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Take a Look Into Our Market Access Work

Have you wondered what our Market Access work is like? Take a peek below at some recent projects.

If you have similar needs in your organization for our assistance, we’d be happy to hear what your needs are and discuss how we would approach addressing them.  Email Greg Hall at to find out more.

  1. Biosimilar coding scenario testing. Worked with a biosimilar company to determine the impact that various coding scenarios could have on product uptake at the time of launch and beyond.  Conducted a qualitative market research study with 20 oncology practice managers as well as a quantitative study with another 50 practice managers and developed a financial impact model.  Completed all aspects of the project (from proposal to reporting results) in less than 4 weeks!!
  2. Reimbursement hotline and patient assistance program service vendor contract review and input. Assisted two separate clients by reviewing their vendor contracts and provided input for improvements in terms of service level metrics, contract terms, performance evaluations of their vendor, etc.  One client garnered 10% annual savings moving forward with improved contractual terms based on our input and direction.
  3. Perceptions of marketed product. We conducted an in-depth market research study with pharmacists and clinicians regarding a product used in the hospital inpatient and outpatient setting.  We probed on clinical, cost and payment issues impacting product uptake.  Significant findings included how this class of products is evaluated both from a therapeutic and economic stand point and what are the key differentiators among this class of products given similar safety and efficacy profiles.

Are you getting the most out of the Specialty Pharmacies (SPs) in your network / HUB?

Specialty drugs have been a major growth area for pharmaceuticals and are expected to grow even more in the next several years.  Specialty drugs have one or more of the following characteristics:

  1. High cost – generally this is greater than $600 per month as set forth in the Medicare Part D regulations.
  2. Indicated for the treatment of a chronic, rare illness.
  3. Products are usually injectable or infused, although some products (such as oral oncolytics) may be oral or have some other type of administration.
  4. Complex manufacturing process in association with the production of the product (not usually small molecules).
  5. Special storage and handling (such as refrigeration) requirements might be needed.
  6. Complex monitoring for patient compliance, persistency and side effects may be required.
  7. May be covered under the medical benefit, pharmacy benefit, or, in some cases, both.

The FDA is expected to approve a record 25 specialty drugs this year!  Spending in the U.S. on specialty drugs – to treat chronic, complex diseases such as cancer, multiple sclerosis and rheumatoid arthritis – is projected to increase 67% by the end of this year.


Source:  Express Scripts

There are a number of models that a pharma company can utilize with the launch (and beyond) of their specialty drug product and companies to date vary in their approach to specialty pharmacy (SP):

  • Some use one specific SP to handle distribution and other aspects;
  • Some use a small group (3-5) SPS to handle distribution and other services;
  • Some have an open network utilizing as many as 10-15 SPs;
  • Some direct all patients and providers through a centralized hub that determines the services and distribution options for the patient and directs them accordingly.

Whether you use one or more SPs in your network / HUB, you might not know what your end-user customers (physicians, nurses, billing staff, patients, etc.) think about those specialty pharmacies.  In many cases, pharma companies set up a network / HUB and just assume it is meeting the needs of their end-user customers.  These pharmacies (and the services they provide – or don’t) reflect on your product, so you need to be absolutely sure that they are meeting the needs of your end-user customers.

It is entirely possible that you launched your product with no research done to determine the effectiveness of the various SPs that are being utilized and how end-user customers perceive their value.

Cadence Research & Consulting can help you to determine customer feedback about each SP in order to understand (among other things):

  1. Do your customers value the SPs in your network?  If so, are there certain aspects they are lacking?
  2. Should you consider eliminating an SP from your network / HUB?  Are there other SPs that you are considering?
  3. What are the services provided by each SP in your network / HUB (benchmarking)?
  4. What services could you add to improve the functioning of your network / HUB?

If we can be of service to you in this area, please contact Greg Hall at We would welcome the opportunity to work with you.

Reflections on the Legacy of Dick Fordyce

For the last eight years I have had the honor of presenting the R.R. Fordyce award at the Pharmaceutical Marketing Research Group (PMRG) Institute held each fall.  As Dick Fordyce’s daughter, it is a highly emotional evening for me.

Established in 1999, the R.R. Fordyce award is PMRG’s most prestigious award.  It is given to the person who, like my father, exemplifies the principles of excellence, innovation, and integrity in pharmaceutical market research.  Recipients have demonstrated an exemplary level of character, ethics, and leadership in their professional and personal lives.  They have made an outstanding contribution to healthcare market research in their leadership, decision-making, and mentoring activities.

