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By Emily Mortimer, Manager, Claims Analytics and Statistical Modeling, LexisNexis Health Care®

 

We are used to having instant access to information – from our phones pushing out social media posts in real-time to, increasingly, our doctors knowing about our allergies and prescriptions at the first visit thanks to Electronic Health Records (EHR). It is hard to believe that life sciences and pharmaceutical companies, which have such sophisticated products, rely on data that is often three to 12 months old to inform their sales and marketing decisions.

Sales forces typically look at medical claims quarterly or yearly to learn which physicians have patients who would benefit from a particular drug therapy or medical device. This used to be enough to identify physicians for sales outreach; however, the competition has become fierce. The industry is feeling the compounding pressures of blockbuster patent expiration, competition from generics, regulatory pressures, and changing health care payment and reimbursement rules, as well as increasing consolidation among life sciences organizations and related entities. If a sales rep can approach practitioners immediately after diagnosis but before the therapy option is selected, the likelihood of the company’s treatment option being selected is much greater – either immediately or in the near future.

Below are three key facts life sciences companies need to know about real-time or near real-time medical claims data to support timely business decision-making.

1. Health care technology has evolved and medical claims data is now available quickly, similar to prescription claims data. Sales and marketing teams can now gain key insights from daily and weekly claims feeds. Knowing which health care providers have newly diagnosed patients as well as where it is best to reach that provider makes a sales rep visit or other marketing efforts much more effective and efficient.

2. Using near real-time medical claims data to inform sales and marketing strategies is especially helpful for treatment of conditions where there is a time gap between the patient’s initial diagnosis and treatment (e.g., oncology, autoimmune diseases and neurological disorders). Value is maximized in specialty or small population diseases where new diagnoses may not happen frequently or when the treatment is expensive. Big returns are gained for each new patient therapy.

Let us look at an example. On Monday, Dr. Smith diagnosed several patients with rheumatoid arthritis. These patients then make their individual follow up appointments two weeks later to discuss treatment options, of which there are six on the market. All six may be equally acceptable to treat the patients, so if a sales rep visits the physician before these patients’ follow up appointments, he or she may influence a treatment option.

3. Access to and action upon the near/real-time medical claims data intelligence can increase prescribing two- to three-fold, according to a study by LexisNexis Health Care.

The approach described here is based on the hypothesis that being at the right place at the right time increases chances of success. To test the hypothesis, LexisNexis Health Care recently conducted a pilot study with a pharmaceutical client that has been using its MarketViewTM Early Alerts solution. The client’s therapy is used to treat a rare neurological disorder and is expensive.

The solution identified physicians diagnosing patients with the disorder and sent weekly files of new patient alerts to the company. LexisNexis Health Care used medical claims data to identify changes in diagnosis and treatment patterns among study physicians from a baseline period (12 weeks prior to the study) to a measurement period (12 weeks immediately following the end of the study).

The analysis showed that 12 weeks after the pilot, the customer had 36 percent of the market with providers where they had a sales call history and used Early Alerts, compared with only a 14 percent market share with providers who did not have any Early Alerts data reported. The results were similar after 24 weeks: 40 percent of the market share for health care practitioners with a sales call history and the Early Alerts solution compared with only 14 percent of market share with providers where they had a sales call history, but did not have any Early Alerts data reported. The program also identified new target physicians not previously known to the company.

It is important to note that to take advantage of the approach, the company’s sales and marketing force has to be flexible enough to reprioritize the workload and act on the intelligence immediately. These new leads require a quick follow-up. One could argue, though, it is a good problem to have.

 

About the author

Emily Mortimer is Manager, Claims Analytics and Statistical Modeling, LexisNexis Health Care, where she works directly with customers in the Life Sciences and health care market verticals to identify solutions for the technological infrastructure for medical claims products. Previously, Mortimer was a Senior Data Analyst with Health Market Science, acquired by LexisNexis in 2015. She holds a Master’s in Public Health degree in Epidemiology from Drexel University School of Public Health in Philadelphia, PA.

 

For more information, visit http://www.lexisnexis.com/risk/health-care