Perceptions of young adults as to the future of health care in the 21st century.

This study assessed the perceptions of the need for and quality of future health care programs of those who will be major users of medical services in the 21st century. Findings indicated that most recognize the importance of having medical coverage. While copayment costs were most important in health plan selection, less personal factors (e.g., ease of obtaining appointments) were more important than the plan's quality reputations and its physicians. Finally, few respondents thought the quality of physicians and hospitals would improve. Even fewer believed the range of services covered would be better, access to care would be easier to obtain, or that service would be more personalized. They also expect the costs of health care to escalate, and costs to have more impact on the availability of medical services.

Value of services provided by pharmaceutical companies: perceptions of physicians and pharmaceutical sales representatives.

Pharmaceutical sales representatives (PSRs) are a key component of pharmaceutical companies' marketing strategies in that they are the link between the pharmaceutical company and the physician. PSRs provide various services in order to increase the physician's prescribing activity of their companies' products. Given the high cost of recruiting, training, and supporting a PSR, it is important for PSRs to understand the relative significance physicians ascribe to services provided. This study examined whether there is a gap in the perceptions of physicians and PSRs regarding the value of specific services provided by PSRs. Physicians and PSRs who attended medical meetings were surveyed. Results of the study indicated that there were significant differences in the perceived value between PSRs and physicians. Services which were perceived to be less important to physicians than to PSRs were new product detailing, old product detailing, providing product studies and research findings, PSRs serving as expert consultants, and recruiting physicians to participate in FDA approval drug studies. Services for which there were no significant differences of perceived value between the groups included free product samples and promotional luncheons and dinners.

Alternative medicine among college students.

The use of "alternative" medicine has become increasingly popular in the United States. Books devoted to alternative medicine, e.g., Spontaneous Healing and 8 Weeks to Optimum Health, have become best sellers. Nevertheless, relatively few research studies have focused on the subject. This study examined the role of alternative medicine among college students. Issues addressed included students' familiarity with, use of, and perceptions regarding unconventional health therapies. The study substantiated a phenomenon health care providers across the country are discovering: a growing number of Americans with interest and financial resources support the development of "mainstream" alternative medicine programs. Results of the study also suggest that well-respected traditional health care organizations would not suffer reputation damage if they were to offer such programs.

Providing incentives to control health care costs and remain competitive in the marketplace: a pilot study.

Few marketplaces in the United States have been subject to as much scrutiny, and undergone as much transformation in the 1990s, as has health care. Even based on the slowest growth rates experienced in the 1980s and 1990s, the United States is projected to be spending $3,140,221 per minute on health care by the year 2000. The purpose of this study was to examine how coordination between providers of medical care, and working with their customers (i.e., payors) might reduce costs without compromising quality. Providing incentives to these groups of businesses that form the health systems can be a means for achieving both individual health system objectives. Because of the importance of pharmacists in health care delivery systems, they were considered an excellent group for testing and measuring the impact of incentive programs. The study involved a before and after six month period involving dispensing patterns through a pharmacy benefit manager. Incentives were provided to pharmacies based on percent improvement in generic substitution rates and formulary compliance. A network of 342 independent pharmacies, with their dispensing patterns monitored through a pharmacy benefit manager under its contract program. The results of the study were that generic substitution rates rose from the pre-trial period of 68.5% to 73.7% in the first three months of the trial period, and to 75.6% in the second three months of the trial period. The overall increase in substitution was from 68.5% in the base period to 74.7% over six months. These differences were statistically significant at the 0.05 level. Estimated savings to health plans on an annualized basis would be approximately $3.4 million, and the payout per conversion to pharmacies was $3.23. While not measured directly, no adverse clinical effects were reported due to substitutions. Thus, an incentive system to reward those health care providers can effectively control expenses to achieve mutually desirable goals of all parties. If properly structured, the providers, health systems of which they are a part, and payors can benefit. Using an incentive program like the one designed for this study, health systems may be able to be more competitive in marketing their services to payors.

Health care in the 21st century: marketing's role in vertically integrated delivery systems.

Health care delivery has become one of the most significant economic and political issues of the 1990s. Historical efforts to reform the system to reduce costs while providing quality care to an ever-expanding population have not proven to be satisfactory. With attempts to restructure the industry for the 21st century come important implications for the marketing of health services. This article reviews the economics of the issues, historical efforts to control costs, and activities in the 1990s to restructure the industry. From this, implications for marketing's role in an evolving health care delivery system are described.

Serving patient needs while implementing cost effectiveness programs in health care administration.

The rising costs of health care have focused administrators' attentions on controlling expenses rather than patient needs and preferences. This paper describes a method by which administrators can assess possible cost effectiveness of alternative therapies that may be preferable to patients.

Marketing to the mature population, Part 1: Evaluating the attractiveness of the mature population.

The mature population represents a major market force for the 1990s and the 21st century. Individuals age 65 and older make up a sizable percentage of the population and spend billions of dollars on health-related products and services. Despite the size and apparent attractiveness of this market, it may not be an easy one to penetrate. Pharmacists must recognize the vast differences within this group in terms of what its members want and expect from pharmacies. Only by understanding the unique attributes of the specific subgroups can pharmacists develop an effective marketing plan to serve their needs profitably. Specific marketing techniques for attracting segments of the mature population are described in Part 2.

An examination of physician use of and attitudes toward closed formulary drug programs.

Efforts to control the rising costs of drug budgets has centered primarily on the use of "closed formularies"--systems in which a set of drug products are pre-approved for dispensing to those eligible for expense coverage. Controversy, however, has surrounded these systems with respect to their effectiveness in controlling costs and their impacts on the quality of care for recipients. This study examined California physician attitudes towards the California Medicaid program's use of a closed formulary and treatment authorizations which must be obtained in order to dispense drugs not on the Medi-Cal pre-approved list. A survey of physicians focused on the extent to which they sought to use non-formulary medications, their experience with formulary products that were not their drugs of choice, and the extent to which the overall system impacted their practices. Results of the survey indicated that the closed formularly discouraged physicians from dispensing drugs of choice. Furthermore, physicians often experienced adverse or sub-therapeutic results with formulary medications that they would not have expected had they dispensed their preferred medications.

Researching the market: initial steps in designing a marketing program.

Collecting data about the marketplace is critical for designing a marketing plan. The manager needs to know what types of people are in the market, what pharmacy services they need, who the competitors are and what their strengths and weaknesses are, and where opportunities exist for creating a market niche for the pharmacy. Typically, the pharmacist collects both published and primary data and uses the information gained to position the pharmacy to better serve the needs of selected groups of patients and physicians. The February issue will discuss putting the data to use.

Branded versus generic prescription drugs: perceptions of risk, efficacy, safety, and value.

Efforts to control the increasing costs of health care have created a major market for generic prescription drugs. The authors compare perceptions of the risks, efficacy, and value for the money of various brand name and generic prescription drugs to evaluate how well they will be accepted by current and potential users.

Marketing to public-aid recipients: an examination of pharmacy profitability.

Massive purchasing power, geographic outreach and defined buying methods often make public-aid recipients an attractive target market for pharmacies. Yet one must question how profitable such a target might be. This study shows that pharmacy profit levels for public-aid recipients below those earned in marketing to the private-pay patients may result in hidden benefits.