On the evening of the awards dinner each year, many of the people in attendance seek me out in order to share their stories about my father.  I listen with a mix of joy and sadness.  I knew him as a loving, family-focused father who I miss every day even sixteen years after his passing.  But it also warms my heart to hear about the impact he had in the industry that he loved so much.

I have heard stories about how he had a direct impact on people’s choice of market research as a career; how he made C-suite associates see the importance and value of market research; how he mentored others not just by what he said but how he acted; and how so many looked to him for leadership especially during difficult situations.  It is humbling to know that seventeen years after he retired, his legacy lives on.  He made a difference in the industry and in the people he touched during his career.

My father has undoubtedly influenced my inevitably career choice.  After spending ten years in other areas within healthcare, I started my own career in market research after his passing.  I have find similar joy in the industry working with others to make a significant contribution.  He continues to inspire me to learn new things, grow in the profession, and bring integrity to everything that I do.

Looking at the changing healthcare landscape, I can only hope others (and myself included) can continue to follow his example within healthcare market research.

Katie Fordyce

The Cadence Concierge Experience

I often get asked why I joined Cadence and what sets us apart from other Medical Communications companies. For me, it’s a very obvious answer: we provide a concierge-level quality of customer service.

All agencies care about the outcome of each project. Each team stands a hundred percent behind what they do and are committed to each task at hand, no matter how big or small. But our clients have told us that we consistently go above and beyond that level. A few weeks ago, a client told me that he had just watched the film, “The Grand Budapest Hotel,” and she couldn’t help thinking of how we made her experience feel like she was being looked after by Ralph Fiennes’ character. She said, “You know, you should call it the ‘Cadence Concierge Experience.’”

I knew exactly what she meant. Many hotels have someone that you can ask for advice as to what activities you could do, or where you should go and eat, and you will usually talk to someone who will pull out a city map start drawing circles. However, the very best properties have professional concierge who is genuinely thrilled to guide the guests’ itineraries and usher them through an exquisite experience. At Cadence, we only hire these concierge-level people, screening for individuals with good attitudes and who demonstrate the ability to truly care about our clients. This cannot be simply taught, nor can it be simply bought.

There are a number of unique situations we’ve found ourselves in over the years, and each time our team has gone above and beyond the letter of the contract. We pride ourselves of being one of the best medical communication companies in the industry, and all our team members are highly qualified with many years of experience in the field. As such, we know the extent to which careful attention to what others might consider to be minor or small details can make a major difference to our clients.

In one situation, our team was managing a European meeting and our client was looking forward to exploring the city once the meeting was completed. However, he was a bit intimidated by the public transport system, and mentioned that he was nervous about taking the local train. Our team researched the train lines, accompanied him to the station, and outlined how he could get to his destination and back to the hotel again. He arrived back that evening, full of stories and enthusiastically grateful for our assistance and the boost of confidence it gave him.

On another occasion, the meeting we had organized happened to coincide with a major storm that had moved into the area at the same time advisors were scheduled to arrive. Our client was extremely concerned about the participants getting to the meeting safely and timely, given the cancelled and delayed flights that resulted. To allay their fears, we posted team members in the hotel lobby until very late at night to personally greet each advisor upon arrival, to show them how grateful our client was that they still made the trip despite the delays and less than convenient travel experience. The next day, several of the advisors commented that this small gesture was greatly appreciated, and our client told us that we had made them feel taken care of at the end of a long and frustrating travel day.

One other situation occurred at one of the major European Medical Conferences, where in addition to supervising several projects for large clients, the Cadence team was also assisting in a smaller project for a start-up company. When the Cadence team landed on the tarmac, they found several urgent voicemails from the start-up client disclosing that there had been a terrible mix-up in the printed materials their internal team had prepared for another project, and they didn’t have the ability to fix the problem on their own. Our team jumped to action immediately and found a local printer who was able to recreate the materials. The Cadence team went to the printer, proofed them for accuracy, and then personally delivered them to the hotel where our client told us, “You really saved my bacon!”

Of course, small situations like this don’t make or break any event; however, it has definitely been our experience that if clients and meeting participants feel that all the details of the meeting are being handled professionally and that the organizing team truly demonstrates that it cares, it frees the client to focus on the big picture. Ultimately, our mission is to help our clients reach their short-term and long-term goals, and I think we have found that small acts of kindness go a long way.

