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How can you make medical education successful and what are the many benefits?

Medical education enjoys a unique position among the many channels of communication used by pharma. It offers the opportunity to work closely with opinion leaders; it can be used to broaden understanding within the medical community; it can help medical professionals fulfil their obligations to continue their education; and it addresses everything from appropriate patient identification to off-label use. Of course, there are restrictions to this freedom.

Medical education enjoys a unique position among the many channels of communication used by pharma. It offers the opportunity to work closely with opinion leaders; it can be used to broaden understanding within the medical community; it can help medical professionals fulfil their obligations to continue their education; and it addresses everything from appropriate patient identification to off-label use. Of course, there are restrictions to this freedom. Government bodies and professional associations need to ensure that fair balance and equity are accounted for. Also, because med ed accounts for a proportion of spend from the pharmaceutical industry it is closely monitored for its cost-effectiveness.

We will discuss some of the practical considerations of medical education, particularly in regard to the measurement of success.

Opinion leaders

The importance of the opinion leaders should not be underestimated. Their impact is not limited to their audience of medical practitioners; they may prove influential across other groups, such as payors and government bodies. It is important that the choice of opinion leader is made with the message and audience in mind. Often, it may be an expert from outside the specialty that draws the most attention. For example, a diabetologist speaking to a group of cardiologists may be a more appropriate choice when discussing specific disease states. This variation can also add to the interest level in your programme. Regardless of the type of opinion leader, it is important to remember that they are one of the most valued customers for the pharmaceutical company and need to be treated with due care and attention.

Some opinion leaders have a close attachment with an organisation. These individuals are often called upon to do large quantities of work for the company. In some cases (particularly in uncrowded specialist marketplaces) this is wholly appropriate. In other instances, however, this can be a poor long-term strategy. The credibility of an opinion leader can diminish if they are seen to be too industry-friendly. The most credible opinion leader is one who is chosen purely on the basis of his specialist experience. Gauge the perception of the opinion leader through audience feedback.

Maintaining the credibility of an opinion leader is the responsibility of pharmaceutical companies, the medical education agency and the individual themselves.


When considering the topics for medical education, the first question should be, 'how relevant is the subject?' Even the most scientific data should have some relevance for the practising clinician. Historically, opinion leaders have occasionally been seen as ivory-tower doctors, interested only in large scale, tightly controlled trials and their outcomes. More recently, though, there has been more emphasis on studies with a practical element.

In most disease states, treatment guidelines exist. These are generally developed and implemented at a local level. In terms of medical education, it is important to understand the impact that these treatment guidelines will have on its specific audience. A good rule of thumb is to review the relevant guidance, find the consistent aspects and focus on these. A quick way to lose relevance is to have an audience member think, 'nice to know, but wouldn't work in my practice'. Keep things general enough to be acceptable and specific enough to be actionable.


The method of transmitting the message is never more important than the message itself, but it is important that appropriate vehicles are used. Medical education can be delivered through hard copy, web or CD-based programmes, live meetings, web-casts, audio or video recordings, circulated through periodicals or even through virtual reality settings. Choosing the appropriate vehicle will increase your likelihood of success. Multiple formats can also be very cost-effective, especially when using multiple languages or localised information. Live meetings can sometimes be recorded for further distribution, or the transcripts translated into other languages and distributed via hard or electronic copy, for example.

Live meetings have also developed with technology. The advent of wireless keypads has allowed for much greater flexibility in gaining audience interaction. Speakers can pose questions to a group then receive instant feedback. This not only enriches the data that can be derived for future purposes (such as a meeting report or journal supplement) but also makes for a more interesting experience for the audience.

The same level of interaction can be
achieved through web-based programmes, allowing for greater numbers of responses.

Gauging success

As with any investment, medical education should be measured for effectiveness. But how does one gauge success in a complicated multi-channel sales environment like pharmaceuticals? Given that sales and market share figures are an aggregation of sales force effort, marketing and advertising, peer influence, treatment guidelines and countless other factors, measuring the discreet impact of medical education can be difficult.

Direct measures should be the first port of call. Audience numbers, response rates and qualitative measures such as audience feedback should be considered. Many pharmaceutical companies use sales representative research (often called DFU, or Detail Follow Up). This can be an excellent tool for capturing the popularity of a med ed programme from the ground level.

