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ePharma: The Online Pharmaceutical Industry, 2006-2011

Table of Contents

1. Executive Summary: Online Solutions Exhibit Strong Potential in the Pharmaceutical Sector

2. Introduction: The Roles of Online Communications in the Pharmaceutical Sector are Expanding Rapidly

• 2.1  What is the Internet and How Has it Changed Commerce?
  • 2.1.1 The Internet Has Grown Rapidly in Importance, Especially Since the Mid-1990s
  • 2.1.2 Currently Over a Billion People Worldwide Use the Internet
  • 2.1.3 eCommerce Constitutes One of the Most Important Developments in the History of Business
  • 2.1.4 The Internet and Consumer Behaviour - Companies Need to Have Strong Internet Marketing Strategies
  • 2.1.5. Advertising and Placement on Search Engines Is Big Business
  • 2.1.6 Competition for Internet Site Listing via Search Engines is Fierce
  • 2.1.7 Paid Inclusion May Further Reduce the Public's Confidence in the Pharmaceutical Industry
  • 2.1.8 Online Security is Still an Important Concern Among Consumers
  • 2.1.9 The World Pharmaceutical Market Continues to  Grow, But Faces Mounting Challenges - Greater Use of Online Technology Can Contribute To Its Further Successes
• 2.2 The Sale of Pharmaceutical Products to Patients via the Internet
  • 2.2.1 Online Pharmaceutical Sales Generate Multi-billion Dollar Revenues Annually
  • 2.2.2  Consumers Seeking Lower Healthcare Costs Drive Online Pharmaceutical Sales
  • 2.2.3 Counterfeiting and Misuse of Drugs Cast a Heavy Shadow over Online Pharmaceutical Trading
  • 2.2.4 The Importation of Pharmaceuticals into the US via Parallel Trade is a Highly Controversial Issue
  • 2.2.5 Various Types of Online Pharmacies Exist - Some Act Legally, Others Illegally 
  • 2.2.6 The Regulation of Online Drug Sales is a Very Complex and Difficult Process
• 2.3 Online Patient Information and Education and Use of  The Internet as a Part of DTC Promotion of  Pharmaceuticals
  • 2.3.1 DTC Promotion Serves an Important Communicational Role in Healthcare
  • 2.3.2 A Majority of Adult Internet Users Seek Healthcare Information Online
  • 2.3.3 An FDA Survey Reveals that Most Doctors Believe that DTC Advertising Involves Patients More in their Healthcare
  • 2.3.4 A Recent Study by Yahoo! Reveals that Consumers  Seeking Medical Information Online Are Following-up That Searching With Informed Visits to Medical Practitioners
  • 2.3.5 The Internet is Ideally Suited to the Promotion of  Both Pharmaceutical Products and Health Education
  • 2.3.6 Increasing Numbers of Consumers Are Seeking Medical Information Online - While This Raises Health Awareness, There are Accompanying Dangers
  • 2.3.7 Large Amounts of Public Funding Are Spent on Heath Education - With Online Channels Being Used Increasingly
  • 2.3.8 Healthcare Companies are Also Major Providers of  Healthcare Information to the General Public, Especially That Related to the Use of Pharmaceuticals
• 2.4 Use of the Internet to Promote Pharmaceutical Products to Doctors (eDetailing)
  • 2.4.1 eDetailing Constitutes a Useful Marketing Strategy That is Possibly Not Being Used to Best Effect in Healthcare
  • 2.4.2 eDetailing Provides Potential Benefits to Both Prescribers and Healthcare Companies
• 2.5 The Use of the Internet in the Prescribing of Drugs (ePrescribing)
  • 2.5.1 ePprescribing Can Provide Greater Efficienc and Convenience to Doctors, Pharmacists and Patients
  • 2.5.2 ePrescribing Makes it Easier to Track Prescribing Trends
  • 2.5.3 Advances in Technology have Encouraged the Use of Handheld Devices
  • 2.5.4 Online Technologies Exhibit Great Potential for Benefiting the Pharmaceutical Sector