Susanne Blassingille

The Forward March of Regress

The Annual Meeting of the American Society of Clinical Oncology (ASCO) is one of the largest (if not the largest) cancer meetings in the world, and certainly within the United States. Practicing oncologists, nurses, physician scientists, research scientists, and thousands of pharmaceutical and biotechnology professionals, to say nothing of the myriad of patient support and advocacy experts, descend each year on Chicago the first weekend in June to network, recruit partners and allies, and of course to present the results of clinical trials both large and small.

The expectation within the American media, as well as within the culture it serves, is that ASCO should herald the announcement of some Grand New Development in cancer therapeutics, some kind of breakthrough treatment taking advantage of the bleeding edge of scientific and translational research to completely change the paradigm of care for some (or all) cancer patients. And while this does happen from time to time (such as with Herceptin or Gleevec), the advance of cancer care usually doesn’t follow this pattern. More often, new investigational agents are shown to make only incremental gains against the standard of care, subtly shifting the balance of the therapeutic index for patients. And sometimes new research shows that impressive new advances can be made with old drugs.

Take for example, the report on the Eastern Cooperative Group (ECOG) trial E3805 (aka “CHAARTED”), which compared androgen deprivation therapy (ADT) with or without the drug Taxotere in men with metastatic hormone-sensitive prostate cancer.[1] In this trial, Dr. Christopher Sweeney explained that Taxotere, which had been approved in 2004 for use in metastatic prostate cancer (but only in men whose disease was no longer responsive to hormone therapy) had been shown to confer a two-month increase in overall survival. The hypothesis of this trial, however, was that Taxotere would be more effective at prolonging overall survival if administered before the metastatic disease became refractory to hormone therapy. It turned out that their hypothesis was right, as the addition of Taxotere to ADT resulted in an increase of nearly 14 months to median overall survival for the entire patient population, and an increase of 17 months for patients with high volume disease. Thus, a substantial gain in survival was achieved not by developing either new drugs for new targets, or even new drugs for old targets, but simply by using old drugs for old targets in a new way.

And sometimes new advances can’t be made with new drugs either. The first report of the Phase 3 collaboration between the Breast International Group and the Alliance for Clinical Trials in Oncology (previously known as the North Central Cancer Treatment Group), BIG-2-06/N063D (also known as “ALTTO”), was also reported at this year’s ASCO meeting.[2] Dr. Martine Piccart-Gebhart discussed how she (along with co-PI Dr. Edith Perez) and many in the breast cancer community had been impressed by the improved survival outcomes associated with Herceptin use in the adjuvant setting for patients with early-stage HER2+ breast cancer, and designed the trial to determine if dual blockade of the HER2 receptor (using both Herceptin as well as the HER2-targeted tyrosine kinase inhibitor Tykerb) would provide any additional clinical advantage. The ALTTO trial was a massive undertaking, with over 8000 patients registered to four different treatment arms; I was present at the initial investigator’s meeting which kicked off the trial in 2007, and even then it seemed like a mind-boggling feat to accomplish. But accomplish they did, though it turned out to be a negative trial. In her presentation, Dr. Piccart-Gebhart explained that excluding the Tykerb monotherapy arm (which had been shut down in 2011 due to evidence it would not show non-inferiority to the Herceptin monotherapy arm), the three remaining arms were virtually indistinguishable in terms of disease-free survival and overall survival, and the Tykerb-containing arms demonstrated significantly higher incidence of adverse events, particularly with regard to diarrhea and rash.

The ALTTO results were a blow, not just to the study investigators and sponsors, but also to those who work in the field of breast oncology. In his commentary immediately following the ALTTO results, Dr. George Sledge (one of my favorite oncologists ever[3]) expressed his frustration with the failure of the trial, not just because of its immediate ramifications, but because it signals a failure of the field of breast oncology to understand a key aspect of the disease, as well as to be able to extrapolate success in the neoadjuvant or metastatic settings to the adjuvant setting. It had been hoped that showing a benefit to pathologic complete response (pCR) in the neoadjuvant setting (which had been shown for the combination of Tykerb and Herceptin in the NeoALTTO trial) could serve as a reliable indicator of overall survival benefit in the adjuvant setting. Unfortunately, the experience with Herceptin in this regard now appears to be the exception, not the rule. Indeed, Dr. Sledge pointed out that the role of biologics as adjuvant therapy for multiple tumor types now appears to be largely futile.

