Company: Actelion Pharmaceuticals US, Inc.
Contact: Pablo Przygoda, Patient Initiative Product Manager
Location: San Francisco
Industry: Pharmaceuticals, B2C
Annual revenue: $1,200,000,000
Number of employees: 1500

Quick Read:

Actelion Pharmaceuticals' Tracleer product won US approval in 2001 as the first oral treatment for pulmonary arterial hypertension (PAH), a complex illness that isn't well known among doctors, and difficult for patients to understand as a result. Tracleer helps patients control the symptoms of PAH, but it has a drawbacks of its own, including slow and gradual results, monthly blood test requirements and myriad side effects.

Faced with high patient-dropout rates in the years that followed Tracleer's release, Actelion Pharmaceuticals delved into market research and learned that it was not competing against other PAH therapy brands, which faced similar challenges. Rather, it was battling patient perceptions and expectations, which were causing patients to stop therapy before beneficial effects could be achieved.

"When we realized that, we decided to fill in the gap with patient education," said Pablo Przygoda, patient initiative product manager for Actelion Pharmaceuticals' US subsidiary.

By helping patients understand what to expect and providing them with a variety of support tools, the company succeeded in increasing therapy persistency among US patients by 20%. That helped boost US demand for the drug in 2007, when Tracleer sales grew 31% worldwide.

The Challenge:

There is no cure for pulmonary arterial hypertension (PAH) - or continuous high blood pressure in the pulmonary artery. Though Actelion Pharmaceuticals' Tracleer has proven effective in managing PAH symptoms, the benefits typically take two to three months to be realized.

In the meantime, patients often suffer from a variety of side effects, ranging from headaches, hot flashes, rashes, and low blood pressure to more serious issues such as liver damage. Treatment also necessitates monthly blood tests, which can also dishearten patients. As a consequence, many patients stop taking Tracleer within the first three months of treatment.

With the help of Montgomeryville, PA-based Roska Healthcare Advertising, which specializes in marketing niche healthcare products, Actelion sought to develop a free support program that would...

1.  Help patients understand and manage their disease
2. Set realistic expectations for patients
3. Forge relationships with patients and foster their trust
4.  Maximize patient success with the Tracleer therapy
5. Increase patients' staying power and commitment to the therapy

The Campaign:

Launched at the end of 2006, Actelion's "Sure Steps" program attempted a new breed of direct-to-patient communication using multiple channels:

• Physician-provided materials: Actelion aimed to initiate patient education and encourage program enrollment the moment patients were prescribed Tracleer. Physicians were supplied with in-office materials designed to inform and prompt ongoing conversation about PAH. These included detailed brochures explaining the illness, program, and treatment, along with an interactive DVD and patient journal.
• Multi-wave, tailored direct mail: Actelion identified patient segments based on the length of involvement in the program, and then developed a series of direct mail pieces targeting each phase of treatment so that all patients received information that was timely and directly related to their level of experience in the program. New patients received mailings on a weekly basis to help guide them through the grueling first three months; after that, patients received quarterly mailings.
• Live support: Fifteen nurse counselors specially trained to answer questions about the program, therapy, and the disease were available five days a week to provide one-on-one support and help patients work more effectively with their physicians. "The nurse counselors have been particularly instrumental in giving patients hope and emotional support," said Przygoda.
• A patient-centric Web site: The Tracleer Web site was redesigned so that 80% of the homepage was devoted to patient-related information, driving home the company's emphasis on patient support. An additional Web site dedicated solely to the Sure Steps program was also created to encourage patients to enroll in the program and access its support services.

All communications were designed to engage patients while promoting acceptance and action. "We tailor the messages to let patients know that they are not alone, to explain what they can expect from the therapy, and to make sure they understand the importance of doing the monthly lab tests," said Przygoda.

Actelion also regularly surveyed patients to garner feedback and determine new ways it could continue to add value for its patients. Based on comments it has received, Actelion will soon add webcasts that allow patients to directly interact with highly recognized specialists in the field.

The Results:

Since its implementation more than a year ago, the multi-faceted educational program has resulted in a 20% increase in therapy persistency among patients enrolled in the program.

About 90% of patients polled said they were satisfied with the Sure Steps program, and 89% agreed that it's helped them better understand PAH and the Tracleer treatment, proving that well designed customer-focused programs can increase both patient satisfaction and brand sales.

"Once we build that relationship of trust and they understand the treatment, patient persistency increases dramatically," said Przygoda.

While direct contact with the nurse counselors is largely considered the best feature of the program, 80% of enrolled patients agreed that all channels are useful and make the nurse counselors more effective.

About 40% of Tracleer patients are enrolled in the program, which bests the industry average of 5%-15% for patient support programs. Przygoda acknowledged that such a high participation rate is due in part to how sick these patients are, but he said he also believes it is because of the quality of the program and the level of awareness the company has achieved.

The program has been successful in positioning Actelion Pharmaceuticals as more than a product provider—as a company that also supports and cares for its patients. Such a stature continues to strengthen the company's sales efforts in the US.

Parent company Actelion Ltd. Released its preliminary 2007 financial results last week (Jan. 21), saying global revenues rose 39%. It singled out Tracleer: "This performance is the result of strong product sales, driven by Tracleer." Global sales of Tracleer rose 31% last year, it said.

Lessons Learned:

• Use a multi-touch approach. Actelion established relationships with patients from day one, in the physician's office, and then followed through with regular communication by phone, mail, and the internet. This execution allowed for better reach, frequency and customization, which resonated with patients and helped to keep them on track.
• Offer human compassion. Providing live contact with nurse counselors made for a larger investment, but it also gave patients what they needed: empathy and an open ear. And it paid off with patient satisfaction and persistency in the program. It also helped establish Actelion as a company with a heart.
• Amplify your success. Actelion found that it could expand the Sure Steps program to other brands once it understood the barriers to patient adherence and identified effective ways for rectifying them. It is beginning to offer similar services to patients using Ventavis, an inhalation therapy also for the treatment of PAH, and is confident that the program will be similarly endorsed by Ventavis patients.

Related Links:

• SureSteps program (www.actelionsuresteps.com)
• Tracleer (www.tracleer.com)
• Actelion Pharmaceuticals (www.actelion.com)
• Roska Healthcare Advertising (www.roskahealthcare.com)

Note: 2007 revenue and employee numbers are for parent company Actelion Ltd. of Switzerland.