The document discusses point-of-care patient recruitment programs that can help pharmaceutical companies address challenges in clinical trial recruitment. It notes that physicians are the most trusted source of healthcare information and that over 50% of clinical trial participants join at their doctor's suggestion. SMI offers programs that create physician endorsement for clinical trials by providing branded materials for exam rooms and waiting areas, which has led to increased patient interest and enrollment in various case studies described.

1. SMI Point-of-Care Patient Recruitment Programs Presented to:

2. Why Recruit Patients at the Point of Care? Negative media coverage and the public’s negative perception of the pharmaceutical industry and the FDA is hindering clinical research and causing clinical trial costs to soar to over $1 billion dollars. Problem 87% of people believe that clinical participants will suffer from more pain and experience more side effects than if they remain on their current treatment. 1 62% of people believe that pharmaceutical companies manipulate clinical trial data 2 50% of people stopped trusting clinical trial results/information between 1996 and 2002 2 Solution Physicians continue to be the most trusted source for healthcare information. Physician endorsement for your trial is an essential element for its success. 83% of individuals believe that it is “essential” or “very important” to test new treatments on humans before they’re approved for use. 4 Over 50% of individuals that have participated in a clinical trial did so at the suggestion of their physician. 5 Point-of-Care Patient Recruitment Programs create physician endorsement for your trial, enabling you to finish recruiting on schedule and the trial is not delayed. (1 – 5) 2007 Applied Clinical Trials Article Subject Recruitment

3. What Can SMI Do For You? Implement a HIPAA compliant patient recruitment program designed to increase patient enrollment for your trial. Use the Devon Health PPO Network to help identify the physicians that are ideal for your study. Recruit selected physicians to participate in your patient recruitment program Provide surveys and feedback from the participating offices about your patient recruitment program and clinical trial. Provide contact information for patients interested in participating in your trial.

4. According to a 2006 report published in Medical News Today: 85% of cancer patients stated that they were unaware of available and appropriate clinical trials at the time they were exploring treatment options According to a 2007 study in Applied Clinical Trials 92% of clinical trial participants learned about the clinical trial from their physician According to a 2005 study by the Michael J. Fox Foundation: 95% of patients being treated for Parkinson’s Disease agreed that clinical trials were essential to find better treatments. Only 18% of those patients said they were satisfied or somewhat satisfied with the amount of information available about clinical trials for people suffering with Parkinson’s Disease According to a 2006 study by Harris Inter active: Over 52% of consumers take action after seeing an ad at the point-of-care, compared to 29% that take action after seeing an ad on TV/Radio/Magazine 6 84% of patients with cancer are more likely to consider a treatment option promoted at the point-of-care, than a treatment promoted on TV/Radio/Magazin e. 7 ¹ 2007 Study Harris Interactive ²2007 Study Harris Interactive Additional Statistics

5. SMI Physician Database Our physician database actively tracks and integrates 2,500 disparate sources to deliver the most up-to-date provider profiles. SMI can target physicians by contact information, demographics, specialty, education, and ethnicity. The SMI Physician Database delivers industry leading coverage using a single source. All identifier and demographic information is available With the most accurate industry identifiers, our data can easily be compared to a clients’ match list.

6. Multi-cultural Physician Practice Penetration SMI has designed and implemented numerous point-of-care marketing programs for clients that wanted to target only Hispanic patients, consumers and physicians. Participating physicians included OB/GYN, Cardiologists, Pediatricians, and FP/GP from the top 25 Hispanic Markets. All participating physician practices are qualified to ensure that their percentage of Hispanic patients, meets the needs of our clients

7. SMI has access to approximately 250,000 healthcare facilities totaling over 400,000 physicians across the United States. This list only represents our physician office network Allergy/Immunology 4,279 Orthopedic Surgery 11,195 Cardiology 14,249 Pediatrics 16,876 Dentistry 161,949 Physical Medicine 4,038 Dermatology 7,358 Plastic Surgery 3,798 Endocrinology 3,047 Podiatry 2,811 Gastroenterology 7,665 Primary Care 38,873 Geriatrics 4,000 Psychiatry 20,075 Infectious Diseases 2,311 Pulmonology 4,821 Internal Medicine 26,596 Radiation Oncology 1,518 Neonatology 361 Radiology 5,754 Nephrology 4,875 Rheumatology 2,262 Neurology 6,796 Urology 5,421 Obstetrics/Gynecology 22,139 Occupational Therapy 1,490 Oncology 3,668 Ophthalmology 13,852 Otolaryngology 1,484 Physician Office Penetration

8. Clients place information about their clinical trial or trials on exam table paper Exam table paper provided to physicians free of charge to ensure the clinical trial of interest is the focal point in selected exam rooms Point-of-Care Programs: Branded Exam Table Paper

9. Point-of-Care Programs: Educational Health Panels Informative 24” x 30” print displays in the waiting rooms or other areas of selected healthcare facilities Clients choose the type of healthcare provider to target Used in conjunction with other Point-of-Care campaigns or as a stand alone effort SMI encourages all clients to include a “take one” informational brochure with each educational health panel campaign

