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Navigating the New Health Economy

Paul Holmes 07 May 2005

The discussion over behavioral medication use by children has grown from a slight murmur into a full-fledged roar. Clinical organizations, consumer groups and pharmaceutical manufacturers find themselves embroiled in disputes over the safety and necessity of medications to treat behavioral conditions in children. Legislative entities have immersed themselves in the debate and have recently taken action – specifically on the use of antidepressants by children - to bring clarity to an area of prescription healthcare that had gone largely unnoticed until recently.

With the debate over behavioral medication use among children surging, Medco Health Solutions, the nation’s leading pharmacy benefit manager (PBM) serving 60 million Americans, saw an opportunity to own the national spotlight to support its series of Drug Trend client meetings – the most important client events of the year – and reach its primary purchaser – the benefit manager - by tapping into the highly charged debate and highlighting its ability to identify the prescription trends that affect the cost of prescription healthcare.

The effort became one of Medco biggest PR successes, generating more than 950 branded stories to date, totaling more than 156 million media impressions, including nine national wire stories, two USA Today features, two New York Times features, two Wall Street Journal stories and a feature in US News & World Report. Nearly 450 stories occurred in a 24-hour period, generating a national buzz for Medco and establishing the company as “the knowledge source” for its clients.

Coyne PR challenges included: the business environment around the PBM industry was still thick with scrutiny from government sources and media, a survey of Medco clients found that benefit managers – the primary purchaser of PBM services - viewed PBM brands as virtually identical, and there was no differentiation among the four leading PBMs and strategic communications were needed to stretch a limited PR budget over a six-month period.

The primary objectives of the effort were to communicate Medco’s industry leadership through its ability to identify the trends shaping the use of prescription medications; and stimulate a “Medco media buzz” around its spring Drug Trend Symposium and its fall Best Practices Workshops by owning “news of the day.”

Research included: daily monitoring of legislative and clinical attention on behavioral medication use in children beginning in fall 2003, including the Food & Drug Administration’s public health advisory linking pediatric antidepressant use to suicidal tendencies, an exhaustive internal analysis of pediatric patient prescription data from the more than 550 million prescription transactions Medco managed in 2003 to identify pediatric behavioral medication use. Among the more striking findings were that spending for behavioral medications in children rose 77 percent between 2000 and 2003, overtaking antibiotics and asthma.

Spending on medications primarily used to treat attention deficit/hyperactivity disorder (ADHD) increased by 183 percent for children overall, and by 369 percent increase for children under age 5; spending on antidepressants for children grew 25 percent, and use rose 27 percent between 2000 and 2003; and use of antipsychotic medications used to treat severe behavioral conditions increased by more than 60 percent from 2000 to 2003, while spending rose 142 percent in the pediatric group, a specific antidepressant analysis in response to the FDA’s fall 2004 formal warnings about the use of antidepressants in children.

To maximize regional impact, the team additionally looked into localized data when warranted, review of numerous published clinical studies and research including the U.S National Ambulatory Medical Care Survey, and position statements on pediatric behavioral conditions and treatment from leading clinical organizations including the American Academy of Pediatrics, the American Psychiatric Association, the American Academy of Child and Adolescent Psychiatry and the National Institute of Mental Health.

The team ultimately secured the participation of the American Academy of Pediatrics, represented by the Academy’s president, Dr. Carden Johnston, to support the behavioral medication report data and serve as a spokesperson and daily audits of media coverage of prescription healthcare and pediatric behavioral conditions, noting specific reporters, story tone, and quoted sources to turn to for additional support.

The program’s strategy centered on three main pillars: leverage the vast prescription usage data Medco holds to issue two compelling national analyses on the use and cost of behavioral medication use in children; secure clinical support and participation by a credible organization to comment on the report’s implications; and roll out a strategic media relations plan that used key media opinion leaders to drive the story nationwide around Medco’s spring client Symposium, and produce an additional spike in coverage around its fall workshops

Coyne PR secured embargoed advances with key national media including the Associated Press, the New York Times, USA Today, Reuters, the Wall Street Journal and United Press International to break the Medco report leading into Medco’s May Symposium, secured a national broadcast exclusive on the CBS Early Show with Dr. Carden Johnston of the American Academy of Pediatrics, breaking the news of the report in the broadcast channel, arranged a 20-city satellite media tour and 20-city radio media tour to drive broadcast coverage in local markets, pursued heavy “day of” pitching on the morning of the report release to key drive time national radio networks, rolled out a nationwide “breaking news” overnight report distribution to business editors and healthcare industry reporters at the top 100 daily newspapers, supported by intensive hand-to-hand pitching, extended media outreach to 125 key vertical trades to continue to momentum, developed and distributed an on-site Symposium publication called “Solutions” reporting the release of the behavioral data in a journalistic fashion, and distributed to each event attendee and created a mass direct-to-client e-mail communication featuring the report and major media coverage for those clients not in attendance

The firm also secured an exclusive advance with the New York Times breaking the detailed report on antidepressant use by children, offered to USA Today a customized report on antidepressant use based upon the parameters the reporter set, which resulted in a feature story on the issue, Heavy “day of” pitching of the report to targeted daily business media including AP, the Wall Street Journal and Bloomberg, deskside media interviews for Dr. Carden Johnston with AP, and key national parenting publications Parenting magazine, Baby Talk magazine and Parents magazine in the New York market, targeted regional business media pitching to Bloomberg, Crain’s publications and Investors Business Dailyand an audio news release in Chicago securing 90 broadcasts in the Chicago market alone

As of October 2004, the media results were judged as nothing but stellar by Medco Public Affairs executives. The team successfully stole the national spotlight as a reputable “knowledge source” on the topic of behavioral medication use in children and created more than an industry buzz.

The campaign has generated more than 877 branded stories to date totaling more than 140 million media impressions, this year’s media impressions tripled that of the campaign around Medco’s 2003 Drug Trend coverage, and the number of stories increased 347 percent, Medco owned the national healthcare story of the day on the first day of its spring Symposium; nearly 450 stories occurred in a 24-hour period, ensuring that benefit managers across the country received the Medco message, Medco established a position of value, resource and authority with key national media opinion leaders with nine national wire stories, two USA Today features, two New York Times features, two Wall Street Journal stories and a feature in US News & World Report; additional requests for customized data reports have been received from 10 of the top 25 daily newspapers, the team extended the news with a broadcast advance on the CBS Early Show, and multiple branded segments on CNN, MSNBC, NPR, Good Day Live, CBS Radio Network, contributing to more than 150 broadcast segments, the effort garnered significant national and regional coverage in key business publications including features by Bloomberg, Dow Jones News, Crain’s New York Business, Crain’s Chicago Business and Investors Business Daily.

The team drove the Medco message into local markets with branded stories in 74 of the top 100 newspapers and as a testament to the validity of Medco’s report and the value the company brings in terms of the vast data resources it holds, Medco has received invitations to collaborate on detailed studies with Columbia University and the American Academy of Pediatrics.

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