But I don’t lose hope. Negative trial data may be disappointing, and they may be a psychological roadblock for research, but scientifically they are just as informative as positive data.[4] Indeed, with the public presentation of ALTTO now all but completed (there will be some future updates that are unlikely to change the outcome), researchers can now move away from its answered question and explore other options. More molecular targets are ripe for investigation, such as PI3K, MET, and Hsp90. Researchers and pharmaceutical companies are hard at work on the bleeding edge of the oncological pipeline, and future ASCO meetings will display the fruits of their labor.

Meeting Planning Processes 101’s

Planning 101’s

No matter where you are in the planning process for your upcoming program, we thought you could use some ideas of what to discuss with your vendor of choice. Here are some of our top 10 tools & priceless pieces of advice.

Six or more weeks prior to the meeting

#1        Pick a date that works best for your speakers and team members. Make sure to review the calendar to ensure that the date doesn’t fall over any holidays.

#2        Determine the start and end times of the meeting, and if you will require a separate room for meals and or breakouts. This is important to know when venue sourcing.

#3        Work on an invitation that will get people’s attention by using your companies branding for added visuals. Cadence can also assist you with specific meeting graphics based on the content of your program. Just ask us how we can help!

#4        We suggest using email as your first line of communication. Most physicians don’t have time to read through their physical mail, and faxes tend to get ignored.

#5        Ensure confirmations go out as soon as possible so the attendee has all the information they need to block out their calendar and book any travel arrangements necessary.

#6        Submit your rooming list, menu, AV requirements and final meeting details to the hotel. Make sure to include a final head count.

One week prior to the meeting

#7        Ensure all attendees receive a final confirmation with all the meeting/travel details including: ground transportation, hotel parking, flight arrival & departure details, hotel confirmation numbers and contact information for them to be able to reach someone in the event they are having a travel issue.

#8        Finalize Meeting Agenda.

#9        Print all meeting handouts ahead of time when possible.

#10       Partner with a great vendor like Cadence Research, to ensure that your next meeting is a great success!

Hotel Do’s & Don’ts

☐         Make sure that the hotel cannot move the meeting room location without your prior written consent. One way to ensure this is by having the hotel list the names of the meeting rooms on the contract.

☐         Ensure that your sleeping room rate is effective three days prior and post meeting. In the event you have a guest that wants to stay over or come in early.

☐         Confirm there is a “Force Majeure” clause in your contract to protect you against acts of God, war or terrorism.

☐         A “No Walk Clause” – is also a necessity when signing a contract. You want to make sure the hotel cannot walk any of your guests to another hotel.

We hope you found this to be helpful, these are just a few key items to remember when planning a meeting. Cadence Research & Consulting has more thorough checklists for each and every program, and we would appreciate the opportunity to plan your next program. Please let us know how we can help YOU to ensure that your next meeting is an amazing success!

Can you create Competitive Immunity through the Challenger Sales Model?

With the global healthcare market becoming more and more complex, and the number of decision makers involved in patients’ care decisions growing exponentially, those competing in today’s integrated delivery networks (IDN) need to re-think their current sales approaches.

Sales organizations that depend on a transactional based sales approach, where the focus is on presenting as much information about your products or services as possible, or the relationship approach, where it’s all about making friends, need to seriously consider what Mathew Dixon & Brent Adamson have coined as, “The Challenger Approach to sales.” Here the focus is providing solutions tailored to your customers’ business challenges and challenging your customers to take action.

A Challenger Representative is defined by:

  1. The unique ability to teach for differentiation during a sales call
  2. Delivering a tailored message based on their understanding of their customer’s unique economic drivers
  3. Taking control of the sales process by comfortably challenging customers.

So what makes the Challenger Selling Model a perfect fit for organizations selling in the IDN setting? It enables you to build the competitive immunity that comes from becoming an invaluable business partner. By offering your customer tailored business solutions that allow them to be successful, you take the focus from selling based on just price and shift to a more powerful value proposition.

The good news is that selling is a science, a teachable skill, and a process that anyone can learn, but you must provide your sales organization with the tools and training needed to deliver effective selling messages.

How do you do this?

