The Road Less Traveled

Actelion Pharmaceuticals’ Sure Steps program diverges from traditional loyalty marketing tactics

April 2007 By Amy Syracuse

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Widespread misperceptions, the complicated nature of treatments and the gravity of the disease itself underscored the issues Actelion needed to address in its customer communications. These issues also helped crystallize the Sure Steps theme. “To tell a patient they have a chronic life-threatening disease is a very gentle process and can’t be explained in a quick doctor’s visit,” Grossman stresses. “It needs to be explained one step at a time. We’ve created our program based on that [idea].”

A Pathway of Support

Launched on Oct. 1, 2006, Sure Steps offers PAH patients a “pathway of support.” It provides resources and information about PAH and the Tracleer treatment via phone, direct mail, the Web and in-office patient education packages.

Timing is of utmost important to the program. By taking the view that Sure Steps is a partner on a Tracleer patient’s journey to improved health and quality of life, Actelion strives to deliver the right information to the right patient at the right time across multiple channels. Patients are segmented and receive communications customized to their stage of treatment. A relatively high percentage of communications is concentrated in the two months following program registration.

“We’ve learned that the first eight weeks are critical to helping patients have the right outlook on their future,” says Grossman. “Because we know the time frame during which the patient has been on the drug and diagnosed, we can tailor information for that.”

Program messaging largely focuses on inspiration and empowerment. “It’s a source of ongoing support for patients, designed to remind them of the optimism that can be found in everyday accomplishments,” says Jay Bolling, president of Roska Healthcare Advertising, a specialized division of Roska Direct.

Content ranges from the educational—background on PAH that can be shared with friends and family to explanations of medical testing requirements while undergoing treatment—to the emotional—inspirational quotes on living life to the fullest and upbeat images of active adults. And, above all, Sure Steps materials are designed to be as relevant, easy-to-understand and accessible as possible. “We try to stay away from being this huge educational library that becomes daunting for patients,” Bolling continues. “It’s very much a support environment.”

The First Step

From the beginning, Actelion knew that the key to a positive patient experience was starting the treatment journey on the right foot. That meant making the right impression at the very first exposure—before the patient left the doctor’s office. To meet this need, the company developed a robust in-office element to Sure Steps, enlisting the aid of prescribing physicians and Actelion’s own sales force.

Most customers are introduced to Tracleer and the Sure Steps program through an Actelion-produced information kit given to them by their doctors. Among the materials included in the kit are fact sheets and frequently asked questions, a Sure Steps brochure with registration details, and a graphical representation of what takes place inside PAH patients’ bodies. The latter is designed to be interactive; physicians can write on it to demonstrate the individual’s current state and the disease’s typical progression.

Behind the scenes, Actelion’s sales representatives are charged with providing Actelion’s prescribers with the kits, fielding questions about how materials should be used and providing physician and nurse feedback to Actelion’s marketing department.

“We work closely with the representatives … training them, getting their feedback and developing materials they can sell as complementary to the brand itself,” Bolling says. “We get them engaged and they engage the health care professionals … so it’s not something that’s going to get relegated to a [physician’s] sample closet.”

The in-office kits are vital to the program’s success not only because they provide a comprehensive introduction, but also because they help improve the quality of patient-physician interactions. “The more positive the relationship with the physician and the more comfortable the patient feels coming out of the office, the more likely they are to remain on therapy,” Bolling explains.

As an added bonus, some physicians like the benefits of the program so much that they send out personal letters to their PAH patients, encouraging them to sign up for Sure Steps. “The response rates we see out of that are tremendous; it’s really a team effort,” says Grossman.

A Robust Data Infrastructure

As part of the Sure Steps enrollment process, Actelion has developed a HIPAA release form that is compliant with privacy regulations in all 50 states. Patients must complete the form to authorize the company to disclose their health information to program representatives and third-party providers involved with the implementation of Sure Steps. Of note, the HIPAA release is available in a written version, as well as a verbal version delivered over the phone that can be inventoried and archived.

Once a patient has accepted the HIPAA release and opted in, Actelion’s database marketing systems kick in. The company has married its Sure Steps marketing database with the FDA-mandated patient registry database. Accordingly, when patients register, a data transfer process checks the registrant’s information against Actelion’s registry database, verifies it and sends it back, along with details about the patient’s prescription status.

“We know whether the patient has been enrolled in the Tracleer Access Program [to manage prescriptions], whether or not they’ve received shipment, whether they have discontinued therapy or not received shipment,” says Bolling. “We can customize the program according to that information.”

