But, what exactly is an e-poster?

An e-poster is a new and engaging way to communicate the core message of scientific posters. Presented on a large touch screen computer, an e-poster makes use of BaseCase’s cloud-based platform which turns health economic evidence into web-based apps. These user-friendly, interactive apps communicate clinical and economic messages in a format comprehensible even for non-experts.

Michael Blankenburg from Bayer explained that “the e-poster brings life to any economic model”. It combines the best of two worlds - presentation of the key messages of healthcare evidence with interactive communication which allow customers to engage with the model. “It was an eye-catcher that supported, in a unique way, the message of our poster”.

Michael Blankenburg, Bayer Healthcare Pharmaceuticals (right) presenting his e-poster at ISPOR Madrid.
Also in the photo is Kurt Mueller, Pharmalevers (left).

ISPOR Washington D.C. will see BaseCase partenering with ThermoFischer to showcase the e-poster on Cost and Effects of Using Vitro Diagnostic Testing for Peanut Allergy. So if you’re attending ISPOR this June, we recommend you stop by and say ‘hello’ to the BaseCase team (booth #5), and while you’re there, put your fingers on the evidence and ‘feel’ the model.

Want an e-poster for ISPOR Berlin? Send an email to info@basecase.com and we’ll contact you to discuss your specific requirements.

Stop by the BaseCase booth #5, located at the concourse level across from registration, to see how our spreadsheet-based web apps communicate the comparative effectiveness of your products. BaseCase’s iPad-friendly apps run everywhere and now they can even be turned into a PDF and viewed from PowerPoint. Our apps also support detailed user-analytics so you can track the number of times your app is accessed, how long it is used in the field, and which reps are generating reports.

Test out one of our interactive budget-impact, cost-effectiveness, or patient eligibility apps and see how we visualize your data to best demonstrate your product’s value.

Want to discuss any of the mentioned tools or an upcoming project with us in detail? Send an email to info@basecase.com to book a face-to-face meeting and we can tailor a BaseCase solution to meet your needs.

Today I was going to tell you the tale of my son’s broken wrist (he is fine now, this happened in January, but the insurance issues are fascinating), but I got distracted thinking about another fascinating subject that many do not understand well: confounding by indication. I especially started thinking about it in the context of how decisions and policies are made, and how not having the right data at the right time leads to this “Titanic effect” for a technology. What do I mean by this? Well, let me explain.

Some say the Titanic sank simply because of poor preparation — not enough life boats, not enough training on the evacuation procedure, in other words “not enough imagination” to plan for a catastrophe. It was derailed in its course by an entirely predictable natural calamity that had not been planned for adequately, even though the risk was obvious in retrospect. Was this just on of those “unintended consequences” that could have been avoided with more clear vision? Perhaps, but the Titanic is, ahem, water under the bridge. But we can focus on some more mundane and current potential missteps and make some guesses.

Let’s talk about medical technologies, and drugs in particular. Let us say that there is a new sepsis drug that has been tested among patients with sepsis but without organ failure. This drug appears to prevent organ failure in a fraction of the treated patients, and also reduces mortality by 6%. The only obstacle to widespread use of this drug is its acquisition cost, which is much higher than what the hospital’s critical care pharmacist is used to paying for other drugs. Because of this high cost, the drug, despite being on the formulary, gets administered only to those patients who have developed not one, but two organ failures. The savvy pharmacist looks at the outcomes of these patients and, after comparing them to those of the patients who did not receive the drug, concludes that the new sepsis drug, instead of saving lives, actually kills. The P&T committee discusses this, dumps the drug from the formulary and other hospitals follow suit. What’s wrong with this picture?

Several fallacies are at work here, including an overly broad inference of causality and bias. But the most important lesson is to do with confounding: because of its apparent expense, the drug has been niched into a population of patients who a). were not the ones that exhibited the evidence of benefit in the trials, and b). have a very high risk of mortality at baseline. So, not only is it not valid to conclude that the drug killed these patients, but it is not even valid to say that the drug does not work — it may well work in the populations that it was shown to work in, but not in this, much more ill, population. You see the difference? It is like saying that you umbrella failed to keep you dry when you opened it only after you already got soaked.

So confounding by indication is one reason that drugs “fail” - they are given to people who are by definition not going to do well, and the confirmation bias pushes us to say see, it’s expensive and doesn’t work. So how do we overcome this phenomenon and make sure that appropriate patients get access to useful technologies? I believe I have a very simple answer: don’t squeeze the toothpaste out of the tube if you don’t want to have to cram it back in. Huh?

In other words, do what I always advocate: be ready with the relevant data before the train leaves the station, before the cat gets out of the bag, before the horse gets out of the barn. It is very well known that cognitive biases, once established, are difficult to overcome. The pharmacist’s first concern is for being able to use his very limited resources efficiently, and to guard from spending his monthly budget on a potentially useless intervention in a single patient only to be left with no resources to care for all of the other patients. Yet many manufacturers at launch send their reps to the pharmacist with two virtually unrelated stories: one about efficacy and the other about the acquisition price and its impact on his budget. When the drug is expensive, the efficacy pales in comparison to the price tag, and the pharmacist has no choice but to restrict the use of the drug, thereby consigning it to failure by confounding by indication. Sound familiar?

