calcul roi study -ims health consulting
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December 2009
Patient Channel ROI Evaluation
IMS Health Consulting
Agenda
• Objective
• Research Methodology
• Methodology Assumptions
• Study Results
• Conclusions
Objective• To assess the impact of the Patient Channel program on Brand X
prescribing behavior of participating physicians
Patient Channel
for
Brand X
Incremental
Brand X NRx,
Physician Penetration
and ROI
Research Methodology
• Impact of the Patient Channel program for
Brand X was assessed using IMS Consulting’s
Promotion EvaluationSM methodology
– Paired comparison analysis to measure changes in Brand 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
• 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
Methodology Assumptions
Control Group Selection
• 34,345 potential Test physicians were matched to the IMS Health prescriber
universe to identify potential Control physicians based on the following criteria:
– Brand X script writing behavior/volume in the pre-test period;
– MD specialty;
– MD geography; and
– Overall writing decile
• 32,189 Test physicians were successfully matched to a Control physician
Quality Control Procedures
• A key quality control procedure was utilized to ensure that sporadic
reporters do not bias the results
– Active Writers – a physician must generate at least one prescription during the most current three months to be included in the analysis
0
5000
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15000
20000
25000
30000
35000
40000
Pre-6 Per-5 Pre-4 Pre-3 Pre-2 Pre-1 Test Post-1 Post-2 Post-3 Post-4 Post-5 Post-6
Bran
d X
NR
x
Test Control
Brand X NRx ComparisonDuring the six month post period, Test physicians prescribed 1.3% more Brand X NRx compared to
Control physicians. This change in prescribing behavior is statistically significant (cl=95.17%).
Note: cl = Confidence level; if cl >= 90% the program impact is significant, cl=80-90% is directional. Analysis conducted
: ANCOVA.
6 Month Analysis
Brand X Physician Penetration Comparison
54.4% 54.4%
56.4%
56.0%
53.0%
53.5%
54.0%
54.5%
55.0%
55.5%
56.0%
56.5%
57.0%
Test Group Control Group
% P
hysic
ian P
enetr
ation .
Pre-Test Post-Test
Physician penetration increased by 2.0 percentage points among the Test group and by 1.6 points
among the Control. The resulting differential in penetration of +0.4 points between the two groups is
not statistically significant (cl=51.47%).
Note: Physician Penetration is defined as the ratio of MDs writing Brand X / MDs in program. Analysis conducted : Z-test
2.0 point increase
1.6 point increase
6 Month Analysis
ROI Analysis – Methodology
Step I
Step II
• Calculate Average Product TRx (average retail price for a prescription) =
TRx sales/ 6 month study period (for Brand X is $154.79 (source: IMS NPA
Plus – TRx retail price)
Step III
• Calculate Revenue Associated with Test Physicians = Projected Product
TRx x Average Product Price
1,151,276 x $154.79 = $178,202,558
Step IV
• Calculate Revenue Associated with Control Physicians = Projected
Product TRx for Control Physicians* x Average Product Retail cost
1,136,501 x $154.79 = $175,915,580
Note: Projected Product TRx for Control physicians calculated using Index of Adjusted Means (1.01) from ANCOVA, which means Test
physicians wrote 1.3% more Brand X NRx than Control physicians during a 6 month post-test period. Program costs reflect costs associated
with only the measured hospitals during the 6 mo post-test period.
• Incremental Revenue due to the program = Revenue Associated with Test
Physicians – Revenue Associated with Control Physicians
$178,202,558 - $175,915,580 = $2,286,978
Step V• Return on Investment = Incremental Revenue from program/ Cost of the
program
$2,286,978/$487,749 = 5:1 or $1,799,229
6 Month Analysis
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30000
35000
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45000
Pre-6 Pre-5 Pre-4 Pre-3 Pre-2 Pre-1 Test Post-1 Post-2 Post-3 Post-4 Post-5 Post-6 Post-7 Post-8 Post-9 Post-
10
Post-
11
Post-
12
Bran
d X
NR
x
Test Control
Brand X NRx ComparisonDuring the twelve month post period, Test physicians prescribed 2.1% more Brand X NRx compared
to Control physicians. This change in prescribing behavior is statistically significant (cl=99.94%).