3. Use of the Internet to Facilitate DTC Promotion and Consumer Healthcare Education

• 3.1 DTC Promotional Spending on the Internet Currently Accounts for Less Than 5% of The Total DTC Budget
• 3.2  DTC Promotional Spending on the Internet is Set to  Rise to over $100m in 2011
• 3.3  SWOT Analysis of Internet Use By Consumers of Pharmaceutical Products
• 3.4 Advanced Communications Technologies Will Continue To Expand Their Presence in the Pharmaceutical Industry - Consumers Will Increasingly be Targeted
• 3.5  Acceptance by Consumers and Competition for their Attention Constitute the Principal Limitations of Advanced Communicational Technologies in Healthcare
• 3.6 The Internet is the Fastest-growing Channel in Pharmaceutical Marketing
• 3.7 A Shift in Focus from DTC Advertising in the Mass Media to That Through the Internet Will Become More Pronounced
  • 3.7.1 The Top 10 Pharmaceutical Product Sites in the US Receive Several Million Visits from Consumers Per Year
• 3.8  Pharmaceutical eMarketing Appears to be at a Turning Point - Experts Predict Significant Growth and Emphasis on That Channel
  • 3.8.1 Experts Surveyed By Visiongain Have Great Optimism for the Continuing Growth of eMarketing and  Promotion to Consumers - Underlying Factors are  Highlighted and Explained
  • 3.8.2  Success of eMarketing and Promotion Will Probably  Be Closely Linked to Revenues and Profits, Our Survey Reveals
  • 3.8.3 Calculating the Efficacy of Internet Promotion Is Difficult - But Some Healthcare Companies Have Observed Markedly Improved Performance Compared With Other Channels 
• 3.9 The Internet is an Important Component of Patient-centred Healthcare
• 3.10 eMarketing in the Pharmaceutical Industry Needs to be Taken Out of Isolation and Treated as An Integral Part of Marketing
  • 3.10.1 The Internet Requires Specialised Understanding of its Characteristics and Potential in DTC Promotions
  • 3.10.2 DTC Promotions via the Internet May Not Be Best Suited to Every Marketing Application
• 3.11 Pharmaceutical Companies Need To Ensure Internet Sites Comply With Regulations
  • 3.11.1 The FDA Recently Conducted a Public Hearing on DTC Promotion of Prescription Drugs and Other Healthcare Products
  • 3.11.2 Pharmaceutical Research and Manufacturers of  America (PhRMA) Recently Issued Guidelines for DTC Promotion
• 3.12 The Effective Naming of Pharmaceutical Internet Sites is an Important Consideration
• 3.13 The Internet Can Bridge the Gap for Consumer Education and the Communication of Risk
• 3.14 The Recent Partnership between Yahoo and Medsite Constitutes an Important Development in Internet-based Promotion of Healthcare
• 3.15 Google is Now the Top Online Searching Tool for Healthcare
• 3.16 Novartis Has Formed a Partnership with Jeeves Solutions to Optimise the Use of Branded Internet Sites
• 3.17 Presentation of Clinical Trial Information is Likely to Attract Increasing Scrutiny From Regulators
• 3.18 PhRMA Launches an Online Database to Promote Access to Free Medicine for Eligible US Patients
• 3.19  The Use of Email in Pharmaceutical Marketing is on the Rise, Despite Restraining Factors
  • 3.19.1 A Major Advantage of Email is Its Use in Individualised Marketing
  • 3.19.2 Email Marketing is Subject to Limiting Factors
  • 3.19.3 Safeguarding Personal Information and Privacy When Targeting By Email - Penalties Exist for Non-Compliance
  • 3.19.4 Compliance With HIPAA Legislation Is Vital in US eMarketing to Consumers of Healthcare
  • 3.19.5 Confusion with Internet Spam Must be Avoided in Promotional Campaigns by Email
  • 3.19.6 Permission-based Marketing via Email is Becoming Increasingly Important
  • 3.19.7 Email Communications Should Not Mislead and Should Have Administrative Support that Enables Opt-out
  • 3.19.8 There is Now Greater Integration of Email Responses with Corporate Databases - Especially CRM
  • 3.19.9 The Use of Advanced Technological Features of Email is Increasing
  • 3.19.10 Companies Are Installing Full-time Email Marketing Managers
• 3.20 The Industry Can Benefit from Online DTC Promotions - Especially Since Other DTC Channels are Decreasingly Effective

4. eDetailing and Other Use of the Internet by the Medical Profession is Set to Rise