10. Case Study – Hypogonadism 470 referring physicians/80 Investigators – 550 total participating offices Phase III medical research study is being conducted locally to evaluate the effectiveness of a testosterone gel in increasing testosterone blood levels in men ages 18-80 Inclusion criteria: must be between 18-80 yrs of age and have a medical diagnosis of biochemical hypogonadism (total testosterone <300 ng/dl), which will be confirmed through two blood tests during the screening visit. RESULTS 75% of the exposed patients had never participated in a clinical trial 88% of the participating offices had patients take materials and discuss the trial with their physician 50% wanted to participate in the trial 90% of the participating offices want to participate in future SMI patient recruitment programs

11. Case Study- Adolescent Depression 85 investigators participated in the program Study is designed to assess the safety and efficacy of escitalopram in the treatment of depressed pediatric patients Study was conducted as a double-blind, randomized, parallel group, flexible dose study Inclusion criteria: Patient must meet diagnostic and statistical manual, Fourth edition (DSM-IV) diagnostic criteria for major depressive disorder Patients current depressive episode must be at least 12 weeks in duration Patients must have a caregiver or parent that agrees to accompany them to all clinic visits. RESULTS 63% of the offices said the materials made it easier to discuss adolescent depression with their patients and their parents 89% of the exposed patients were interested in participating in the trial

12. Case Study - Fibromyalgia 195 referring physicians/15 investigators = 210 participating offices Inclusion criteria: patients must be between 18-70 years old, must meet the primary diagnosis of Fibromyalgia ( as defined by the 1990 American College of Rheumatology (ACR) Criteria) RESULTS Almost 70% of the offices said the materials made it easier to speak with their patients about Fibromyalgia Almost half of the exposed patients wanted to participate 90% of the participating offices had patients take the materials/talk with their physician about the trial.

13. ROI Research and Reporting SMI works with IMS and Nielson to provide you with measurable ROI for your point-of-care campaign. According to IMS, the average 6 month health panel campaign produce an average ROI of $5 for each $1 spent that’s 127% higher than the $2.20 median ROI for traditional DTC TV advertising. IMS will measure the prescription habit of The Defined Test Group: Following completion of this process, test physicians will be identifiable for post-program impact analysis, via: Physician Name, Location/Zip Code, IMS Doctor # Control Group Selection: IMS will select a group of similar physicians from the IMS Health physician universe to use as potential “Control” physicians. These potential control physicians are similar to the test physicians based on: Product NRx and/or TRx volume and share in the pre-test period; Market NRx and/or TRx volume in the pre-test period; Geography Physician specialty A six month educational health panel campaign produces an average of 2 additional prescriptions per physician in the test group compared to the physicians in the control group.

14. Physician Testimonials “ The program has been wonderful. It’s very physician friendly and is helpful in managing the practice.” -Neurological Stroke and Care “ This stimulates the patients curiosity regarding the brand name medication.” -Lawrence Papura, MD. “ It’s wonderful to have usable marketing materials! The savings to the office is also appreciated.” -Hartville Family Physician “ Great program. Helpful and supportive to our practice.” -Salisbury Medical Clinic

15. The Patient Experience From the waiting room area.

16. The Patient Experience To the exam room…

21. About Us SMI is the fastest growing Point-of-Care Marketing and Communications company. Our mission is: to design and implement patient recruitment campaigns that create maintain, and foster a relationship between our network of referring physicians and our clients. SMI successfully balances the needs of our clients, participating physicians, and their patients to benefit all stakeholders. All sponsored educational campaigns are provided to our physicians free of charge which helps to ensure that clinical trial and product information are the focal point in the selected healthcare facilities. SMI has a seven member physician advisory board that oversees our Point of-Care marketing campaigns.

22. Our Leadership OUR CEO SMI was acquired by Dr. John A. Bennett in 2003 the CEO and Founder of Devon Health Services, Inc. Dr. Bennett joined Delaware County Memorial Hospital as an emergency room physician in 1978. In 1984 Dr. Bennett founded 13 outpatient diagnostic imaging and physical therapy centers. Dr. Bennett went on to build the largest PPO Network in the Northeast. In 1995, it was renamed Devon Health Services OUR PRESIDENT Stephen P. Delozier, president of SMI, has been working in the healthcare industry for over 20 years. Mr. Delozier began his career as a sales representative for Bristol Myers Squibb. After many years with Bristol Myers, he left the pharmaceutical industry and began managing radiology, primary care, and multi-specialty group practices. After nearly two decades of successful practice management, he, Dr. Bennett, and a few others built a national PPO Network, Devon Health Services In 2006, Mr. Delozier was promoted to president of SMI Devon Health Services, Inc. is now operating at the national level, processes over 3 billion dollars in claims and affects over 3,000,000 lives. Devon currently employs over 100 people.

23. Devon International Group