Is there a way to avoid this scenario? I think so. It is self-evident that you have to have good data. The surprising thing is that good data are necessary, but not sufficient: the timing of these data is critical as well. It is easier to help people form an opinion where none exists than to change one that is already there. So, to be successful, the manufacturer with a good technology must have a coherent effectiveness and cost-effectiveness proposition right out of the gate. Not only that, but it is imperative to help the clinician understand what patients might benefit from the technology (no, not all patients should be on your drug). This is the kind of a collaboration that will ultimately benefit all stake holders: 1). Appropriate patients will get the opportunity at better outcomes, 2). The pharmacist will understand up front the value proposition and the potential scope of use, and 3). The manufacturer will profit from providing a beneficial service. Isn’t this the intent of all this drug development?

If all this seems all too obvious, it is because this is not rocket science. But why, then, do I see so many companies get into trouble with this very scenario? Is it just the case of “best laid plans” or is it a real blind spot that needs to be illuminated? You tell me. Given the investment that goes into drug development, I think it makes sense to approach this gap earnestly, instead of just shuffling the deck chairs on the Titanic.

Author: Dr. Maryna Zilberberg of Healthcare, etc.. Find her on Twitter.

The iPad has been taking the healthcare, pharmaceutical and medical device industries by storm since its inital release two years ago (in April of 2010). Doctors, patients, key account managers, hospitals, health economists, pharmaceutical reps and medical device sales reps have been in on the action. Just consider Novartis CEO Jimenez’s memo to employees that Apple’s “game-changing” iPad will make it possible for sales reps to save 205 hours over the course of the year and allow “the entire field to make an incredible 35,000 additional customer visits each year”. Previously, sales representatives struggled with the ability to differentiate themselves through clear, concise, and interactive messaging, but the iPad now gives these Key Account Managers an effective way to communicate the economic evidence.

A web app developed by a health economist for the pharmaceutical and medical device industries

Since pharmaceutical and medical device companies invest significant time persuading payers to adopt their products, communicating economic evidence efficiently via the iPad has become an important part of this value proposition. New iPad apps, that allow the presentation of interactive content on the iPad, provide similar productivity gains for Key Account Managers with the communication of health economic evidence.

Despite the iPad’s appeal, it does come with some drawbacks regarding health economics. A major shortcoming is that the iPad doesn’t support Microsoft Excel or Adobe Flash which are some of the main programs used to create and present economic models. And of course there is the challenge of distribution; how can you smoothly implement a tool for the iPad across a sales force that is spread around the globe? Will you need to create two tools, one for PCs and one for iPads?

BaseCase Interactive is a value communications platform specifically designed for the healthcare industry. BaseCase solutions, developed with the iPad in mind, will ensure your field teams can present interactive and easy-to-understand presentations that engage the customer. BaseCase’s benefits also extend to the brand teams, offering analytics to monitor the usage of sales presentations and measure performance. BaseCase’s intuitive features, such as sliders, fully compliment the iPad’s touch screen. The presentations even run offline when an internet connection is not available.

By adopting BaseCase as the platform for global value communication tools, pharmaceutical and medical device companies can easily overcome the technical limitations of Excel or flash-based presentations, to fully take advantage of the iPad for customer communications.

Understandably this is in part because of the lack of clear guidelines from the FDA. However, a shift is starting to occur. Pharmaceutical and other drug-development companies, like Pozen, are starting to create digital advisory boards and joining the rest of the corporate voice on Twitter, Facebook, and other social media platforms.

As Dr. Daniel Palestrant, CEO and founder of physician social media site Sermo, states “the ability to control the message is no longer possible. The opportunity for industry is no longer to control the conversation, the opportunity is to be part of that conversation.” This large scale shift does not mean that pharmaceutical companies are losing control of their message, but that there is potential for a collaborative approach where companies can directly interact with their customers. Boehringer is now taking advantage of this two-way communication channel and has one of the most active and responsive Twitter accounts. Pfizer also has recently reached approximately 17,920 people via Twitter with a potential reach of over 13 million. Interestingly enough, one of the most dominant themes of these Twitter interactions is oncology.

Other pharmaceutical companies are now taking advantage of this opportunity to establish soft power and going one step further. Johnson & Johnson has created their own social media channel. Novartis has also created their own unique community platform where patients and healthcare professionals can interact from all over the world. Sanofi-Aventis provides a tv website with six themed channels relevant to different stakeholder groups.

Whether or not all pharmaceutical companies will join the digital movement is yet to be seen, but as of now it is known that many in the industry are making an effort to interact with consumers in a visually and technologically modern way.

For example, take the market share of four different drugs. If one drug gains market share, at least one of the other drugs must lose market share accordingly. Why don’t you just play around with the linked sliders below to get an idea of how they work?