• 4.1  Investment on eDetailing Will Continue to Rise, Despite Mixed Results to Date
• 4.2 The Numbers of Prescribers Engaging in eDetailing Will Also Increase Steadily
• 4.3 SWOT Analysis of Internet Use by Prescribing Medical Professionals
• 4.4 Advanced Communications Technologies Will Continue To Expand Their Presence in the Pharmaceutical Industry - Prescribers Will Increasingly be Targeted
• 4.5 Acceptance by Prescribers and Competition for their Attention Constitute the Principal Limitations of Advanced Communicational Technologies in Healthcare
• 4.6 While the Number of Sales Representatives Has Increased Greatly in the Past Few Years, Access to Doctors Has Become Increasingly Difficult
• 4.7 European Pharmaceutical Companies Are Set to Reduce Sales Forces, Concentrating Instead on More Sophisticated and Targeted Forms of Sales Promotion
• 4.8  Return on Investment from eDetailing Is Currently Subject to Close Scrutiny in the Industry
• 4.9 eDetailing Requires Prescribers to Change their  Practices - Companies Need to Build Trust
• 4.10 Experts Surveyed By Visiongain Agree that eDetailing Will Continue to Expand from 2006-2011
• 4.11 Pharmaceutical eMarketing in Europe Often Poses a Greater Challenge Compared With the More Homogeneous US Market
• 4.12 Technological Solutions for eDetailing have Progressed In Recent Years
  • 4.12.1 eDetailing via Interactive Online Software
  • 4.12.2 eDetailing via Video Conferencing  
  • 4.12.3  eDetailing via Medical Portals
  • 4.12.4  eHealthcare Solutions' Vertical Internet Advertising    Network is an Example of Grouped Healthcare Sites
• 4.13  Medical Portals Constitute a Promising Technology or Communications Between the Pharmaceutical Industry and Other Stakeholders in Healthcare, Especially Prescribers
• 4.14  It is Important for Companies to Determine Optimal Strategies for eDetailing - Using Appropriate Metrics is Important
  • 4.14.1 Meeting the Needs of the Target Audience in a Strategic Manner is the Best Way to Increase ROI
  • 4.14.2   It is Important to Consider the Product Life-cycle When Preparing an eDetailing Strategy
  • 4.14.3 eDetailing Should be Integrated into the CRM System of a Company
  • 4.14.4 Thinking Globally, Acting Locally Is Vital in Healthcare Marketing
  • 4.14.5  Choosing the Correct Agency to Perform eDetailing is Important
• 4.15 eDetailing Differs from the Traditional "Push" Model of Sales Promotion - This May Suit Prescribers Better
• 4.16 Prescribers are Divided Upon eDetailing as a  Preferable Form of Communication with the Pharmaceutical Industry
  • 4.16.1 Information Overload for Prescribers is a Limiting Factor of eDetailing
  • 4.16.2 eDetailing Causes Some Doctors to Decrease Prescribing of the Promoted Drug
• 4.17 Material Inducements Have Been Prominent in Driving Prescribers' Acceptance of eDetailing
  • 4.17.1 Recent Regulations Have Reduced the Use of Honoraria in eDetailing, With the US Market Particularly Affected
  • 4.17.2 Europe is More Tolerant of Honoraria in eDetailing But Poses Other Challenges for eMarketers
• 4.18 Security of Access is an Important Issue for Physician-only Internet Sites
• 4.19 The Pharmaceutical Industry Can Overcome Limitations on eDetailing Practices, Possibly in An Advantageous Manner
• 4.20  eMarketing Will Become Increasingly Important to the Pharmaceutical Industry

5. ePrescribing Now Plays an Important Role in Healthcare  Increasingly Important to the Pharmaceutical Industry

• 5.1 The Number of Prescribers Using ePrescribing is  Increasing
• 5.2 Investment in ePrescribing is Also Growing Steadily
• 5.3 Uptake of ePrescribing Increases According to the Number of Prescribers in the Medical Practice
• 5.4 Prescription Writing Constitutes One of the Largest Paper-based Processes in Healthcare
• 5.5  Administrative Benefits Drive ePrescribing, But Process Implementation Should Not Disrupt Existing Processes
• 5.6 Technology Vendors in ePrescribing Are Competing Vigorously to Meet Clients' Requirements
  • 5.6.1 Allscripts - A Brief Case Study of This Leading ePrescribing Vendor
• 5.7 Alliances of Stakeholders of ePrescribing Constitute an Important Driver of the Technology
  • 5.7.1 Caf Rx - A New Alliance to Promote and Facilitate ePrescribing in the US
• 5.8  The Uptake of ePrescribing Systems Is Occurring Only Gradually