Note: cl = Confidence level; if cl >= 90% the program impact is significant, cl=80-90% is directional. Analysis conducted : ANCOVA.
12 Month Analysis
Brand X Physician Penetration Comparison
54.4% 54.4%
63.0%
62.2%
50.0%
52.0%
54.0%
56.0%
58.0%
60.0%
62.0%
64.0%
Test Group Control Group
% P
hysic
ian P
enetr
ation .
Pre-Test Post-Test
Physician penetration increased by 8.6 percentage points among the Test group and by 7.8 points
among the Control. The resulting differential in penetration of +0.8 points between the two groups is
directional (cl=88.33%).
Note: Physician Penetration is defined as the ratio of MDs writing Brand X / MDs in program. Analysis conducted : Z-test
8.6 point increase
7.8 point increase
12 Month Analysis
Step I
Step II
• Calculate Average Product TRx (average retail price for a prescription) =
TRx sales/ 12 month study period (for Brand X is $158.15 (source: IMS
NPA Plus – TRx retail price)
Step III
• Calculate Revenue Associated with Test Physicians = Projected Product
TRx x Average Product Price
2,371,358 x $158.15 = $375,028,845
Step IV
• Calculate Revenue Associated with Control Physicians = Projected
Product TRx for Control Physicians* x Average Product Retail cost
2,322,584 x $158.15 = $367,315,266
Note: Projected Product TRx for Control physicians calculated using Index of Adjusted Means (1.02) from ANCOVA, which means Test
physicians wrote 2.1% more Brand X NRx than Control physicians during a 12 month post-test period. Program costs reflect costs associated
with only the measured hospitals during the 12 mo post-test period.
• Incremental Revenue due to the program = Revenue Associated with Test
Physicians – Revenue Associated with Control Physicians
$375,028,845 - $367,315,266 = $7,713,579
Step V• Return on Investment = Incremental Revenue from program/ Cost of the
program
$7,713,579/$988,905 = 8:1 or $6,724,674
12 Month AnalysisROI Analysis – Methodology
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15000
20000
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30000
35000
40000
Bra
nd
XN
Rx
Test Brand X Control Brand X
Brand X NRx ComparisonDuring the eighteen month post period, Test physicians prescribed 3.2% more Brand X NRx compared to Control
physicians. This change in prescribing behavior is statistically significant (cl=100.0%).
Note: cl = Confidence level; if cl >= 90% the program impact is significant, cl=80-90% is directional. Analysis conducted : ANCOVA.
18 Month Analysis
Brand X Physician Penetration Comparison
54.4% 54.4%
66.9% 65.4%
0.0%
10.0%
20.0%
30.0%
40.0%
50.0%
60.0%
70.0%
80.0%
Test Group Control Group
% P
hysic
ian P
enetr
ation .
Pre-Test Post-Test
Physician penetration increased by 12.4 percentage points among the Test group and by 10.9 points among the Control.
The resulting differential in penetration of +1.5 points between the two groups is statistically significant (cl=99.47%).
Note: Physician Penetration is defined as the ratio of MDs writing Brand X / MDs in program. Analysis conducted : Z-test
12.4 point increase 10.9 point increase
18 Month Analysis
ROI Analysis – Methodology –18 Month Post Test
Step I
Step II
• Calculate Average Product TRx (average retail price for a prescription) =
TRx sales/ 18 month study period (for Product is $157.64 (source: IMS
NPA Plus – TRx retail price)
Step III
• Calculate Revenue Associated with Test Physicians = Projected Product
TRx x Average Product Price
3,442,456 x $157.64 = $542,678,747
Step IV
• Calculate Revenue Associated with Control Physicians = Projected
Product TRx for Control Physicians* x Average Product Retail cost
3,335,713 x $157.64 = $525,851,471
Note: Projected Product TRx for Control physicians calculated using Index of Adjusted Means (1.03) from ANCOVA, which means Test
physicians wrote 3.2% more Brand X NRx than Control physicians during an 18 month post-test period. Program costs reflect costs
associated with only the measured hospitals during the 18 mo post-test period.