  1. Build content through your respective marketing teams to ensure tight collaboration.
  2. Create messages that are scalable and repeatable.
  3. Be clear that your marketers bear the responsibility of identifying the message that will be of most value to each respective client stakeholder.
  4. Bring the two teams together that must work closely to make your organization’s transition to the Challenger Selling Model successful – Marketing and Sales Training.

There is no question that transitioning to the Challenger Model approach with your complex clients will be key to the future success of your organization, but the close alignment of your sales training and marketing teams will assure that this transition goes smoothly!

What Does it Mean for a Vendor to be of Service?

Service, like so many words in the business lexicon, seems to have lost it’s meaning as it has become a ubiquitous marketing term.   At Cadence, service speaks to not only what we do but also how we do it.  Service means consistently providing outstanding work AND a providing a great client experience.  Client experience is the foundation of everything we do.  Having walked in our client’s shoes, we understand the dynamic nature of their work environment and the daily demands that are placed upon them that go beyond a single project.   As such, our aim is to be a collaborative partner that our clients can rely on to consistently deliver high quality service.   Our biggest compliment is when our clients tell us that they don’t have to worry about any project that we are involved with.  Giving our clients this peace of mind is what we strive for in every single project.

Sugata Biswas

Leveraging Innovation Centers to Re-prime the Development Pump!


Innovation is a hot word right now in pharmaceutical strategy.  It is futuristic, creative, cutting-edge, energizing, and entrepreneurial.  Innovation is not hype, though.  It is the solution to the reality that internal R&D labs are losing productivity, drug approvals are down, and venture capital for start-ups is drying up.  Innovation has just a little do with a brilliant idea, though, and everything to do with executing it with discipline.

How is this exciting?  This sounds dull.

There is a vibrant community of biotechs, academics, incubators, and accelerators teeming with cutting-edge science.  To forge the deals that will re-prime its development pump, pharma must take its careful processes, performance criteria, gates, and thresholds and apply them to this wild and exciting space.  Innovation is a methodical, stepwise process of diligence, negotiation, contracting, planning, and collaborating.

Inside Out

Innovation is about creating value.  Innovation centers are cropping up in scientific hot spots – outside of traditional pharma campuses – all over the globe.  Pharma’s goal is to embed its best and brightest in the scientific community to partner with entrepreneurs and academicians.  Innovation has, quite simply, turned the pharma model inside out. Done well, innovation can result in on-boarding new products and business models at a sustainable steady state over time.  By looking outside, innovation creates value inside.

— Sherry Danese

What are the biggest concerns manufacturers have about the Sunshine Act?

With regard to the Sunshine Act, the pharmaceutical, biotechnology, and medical device industry are presently concerned with a number of issues:

1)  How will the Sunshine Act weigh on reporting indirect payments to physicians?

The CMS allows manufacturers to send payments to physicians through third-party agents if and only if they remain unaware of the identities of said physicians. Otherwise, the CMS is concerned that manufacturers might adjust their financial relationships to take advantage of an indirect model for sending payments. In addition, CMS will require third-party agents to track payment information on behalf of manufacturers, which can then be reported by either the third-party or the manufacturer, but not both.

2)  How will companies develop and execute aggregate spend plans?

Manufacturers will need to be highly confident in the quality and accuracy of their master databases, including verifying the accuracy of their physician information (including license numbers), removing duplicate records, and improving the usability of their database systems. In addition, manufacturers will need to designate someone within their organization to validate and communicate these payments to physicians, as well as to handle reporting disputes.

3)  How will the Sunshine Act affect physician learning and research?

Dr. Henry Black, a clinical professor in the Department of Medicine at NYU Langone Medical Center, views the Sunshine Act as an “abomination.” Of most concern is that the Sunshine Act requires documentation of gifts and dinners alongside grants that sponsor new research, and may have a chilling effect on the state of clinical research in America. Thus, the Act may prompt a decrease of medical innovation in the United States, shifting the tremendously expensive burden of novel drug and device development to an already overburdened public health system.

4)  How educated and prepared are physicians on the new guidelines?

The American Medical Association has developed an online resource for physicians to help educate themselves on the reporting process outlined by the Sunshine Act. This resource will include, as it becomes publicly available, a physician portal through CMS that will allow physicians to access reporting information, as well as an informational chart that characterizes the differences between federal and state Sunshine Laws.

5)  How can companies maintain relationships with physicians?