If there is a requirement for measuring the impact on sales and market share, one needs to be careful in selecting the data that will show the most accurate impact. The following outlines some of the usefulness and pitfalls of the various market data available to pharmaceutical companies in many markets.

Gross sales (also called ex-factory sales): This is an internal measurement of sales. While this is the most important number to any product team, it is also the most difficult to use as a measurement of effectiveness. It is subject to seasonal buying cycles from wholesalers and large purchasing groups, and would not be a relevant measure for most educational programmes.

Total prescriptions: Measured at the pharmacy level, this is audited data and is available for purchase to pharmaceutical companies. This is a more responsive tool for measuring impact. It is particularly useful when comparing regional data. For example, if a medical education initiative is done in some countries or regions and not others, comparisons can be made to see incremental changes. Importantly, we need to remember that it takes time for physicians to see enough patients to move a number, such as total prescriptions. A realistic understanding of this delayed effect is required.

Prescription share: Calculated by comparing the total prescriptions for one drug with the remainder of its class. A note of caution, however, medical education is often not drug specific (particularly CME accredited courses). Therefore, you can only expect market share of a product to be impacted if the programme is highly specific to the product. Similarly to total prescriptions, there is also a time effect with market share, with a reasonable amount of time needed for patients to get through doctor's doors.

New prescription share: Calculated by separating new from repeat prescriptions. This number is particularly helpful when working in chronic therapy areas (for example, most cardiovascular, depression and asthma products). When looking at large chronic products, it is typical that 85 per cent or more of the prescriptions are repeats. New prescription share is a much more reactive measure.

With any of these 'hard metrics' of sales, it is always helpful to strive for a comparator to show any true difference that the programme may have made. Previous time periods, competitor values, and data from regions where the programme did not take place should all be used. Changes in sales force size and structure, changes in position of the product in the sales call and other programmes conducted in unison are internal factors that need to be recognised. External factors, such as competitor activity or new product launches will also show increased noise, which may make clear impact difficult to see.

Establishing measures before the start of the programme is the preferred method. Colleagues in the market research department should be called upon for their input for larger programmes, to ensure that they have the means in place for measuring return on investment.


As medical education providers, we need to thoroughly understand the end goals
of our customers. Certainly, the relationship with the opinion leader, the broadening of understanding across medical professionals and the representation of the pharmaceutical industry as a source of knowledge as well as products are key deliverables.

But medical education is changing in stature. It has grown in importance and expenditure. With this heightened profile, the people who pay for it want to know what they're getting. So, a clear understanding of return on investment is also a requirement. Regardless of the chosen measure of success, a good agency will understand the potential for impact of a programme in this area. This potential should be evaluated prior to commencing the project and used to evaluate how we are servicing our clients.

If a medical education agency can demonstrate success for the client, it demonstrates success for the programme, and its medical education services.

Benefits of medical education

  • It offers the opportunity to work closely with key opinion leaders
  • It can be used to broaden understanding within the medical community
  • It can help medical professionals fulfil their obligations to continue their education
  • It can address a wide variety of therapy areas.

Choosing your opinion leader

Keep your audience and message in mind at all times. While it may be tempting to stick with an expert who is industry friendly, always strive to attract the person with the most relevant expertise to your chosen subject. Opinion leaders who are chosen first and foremost for their specialist experience - as opposed to their long-standing relationship with a company - will always appear the most credible.

Measuring success

  • Be sure to use the most appropriate market data to measure your success. Popular choices include:
  • Direct measures, eg, audience numbers, responsive rates, feedback
  • Gross sales (also called ex-factory sales) - internal measurement of sales
  • Total prescriptions - audited dated measured at pharmacy level
  • Prescription share - total prescriptions for one drug vs remainder of its class
  • New prescription share - calculated by separating new from repeat precriptions.

Also consider:

  • Internal factors, eg, growth/restructuring of sales force, positioning of the product in the sales call
  • External factors, eg, competitor activity, new product activity.

the authors

Eric Hansen is the account director and Terry Bradley is the business development director at Ogilvy Healthworld Medical Education. They can be contacted at and

2nd September 2008


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