• Incremental Revenue due to the program = Revenue Associated with Test
Physicians – Revenue Associated with Control Physicians
$542,678,747 - $525,851,471 = 16,872,276
Step V• Return on Investment = Incremental Revenue from program/ Cost of the
program
$16,872,276/$1,432,035 = 12:1 or $15,440,241
18 Month Analysis
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Bra
nd
XN
Rx
Test Brand X Control Brand X
Brand X NRx ComparisonDuring the 30 month post period, Test physicians prescribed 4.8% more Brand X NRx compared to Control physicians.
This change in prescribing behavior is statistically significant (cl=100.0%).
Note: cl = Confidence level; if cl >= 90% the program impact is significant, cl=80-90% is directional. Analysis conducted :
ANCOVA.
30 Month Analysis
Brand X Physician Penetration Comparison
53.4% 53.4%
71.7%68.9%
0.0%
10.0%
20.0%
30.0%
40.0%
50.0%
60.0%
70.0%
80.0%
Test Group Control Group
% P
hysic
ian P
enetr
ation .
Pre-Test Post-Test
Physician penetration increased by 18.3 percentage points among the Test group and by 15.6 points among the Control.
The resulting differential in penetration of +2.7 points between the two groups is statistically significant (cl=100.0%).
Note: Physician Penetration is defined as the ratio of MDs writing Brand X / MDs in program. Analysis conducted : Z-test
18.3 point increase15.6 point increase
30 Month Analysis
ROI Analysis – Methodology –30 month post test
Step I
Step II
• Calculate Average Product TRx (average retail price for a prescription) =
TRx sales/ 30 month study period (for Product is $159.48 (source: IMS
NPA Plus – TRx retail price)
Step III
• Calculate Revenue Associated with Test Physicians = Projected Product
TRx x Average Product Price
4,887,002 x $159.48 = $779,396,672
Step IV
• Calculate Revenue Associated with Control Physicians = Projected
Product TRx for Control Physicians* x Average Product Retail cost
4,663,170 x $159.48 = $743,699,139
Note: Projected Product TRx for Control physicians calculated using Index of Adjusted Means (1.05) from ANCOVA, which means Test physicians
wrote 4.8% more Product NRx than Control physicians during a 30 month post-test period. Program costs reflect costs associated with only the
measured hospitals during the 30 mo post-test period
• Incremental Revenue due to the program = Revenue Associated with Test
Physicians – Revenue Associated with Control Physicians
$779,396,672 - $743,699,139 = $35,697,533
Step V• Return on Investment = Incremental Revenue from program/ Cost of the
program
$35,697,533/$1,988,927 = 18:1 or $33,708,606
30 Month Analysis
Conclusions
Metric/
Time Period NRx
Physician
Penetration ROI
6 month +1.3%
Directionally
higher 5:1
12 month +2.1%
Directionally
higher 8:1
18 month +3.2% +1.5 pts. 12:1
30 month +4.8% +2.7 pts. 18:1
This retrospective 5-year look compared prescription writing behavior by doctors affiliated with Patient Channel hospitals
to a control group of physicians in the IMS database that have been matched by the Brand’s script writing in the pre
period, overall script writing volume, geography and physician specialty. The study assessed incremental NRx, physician
penetration (# of docs prescribing) and program ROI at several points over a 5-year period. IMS Consulting’s Promotion
EvaluationSM methodology was employed. Unless otherwise noted, all results are statistically significant.
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