6. Online Purchase of Pharmaceuticals Chapter is a Controversial Part of the Pharmaceutical Sector

• 6.1 The World Market for Online Drug Sales is Set to Increase Steadily from 2006-2011
• 6.2 The Online Pharmaceutical Market Will Continue To Be Heavily Overshadowed by Sales from Other Channels
• 6.3 Only a Small Proportion of US Adults Have Bought Pharmaceutical Products Online So Far - Lack of Trust is Still Prevalent
• 6.4 The Principal Drivers of Online Drug Sales Will be Rising Consumer Acceptance Due To Rising Healthcare Costs and Willingness of Suppliers to Seize Opportunities in the Market
• 6.5  The Principal Restraining Factor for Online Drug Sales Will Be Increasing Regulation
• 6.6  Consumers Point to Low Cost and Convenience As Reasons for Purchasing Drugs Online
• 6.7 "Lifestyle" Drugs Constitute Some of the Most Popular Healthcare Purchases Online
• 6.8 Online Pharmacies Differ in their Operations -Especially Policies for Releasing Drugs to Consumers
• 6.9 Many Authorities Recognise that Prescribing Drugs Over the Internet Creates Significant Health Risks
• 6.10 Illegality Continues to Plague the Online Drugs Market
  • 6.10.1 Pharmaceutical Counterfeiting is Big Business Internationally - Clamping-down on Illicit Operations is Difficult
  • 6.10.2 Mislabelled Packaging and Consumer Fraud Also Constitute Serious Problems
  • 6.10.3 FDA Operation Reveals Many Drugs Promoted as Being Canadian Supplies Originate from Other Exporting Countries
• 6.11 US Pharmaceutical Imports for Personal Use Are Predominantly Supplied by Canadian Online Pharmacies
  • 6.11.1 Canadian Online Drug Exports Increasingly Affected by Obstacles to Trade
  • 6.11.2 Some Leading Pharmaceutical Companies Attempt to Restrict Canadian Drug Exports
  • 6.11.3 Certain US States Establish Internet Sites to Direct Residents to Approved Canadian Suppliers
  • 6.11.4 The US Government Declares that Legalising Drug Importation Would Harm US Drug Development
  • 6.11.5  Canadian Authorities Increasingly Favour Restricting Pharmaceutical Exports to the US
  • 6.11.6 US Public Interest Group Offers Gratitude to Canada for Assisting the Elderly and Poor to Obtain Prescription Drugs - This Typifies Consumers' Enthusiasm for Drug Imports
• 6.12 The Rise of Domestic and Foreign Online Pharmacies Has Led to Greater Surveillance of Online Drug Sales - Especially in the US
  • 6.12.1 In the US, the FDA is the Principal Regulator of Online Pharmacies
  • 6.12.2 The FTC Also Regulates Online Drug Sales in the US
  • 6.12.3 The American Medical Association is Co-operating With the US Government to Regulate OnlinePharmacies
  • 6.12.4 EU Court of Justice Recently Upheld a Ban on Internet Prescription Drug Sales
  • 6.12.5 US Efforts to Curb Illegal Online Drug Sales Continue - Control of That Trade is Still Elusive
  • 6.12.6 Google and Yahoo Clamp-Down Heavily on Illegal Pharmaceutical Advertisements
• 6.13 The Online Supply of Drugs Holds CertainAdvantages that Must Be Weighed Against Significant Risks

7. Mobile Telecommunications Have Potential In Healthcare Similar to that of the Internet

• 7.1  Implementation of Mobile Technologies Will Prove Increasingly Useful in Healthcare
• 7.2 Tablet PCs Have Important Roles in Pharmaceutical Sales and Marketing
  • 7.2.1 Tablet PCs Have a High Degree of Practicality in eDetailing Situations 
  • 7.2.2   Microsoft Leads the Way in Software for Tablet PCs
• 7.3  eDetailing and Other Healthcare Communications   are Now Possible via Mobile Phones and PDAs
• 7.4  Dendrite International Became a Supplier of Custom Mobile Technology to Merck & Co.
• 7.5  eDetailing via iDTV is Another Innovation That is Being Proposed
• 7.6  There Are Many Hypothetical Applications That Could Potentially Be Used With Portable Hand-held Devices
• 7.7  Visiongain Concludes that Mobile Technologies Have Manifold Uses In Healthcare