Since the Sure Steps program is an exclusive benefit for Tracleer patients, the data transfer process also allows Actelion to identify Sure Steps applicants who are not Tracleer patients. “We can send these individuals a communication encouraging them to talk with their physician about Tracleer and letting them know that they need to be on Tracleer to receive the benefits of the Sure Steps program,” Bolling adds.

Giving Patients Options

Sure Steps offers patients a selection of media resources so they can choose the ones with which they feel most comfortable. According to Pablo Przygoda, Tracleer product manager, this helps maximize the program’s reach. “Every patient has a different comfort level with reading mail versus talking with someone on the phone versus searching on the Internet,” he explains. “If we had worked through one channel, we would have only been able to reach a small percentage of our patients.”

Typically, participants receive a welcome mailing shortly after signing up. This communication is followed by a phone call from a dedicated nurse counselor assigned to the patient.

No ordinary call center representatives, Sure Steps’ nurse counselors lend a highly personal feel to the program, giving patients an alternative to busy doctor’s offices when they have questions about Sure Steps materials. All nurse counselors are registered nurses, who have undergone intensive product, program and disease-state training specifically for the program. These professionals help manage patients’ expectations, provide reassurance or clarification about treatment, and refer patients back to their health care professionals as appropriate.

Every effort is made to build relationships between patients and their nurse counselors. Nurse counselors handle both outbound and inbound calls, but the majority of outbound calls are made to patients in the first two months of the program. As a relationship develops between the patient and nurse counselor, patients feel more comfortable and empowered to call in when they have specific needs, Grossman says.

For this reason, consistency is essential. “Once a nurse counselor has spoken to a specific patient, we try to have the same nurse counselor make outbound calls to that patient,” Bolling adds. “Patients are given their nurse counselors’ names during the initial contacts and encouraged to ask for [that individual] when they call in. If a particular nurse counselor is not available, the patient is offered the opportunity to receive a call back or to speak with a different nurse counselor immediately.”

Simultaneously, patients receive direct mail pieces customized to their stage of treatment. These may include inspirational material, information about therapeutic benchmarks and booklets containing practical advice. Actelion also has developed tools and resources designed to facilitate patient-physician interactions and make doctor’s office visits more productive. For instance, the “My Sure Steps Organizer” offers a convenient way to archive illness-related information, while the “My Sure Steps Journal” enables patients to track symptoms. The idea is not only to educate patients, explains Bolling, but also to encourage them to convert education to action and remain dedicated to their Tracleer treatment.

Finally, 24/7 information access is available to patients at www.Tracleer.com. “On the Web site, as with the program, we try to direct patients to the information that’s most relevant to them,” says Bolling. Web content has been segmented into four distinct categories for easy navigation: patients not yet diagnosed with PAH, newly diagnosed patients, existing Tracleer patients and health care providers.



Landmark Achievements

In the first two months of its existence, more than 10 percent of Tracleer patients enrolled in the Sure Steps program. Even with such a high rate of early adopters, Actelion expects enrollment rates to continue to grow.

At this early stage, the company is still conducting research into the program’s impact on persistency curves of patients. But, anecdotally, reviews have been positive. “We’ve gotten good feedback from the people who’ve touched the program: our sales force, our physicians, our nurses and our patients,” says Grossman. “Also, patient organizations like the Scleroderma Foundation and the PAH Association have helped create awareness because they are very supportive of Sure Steps.”

Przygoda calls Sure Steps a “true win-win” scenario. “Patients benefit with useful tools, information and resources so they can better cope with their disease,” he says. Meanwhile, “because we’ve helped patients, [Sure Steps] also assists the nurses and physicians, who consistently have told us that the initial diagnosis and treatment decision discussion are extremely difficult.”

Importantly, the program has been a boon to Actelion’s overall business. “It has helped to … build a stronger relationship with key customers, including physician prescribers, office staff and patients,” says John Marino, Actelion’s vice president of U.S. Marketing.

Down the road, Actelion plans to expand the Sure Steps program by introducing Spanish-language materials, producing an educational patient DVD and developing more prescriber resources. But the company will remain true to the lessons it has learned along its own Sure Steps journey.

“The most important thing is filling the gap in information and supporting patients where we know there are reasons for them to drop off,” says Grossman. “We want our patients to be satisfied with Tracleer and the services they’re getting with it, so they remain on the drug longer and have better outcomes themselves.”

Amy Syracuse is a London-based freelance writer.

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