The relationships between manufacturers and physicians are essential for both scientific innovation and clinical research. However, relationships between the two are subject to more scrutiny now than ever before, from the CMS and state oversight laws, as well as hospitals and academic institutions. At present, the onus is on physicians to understand the reporting and transparency rules, but manufacturers can help by creating systems that are as simple and painless as possible.

Zachary Moore

Will the Sunshine Act eliminate bias from the US healthcare system?

Whether or not the Sunshine Act will improve or diminish the practice of medicine in the United States remains to be seen. But it will not eliminate the role of bias in the medical field or the pharmaceutical industry. Earlier this year, the Department of Health and Human Services ruled that the so-called “Physician Payments Sunshine Act” (Section 6002 of The Patient Protection and Affordable Care Act), will go into effect. The goal of this Sunshine Act is to introduce more transparency into the financial relationships between drug, device, and biologic manufacturers and the physicians who advise, consult, and work with them. Any payment or gift greater in value than $10 given to any physician must be submitted to the Secretary of Health and Human Services, and be posted on a publicly-available website, or prompt a fine of as much as $10,000 per gift, which will be the responsibility of the company. Data will be collected by the Centers for Medicare and Medicaid Services (CMS) beginning August 1, and all 2013 data is due by March 31, 2014. The CMS will begin making these data public by September 30, 2014.

Ostensibly, this Sunshine Act has been created to limit the amount of physician bias in the modern healthcare system, something with which Dan Ariely is intimately acquainted. As a burn patient, he was at the mercy of forces beyond his control, and as he found, often beyond rationality itself. Now, as a noted behavioral economist and psychologist, he’s published widely on the irrationality of human behavior. In his blog, Ariely comments frequently on his research into irrationality and the effects of cognitive bias in the world around us.

In this video from TED, Ariely speaks about how physicians (and other researchers) can be motivated by their own biases to persuade their patients to follow a specific course of treatment.

For companies like Cadence Research and Consulting, the impact of the Act depends on the specifics of the project through which physicians are engaged. Guidance from CMS indicates that market research is exempted from reporting requirements due to the fact that a manufacturer is not paying physicians directly, and that the identity of the manufacturer is necessarily kept hidden from the physician. However, money spent on physician travel, food, and lodging for “promotional” activities like advisory board meetings or investigator meetings should already be recorded. For these items, Cadence proactively maintains a master list of these expenses for each physician that can be tailored to each individual client’s needs. In many cases, clients already provide us with individual reporting spreadsheets that can be completed and submitted with meeting deliverables and close-out files.

Of course, whether or not the Sunshine Act will improve or diminish the practice of medicine in the United States remains to be seen. But it will not eliminate the role of bias in the medical field or the pharmaceutical industry. As Dan Ariely notes, “It’s just a fact of human life: we are compelled to reciprocate favors, and an ingrained inability to disregard what’s in our financial interest.”

Zachary Moore

Mixology…Blending Methodologies for Today’s Challenges

Mixed methodologies research offers the best of both worlds: the in-depth, contextualized, and natural but more time-consuming insights of qualitative research coupled with the more-efficient but less rich or compelling predictive power of quantitative research.

Mixologists practice mixology and bartenders tend bar.   Mixologists evolve the field of bartending, creating innovative cocktails the world has never seen.  A bartender serves the drinks that customers order.

It is time for the mixologists in all of us to shake up market research. Questions rarely come in a box and rarely are contained to a single department.  Now is the time to mix up the methodological approach to help all the stakeholders answer their questions.

Mixed Methods.  What are they?  For some, it means blending primary and secondary research techniques.  Others leverage epidemiology to inform subsequent phases of research.  And others apply social media analytics to augment their data collection beyond traditional channels.

We don’t think the definition really matters.  At Cadence, we like mixing methods to take the best advantage of research techniques across marketing, clinical development, business analytics and forecasting.  There’s no question that traditional concept testing using in-depth personal interviews provides deep qualitative input that is invaluable to answering key questions.   After all, sometimes all you really need from the bartender is a martini.

But, let’s say our client really wants to know if the concept’s underlying technology meets an unmet need in a highly specialized facet of the oncology market.  And, if so, what is the market size and how would the technology be positioned?  And what would the forecast look like at various price points for a product used in this position?   It turns out our client didn’t really want a simple drink, but never imagined the perfection of a Melograno made with orange infused vodka, orange liqueur, fresh pomegranate and fresh pineapple.   To truly be of service to this client, we need to find our inner mixologist and bring a fresh, sophisticated approach.