8. Conclusions Use of Electronic Solutions Will Benefit the Pharmaceutical Sector in an Incremental Manner

8.1  Growth of the Internet Drives eCommerce

• 8.2  eMarketing to Consumers is Vital Now That DTC Promotions Via Television Are Out of Favour
• 8.3 eDetailing Will Compensate for Decreasing Returns on Traditional Sales Promotions to Medical Professionals
• 8.4 ePrescribing Promises Further Efficiencies in Healthcare Systems - Provided Acceptance by Users and Payers is High Enough
• 8.5 Sale of Drugs Via the Internet Causes Much Controversy
• 8.6 Mobile Communications Are Relevant to Modern Healthcare

List of Tables

Table 2.1 Estimated Numbers of Internet Users by  Country, 2006

Table 2.2 The Main Components of the eEnvironment in Business

Table 2.3 Revenue Generation ($bn) by the World Pharmaceutical Industry, 1999-2005

Table 2.4 The Proportion of Consumers Seeking Healthcare Information Online in the US, 2004

Table 3.1 Worldwide Spending ($m) on DTC Advertising by Channel and Share (%) of Budget, 2005

Table 3.2  Spending ($m) on DTC Promotion via the Internet, 2005-2011

Table 3.3 A SWOT Chart for the Use of Online Technologies by Consumers of Pharmaceutical Products, 2006-2011

Table 3.4 Predicted Trends in DTC Marketing

Table 3.5 Typical Exposure Time of a Healthcare Brand Through Various Promotional Channels

Table 4.1  Forecasted Spending ($m) on eDetailing Worldwide by Pharmaceutical Companies, 2006-2011

Table 4.2  The Forecasted Number of Prescribing Medical Professionals Participating in eDetailing Worldwide, 2006-2011

Table 4.3 A SWOT Chart for the Use of Online Technologies by Prescribing Medical Professionals, 2006-2011

Table 5.1 The Proportion of Prescribing MedicalProfessionals Using ePrescribing Worldwide, 2005-2011

Table 5.2 Value ($bn) of the World Market for ePrescribing Technology Solutions, 2005-2011

Table 6.1 The World Online Drug Market ($bn), 2005-2011

Table 6.2 World Online Drug Sales ($bn) Compared With Sales from All Other Channels Combined, 2005

Table 6.3 Prominent International Online Pharmacies

Table 6.4 Canadian Pharmaceutical Exports to the US($m), 2005-2011

List of Figures

Figure 1.1  An Overview of the Online Pharmaceutical  Industry

Figure 2.1  Estimated Numbers of Internet Users by  Country, 2006

Figure 2.2  Estimated Share (%) of Internet Use by  Country, 2006

Figure 2.3  Estimated Use of The Internet by Application, 2006

Figure 2.4  The eEnvironment With Its Commercial Sub-components

Figure 2.5  Revenue Generation ($bn) by the World Pharmaceutical Industry, 1999-2005

Figure 2.6  Top 10 Companies for Total DTC Advertising Expenditure ($m), 2005

Figure 3.1  Worldwide Spending ($m) on DTC Advertising by Channel, 2005

Figure 3.2  Worldwide Share (%) of DTC Advertising Budget by Channel, 2005

Figure 3.3 Spending ($m) on DTC Promotion via the Internet, 2005-2011

Figure 3.4 Drivers of Patient-centred Healthcare

Figure 4.1  Forecasted Spending ($m) on eDetailing Worldwide by Pharmaceutical Companies, 2006-2011

Figure 4.2  Spending (%) on eDetailing Worldwide by Pharmaceutical Companies Compared With That of Traditional Detailing, 2005

Figure 4.3  The Estimated Number of Prescribing Medical Professionals Participating in eDetailing Worldwide, 2001-2005

Figure 4.4  The Forecasted Number of Prescribing Medical Professionals Participating in eDetailing Worldwide, 2006-2011

Figure 4.5,Investment in eDetailing Through the Product Life-Cycle

Figure 4.6  eDetailing as Part of a PharmaceuticalCompany's CRM System

Figure 5.1  The Proportion of Prescribing Medical Professionals Using ePrescribing  Worldwide, 2005-2011

Figure 5.2  Value ($bn) of the World Market for ePrescribing Technology Solutions, 2005-2011

Figure 5.3  Proportion (%) of Prescribers Using ePrescribing Increases With Number in a Medical Practice, 2006

Figure 5.4 Main Features Available in ePrescribing Systems

Figure 6.1 The World Online Drug Market ($bn), 2005-2011

Figure 6.2  World Online Drug Sales (%) Compared With Sales from All Other Channels Combined, 2005

Figure 6.3  Canadian Pharmaceutical Exports ($m) to the US, 2005-2011

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