitioners providing their perspectives on the same types of patients the full 360 degree view of the buying process is revealed.600.000 9.240. Theoretically all appropriate sufferers are included at the starting point at the top of the diagram. physicians reporting on specific patients who meet select criteria.000) Leverage Points and Leakages Prevalence Perception Evaluation Diagnosis Treatment Delivery Complianc Follow-up 20% 11% 8% Total Theoretical Market Potential 100% 73% 68% 60% 50% 3. It is important to consider Figure 2 – Patient Drop Out: Market Leakage Model Cumulative Patients Lost (. The horizontal bar chart shows the drop-out of patients as they pass through the healthcare system.800.000 0.840.000. only 10% of the theoretical target population is still in the healthcare system at the point where a prescription would be written.000 6. more and more of them are lost to the system.000 { { Realized Market Opportunity – Market Leakage Priority Figure 3 – Integrating Stakeholder Perspectives of The Buying Process Physicians Payors Patients Pharmacists Big Picture –4– © 2009. and pharmacists. A general observation in HDM studies is that as sufferers go through the sequential steps in obtaining a healthcare solution. In Figure 2.I P S O S H E A L T H With the HDM data collection strategy optimally including patients reporting on their personal experiences.000 360.

Ipsos Healthcare Dynamics Model research programs usually begin with a qualitative phase that is designed to uncover both the specific steps in the sequence and the language that is used by the key stake-holders.ipsoshealth.) play a part. The steps of the process are quantified.0 2 . the analytics of the HDM provide a systematic approach to identifying the key stakeholders and the impact that each has.snyderman@ipsos. And (for some therapeutic categories). as well as in-market performance monitoring. the mix of influences in decision making can change. Ipsos Health’s business-oriented approach and vast global resources support clients in creating.com or Elys Roberts at elys. The outputs illustrate: the size of various actionable opportunities. and the importance of the perspectives of various stake-holders. Ipsos Healthcare specializes in positioning. By building the linkages in the data collection phase. Ipsos 1 0 . and communication. please visit www.com About Ipsos Healthcare Ipsos Healthcare provides full-service custom research to prescription drug manufacturers as well as biotech and healthcare providers. for a wide range of therapeutic categories and stake-holders. the roles of the stake-holders and the importance of the attitudes and beliefs of these stake-holders.I P S O S H E A LT H multiple relevant stakeholder perspectives at each step along the way in the process to identify both significant opportunities and pragmatic solutions that will optimize product / brand choice. This qualitative learning is then used to inform the quantitative data collection phase. but not exclusive role in the selection of a brand. caretakers. in terms of the numbers of patients flowing through the system. what tactics and messages are most likely to be effective. differentiating and commercializing their brands. contact: Paul Snyderman at paul. c o m / h e a l t h © 2009. Physicians may be dominant in determining a diagnosis and play a leading.4 1 . branding. who are the appropriate targets for marketing initiatives and how do they mutually influence the outcome of the process and finally. but patients are critical to the compliance process – even though other stakeholders (physicians. These outputs provide commercial insight on the critical elements of focus for healthcare marketers.com. an additional option is an EXCEL based simulator which forecasts the impact of marketing initiatives on the buying process and allows for the testing of many hypothetical scenarios. The qualitative phase also provides insight into the range of reasons given for the various decisions made as the patient passes through the system. For more information. etc. To learn more.roberts@ipsos. The HDM approach to the buying process is to apply a flexible design architecture that can accommodate all the steps in the healthcare system. At different points in the process. i p s o s m a r k e t i n g . w w w . The signature outputs from the Ipsos Healthcare Dynamics Model include graphic representations of: the number of patients in the system at various points in the process.

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