Now to show you the full potential of linked sliders, take the model below as an example. This second example uses two separate sets of linked sliders to show a more complex situation and allows you to play around with all the important factors in one model. The values of both sets of linked sliders are used to calculate unemployment payments for several groups. It shows the population of a generic town and the distribution of their inhabitants regarding the labor market. With the sliders, you can set the value of people receiving pensions, the employed workforce, the unemployed [further divided into people receiving money from unemployment insurance (benefit 1), people receiving unemployment pay (benefit 2), and people not receiving federal money], and the population currently in training.

Within the linked slider properties, you can change the exact value of each group as well as change the format from percentage to number. Set the sliders to the desired number of people in any group and click the lock symbol to lock the number. Once you have set each slider to the appropriate value, you can move on to the second set of linked sliders, which then gives the percentage of unemployed people receiving either benefit 1, benefit 2, or no benefits at all.

Once all of the values are set, you can see the total number of people receiving benefit 1, benefit 2, or no benefits in the section below the sliders. You could take the example even further by dividing the unemployed people who receive benefit 1 and benefit 2 into several groups, possibly according to the length of unemployment.

Complex Models on One Page

As you can see, linked sliders allow you to create complex models with lots of factors on just one page. They are easy to implement and offer enough flexibility to adapt them to almost any need, and most importantly - once your models are created, they are easy to use.

Interactive Presentations for Health Economics and Health Outcomes

Let’s consider George – a Life Sciences Key Account Manager at a major pharmaceutical company. He was using an Excel spreadsheet model and PowerPoint to support his sales pitches to hospital administrators, and while he was not failing at making sales, he often found himself frantically flipping through his PowerPoint presentations trying to locate the right slide to answer to the audience’s question. Or George regretted leaving meetings with the promise to respond soon with the correct figures that he was not capable of generating during the pitch. George’s employer was aware of the inefficiencies and decided to take advantage of an interactive presentation solution to improve his team’s pitch and resulting sales.

The Excel model and PowerPoint presentation were incorporated into a fully customized, interactive visual aid for George and distributed among his sales team. The cloud-based presentation allowed George to centrally maintain and update the presentation instantly and for each key account manager to edit their own presentation based on the patient population of the target physician or hospital financial director, and time frame of the upcoming meeting. Each presentation contained the latest clinical and economic evidence, product information, graphics and company brochures, which were all embedded for immediate access. This enabled the reps to interact with their audience during the pitch to create a dynamic discussion that allows for the necessary give-and-take of a sale. As a result, George found his meetings more impactful as they contained the same level as detail but in a much more concise and easily accessible format.

Although the presentation was also available offline, George and his team took advantage of the online capabilities and added hyperlinks to Pub Med and videos for further assistance during the pitch. This quick access to supporting evidence further empowered George with the confidence needed to discuss complex scientific details that had previously made him uncomfortable. The presentation ran on every device, including the iPad, so George could literally hand over the presentation to the prospect as they wished to become involved. This enabled the audience to consider a complex set of data up close, which takes into consideration the fact that the majority of people best learn visually.

In addition, George and his team took advantage of some of the more technologically advanced aspects of the presentation. They responded instantly to customers’ questions as they depended on the presentation to calculate figures with accuracy and to quantify the problem with an integrated spreadsheet-based Return on Investment (ROI) calculation. They also used the presentation to collect notes and ROI results from the meeting in a compact and efficient PDF that they immediately emailed to the client with a single click. In the end, the interactive presentation empowered the sales force to reflect upon and improve their pitch for future presentations by utilizing the cloud-based analytics to determine which content was found most useful in the sales meeting. As a result, George and his team increased their sales as they adapted each pitch to the specific needs of the customers.

The Moral of the Story

As George and his team learned, an opportunity to make a sale is too often lost when the customer is not engaged and the presenter does not allow room for an interaction. Reform your presentation strategy and utilize an interactive, cloud-based presentation to increase your conversion rate, drive top line revenue, accelerate the productivity of your sales team, and strengthen your competitive advantage overall.

We hope you didn’t miss our CEO - Gijs Hubben - discussing how BaseCase is used to communicate economic value to healthcare providers in a visual and interactive format. Gijs and Amélie Balliere-Joachim from Zimmer displayed the evidence at noon on Day One via our recent collaboration and case study. Gijs also took part in a panel discussion titled ‘Successfully Exhibiting Evidence to Obtain Reimbursement of an Innovative Device’.

Discover the interactive BaseCase-Zimmer case study for the first time or refresh yourself by registering to receive access once it is published. Thank you again to all those who attended.

Alternatively, email info@basecase.com and we will send you the case study when it is available.

The collaboration between BaseCase and OptumInsight, a leading provider of global HEOR consulting services, will greatly benefit BaseCase clients worldwide. Our customers can now leverage the expertise of a local OptumInsight consultant to develop their projects.

OptumInsight specializes in analytics, technology and consulting services that enable better decisions throughout the healthcare system. They can now leverage their expert knowledge in these areas with the ability to develop user friendly HEOR web apps on BaseCase’s interactive and easy-to-use evidence presentation platform.

Please contact Isabelle Duperray, Director International Business Development at +33 141398 471 or Emily Shurey, Account Manager at BaseCase, to discuss an OptumInsight / BaseCase Solution.

Thanks for the mention Duncan.