On March 27, 2013, the Wall Street Journal reported that ASCO announced a new clinical tool in development called CancerLinQ.  This is a database that essentially converts all cancer patients in the U.S. to clinical study participants.  The system collects data that doctors record in a patient’s files, such as age, gender, medications and other illnesses, along with the patient’s diagnosis, treatment and, eventually, date of death.   Doctors tap the database for help in developing treatments for other patients.

Our methodology for this client can borrow analytic techniques from epidemiologist and use this new data set to mix it up:

  1. Quantify the market:  Connect to the CancerLinQ database to query real patient data
  2. Assess the technology on-line:  Specialists are too far-flung for in-person research and are too busy for telephone interviews.  Undertake a technology assessment using a longitudinal on-line focus group that allows users to log in and out for short periods of time over several days.  You actually get broader and deeper data at a lower cost.
  3. Leverage social media analytics to determine what is being said in the millions of conversations happening in patient groups, physician networks, Twitter YouTube, Facebook; the possibilities are endless.  Algorithms being employed to look at back-of-mind sentiment and attitudinal behavior are as powerful and complex as those employed by the FBI.
  4. Build a model:  Feed the market size and adoption data into a forecasting model using scenarios for various price points. You can use a choice model if you are after a dynamic assessment or start with a univariate test if you have discrete price points and a fixed product profile.

So, in the end, we mixed a database query, a technology assessment using an on-line longitudinal format, and a dynamic forecast to answer what started out as a “concept assessment” question.  Dig a little deeper, mix up the methods, and deliver truly impactful research.

— Sherry Danese

What will be the impact of the ACA on cancer treatment?

The Patient Protection and Affordable Care Act of 2010 (ACA), commonly called “Obamacare,” is currently approaching full implementation. As of January 1, the Health Insurance Marketplace will provide coverage to those who do not have it provided by their employers. Two years ago the American Society of Clinical Oncology (ASCO) assembled a team to assess the implications of the ACA and craft an official policy statement for the organization. Led by Dr. Beverly Moy, Clinical Director of the Breast Oncology Program at Massachusetts General Hospital, the statement notes several challenges within the ACA specifically with regard to cancer care. The expansion of Medicaid in particular was pointed out as having limited applicability to cancer patients, creating potentially poorer standards-of-care for those who participate in the system, and resulting in suboptimal reimbursement across the board. In addition, ASCO statement noted that the ACA preferentially benefits community health centers while disadvantaging the specialty treatment centers which have now become standard for cancer therapy. In addition, the ASCO statement suggests that Medicaid patients may not be able to participate in clinical trials.

Opinions vary regarding the overall positivity or negativity of the ACA with regard to cancer care. Forbes contributor Scott Gottlieb suggested that the ACA will restrict patients’ access to specialist physicians, including oncologists. He predicted that insurance providers may mitigate costs from cancer patients by limiting their access to in-network providers, effectively forcing them to pay out-of-pocket for the bulk of their care. However, the President of the ASCO, Dr. Clifford Hudis, recently noted in an interview with Reuters that he felt the implementation of the ACA would be a net benefit for his patients, and would especially improve the situation for cancer patients who have had difficulties securing coverage for long-term treatment of their disease.

Dr. Robert Figlin, of the Cedars-Sinai Samuel Oschin Comprehensive Cancer Institute, has expressed a more skeptical view of the ACA with regard to cancer care. In a discussion with CadenceTalk, he noted that the ACA will likely improve treatment of common diseases like hypertension, diabetes, and pneumonia. However, he agreed with Gottlieb that access to oncology specialists would be limited. In addition, he noted that since much of the clinical research in cancer is driven by expert physicians, patients covered by ACA plans are not likely to have access to the latest experimental treatment options, and thus will not have access to the optimal care for their disease. Furthermore, Dr. Figlin observed that the number of available oncologists for patients with insurance coverage prior to the activation of the ACA was already too low, and adding more patients into the coverage pool will likely strain available resources for the whole country.

It will yet remain to be seen whether the increased availability of cancer care will offset any potential limitations in the quality of care, though oncologists all over the country are keenly anticipating the outcome as ACA coverage begins next year.

Zachary Moore