Compliance and adherence is a bit issue in chronic diseases even in developed countries Low treatment compliance is a big problem for an optimum health care delivery and decreases dramatically drug effectiveness (and revenues) Reasons for non-adherence are related to product, patient and physician communication. Approaches that don’t focus on persons don’t work. Approaches removing obstacles work but those focused on people work better. Many of adherence and compliance causes can be addressed with education. Education can also help to fix other business issues Traditional educational “top-down” approach is a long and inefficient path. New approach can be much faster and effective, more customized and more responsive and long-term sustainable. Education must be not only information, but a structured process of knowledge transfer that combines different strategies to achieve measurable behavioural changes (and business objectives. Xeristar is educating general physicians to increase treatment compliance in depression. AFAL (Alzheimer Families Association) is educating relatives in appropriate patient care. Our approach is based in value, end-to-end solutions, technology, innovation and customer satisfaction

1. Education as Marketing in Healthcare Knowledge driven strategies for better business results

2. Business issues

3. “Drugs don’t work in patients who don’t take them” C. Everett Koop, former United States Surgeon General 3

4. Non compliance Compliance and adherence are major issues in chronic diseases even in developed countries Non-compliance is a major obstacle to the effective delivery of health care. Estimates from the World Health Organization indicate that only about 50% of patients with chronic diseases living in developed countries follow treatment recommendations. In particular, low rates of adherence to therapies for asthma, diabetes, and hypertension are thought to contribute substantially to the human and economic burden of those conditions. Compliance rates may be overestimated in the medical literature, as compliance is often high in the setting of a formal clinical trial but drops off in a "real-world" setting. World Health Organization (2003) Adherence to Long-Term Therapies: Evidence for Action 4 Source: RobBlazek, April 2005 Education as Marketing in Healthcare

5. Low treatment compliance is a big problem for an optimum health care delivery… Education as Marketing in Healthcare 5 World Health Organization (2003) (PDF). Adherence to Long-Term Therapies: Evidence for Action

6. …and decreases dramatically drug effectiveness (and revenues) Diabetes non-compliance (98% in US) is the principal cause of complications related to diabetes including nerve damage and kidney failure Hypertension non-compliance (93% in US, 70% in UK) is the main cause of uncontrolled hypertension-associated heart attack and stroke Asthma non-compliance (28-70% worldwide) increase the risk of severe asthma attacks requiring hospitalization 6 Education as Marketing in Healthcare Source: DiscoveryHealth

7. Reasons for non-adherence are related to product, patient and physician communication Product Perception on effectiveness Easy of administration Cost Patient issues Memory Problem solving skills Lack of health literacy Patient beliefs Patient-physician communication Non effective and trusted communication 7 Education as Marketing in Healthcare

8. Approaches that don’t focus on persons don’t work One-size-fits-all Expecting others to do the work Nagging direct mail reminders One-way communication Complex technology 8 Education as Marketing in Healthcare

9. Approaches removing obstacles work… Changes in product Reducingpatients’ out-of-the-pocketcosts Packagingimprovements Dosingchanges Technology Electronicmedical records SMS and Call Centers Reminderssystems Brandwebsites 9 Education as Marketing in Healthcare

10. …but those focused on people work better Patientperspective Patienteducation Patientassistanceprograms Discounts Changingpatientsbelief Involvingfamily Patientexperienceprograms Physicians and medicalstaff Pharmacyinterventions Training physicians Increasingaccess 10 Education as Marketing in Healthcare

11. Many of adherence and compliance causes can be addressed with education 11 Education as Marketing in Healthcare Education on use of medicines Behavioural and motivational interventions Training for health professionals on adherence World Health Organization (2003) (PDF). Adherence to Long-Term Therapies: Evidence for Action

12. Education can also help to fix other business issues Awareness Prevalence Complications Interactions Side effects Loyalty Provided value 12 Education as Marketing in Healthcare

13. Our approach

14. Traditional educational “top-down” approach is a long and inefficient path 14 Education as Marketing in Healthcare

15. New approach can be much faster and effective… 15 Education as Marketing in Healthcare

16. Education as Marketing in Healthcare û û û û Dosage Efectivenness Target Interactions Tolerability Safety KOL û û Specialty Physicians û û Thisisonlyanexample General Physicians û Patients û û Families û û Other medical staff û û …more customized… 16

17. …and more responsive and long-term sustainable Education as Marketing in Healthcare Specificneeds Specificeducation 17

18. Education must be not only information, … 18 Education as Marketing in Healthcare Training Information Specialist defined purpose Target needs User defined purpose Discipline carachteristics Student Content Sequenced for optimal retention Presentation, practice, feedback and assessment Sequenced for optimal reference Presentation

19. …but a structured process of knowledge transfer that combines different strategies… Education as Marketing in Healthcare Technology resources Strategy Methods face-to-face* LMS LMS 19

20. …to achieve measurable behavioural changes (and business objectives) Education as Marketing in Healthcare 20 Customer satisfaction Knowledge transfer Behaviour changes Business results Customer satisfaction is the first step to get business results Behavioral changes in the customers are difficult, but not imposible to measure Education effectiveness measurement is key Finally, you should try to relate behavioral changes with business results

21. Our experience

22. Xeristar is educating general physicians to increase treatment compliance in depression 22 Education as Marketing in Healthcare

23. AFAL (Alzheimer Families Association) is educating relatives in appropriate patient care 23 Education as Marketing in Healthcare

24. Our approach is based in value, end-to-end solutions, technology, innovation and customer satisfaction 24 Value: a learning solution is always an investment with an expected return End-to-end solution: the customer expects a complete solution with minimum management effort Technology: technology allows organizations reducing costs, growing in reach, increasing flexibility and shorting time to market Innovation: we develop each unique always trying to find new ways to improve learning process Customer satisfaction: an excellent service is critical for student satisfaction and for learning effectiveness Education as Marketing in Healthcare

25. Contact