Monthly Archives February 2013

Your Critical KOL Identification and Mapping Questions: Answered

Over the past decade we have worked with leading pharmaceutical and medical device companies around the world to identify and map the key opinion leaders (KOL) that best fit their particular needs and objectives. Over time we have heard a variety of questions ranging from why they should perform KOL Identification and Mapping to how best to do it. We thought we might provide some answers and insights to these commonly asked questions. Our sincere hope is that this provides you a solid framework to discuss KOL Identification and Mapping with your colleagues.

  1. Why Undertake KOL Identification and Mapping? Snowfish recently conducted a large survey involving over 200 physicians. When asked, “what factors are the most important if your treatment selection?” the most important factor was clinical trial data. Given the unalterable nature of clinical data it is the hand you are dealt. The second most important factor, and one which a company has full control over, is KOLs. Over the past decade we have shown companies how influence is really concentrated in the hands of 1 to 2 % of the healthcare practitioners while 50% of the market has zero influence. Another noteworthy point is that our survey pointed out that KOL is not synonymous with peer; recommendation from peers (not KOLs) was designated as least important.
  2. How Can I Use the Results From a KOL Identification and Mapping Project? We have most often implemented KOL identification and mapping projects on behalf of the Medical Affairs and Marketing departments. The results are used in a variety of activities; developing advocates, establishing medical science liaison (MSL) regions, identifying speakers and advisory board members, determining with whom to collaborate on medical communications programs, and understanding the interrelationships with healthcare practitioners within the market. Effective profiling performed as part of the identification and mapping will facilitate successful use of the results.
  3. Are Rx Volumes, ICD-9 or CPT Codes a Good Proxy for Identifying KOLs? Our research is that prescription, diagnostic, or procedure volume is probably one of the worst proxies for identifying KOLs. The general characteristics of a KOL is a very well rounded individual who is conducting research, publishing articles, speaking at major events, and being in a leadership role at major associations along with seeing patients,. The multitude of demands on a KOL’s time attenuates their ability to evaluate and diagnose the bulk of patients. The only exception is in the case of orphan conditions and still, these measures should not be used in isolation.
  4. To Compare the Cost of a KOL Identification & Mapping Can I Simply Divide the Number of KOLs Profiled by the Cost of the Project? Unfortunately it is not that easy. Advanced KOL identification and mapping involves the integration of dozens of data sources, unique profiling, and a clear understanding the product’s objectives. The number of sources used, the level of manual data review, and the number of KOLs identified and profiled and the clinical experience of the team are all major factors that go into the pricing of the project. Quite simply, having been hired to fix faulty KOL mappings, the value of each KOL is driven by the robustness of the data and insights behind them.
  5. How Long Does a KOL Identification Mapping Take? Doing a proper KOL identification and mapping projects takes time and thought. We strongly advise against using a cookie cutter approach. Our experience has been that a well done project usually takes approximately 10 to 12 weeks. Given the importance of KOL identification and mapping, plan ahead for the project and make sure that the time it takes to do the project properly is included in your planning.

In the coming weeks we will identify other frequently asked questions we regularly hear from our clients at the outset. KOL identification and mapping is a very important activity. As we’ve documented, it probably is the most important activity that is fully within the scope of control of a company. KOLs drive awareness, understanding, and adoption of a product. It is hard to envision anything as more important once a product has been developed.

We welcome your questions, thoughts and opinions about this article. If you have any questions please feel free to contact Audrie Bloom at Snowfish, (561)-694-1205 or at

Posted by Dave Fishman  |  1 Comment  |  in Management Consulting

Is the Physician Payment Sunshine Act Super for Physicians?

The power of Sunshine Superman and Green Lantern as Donovan penned in his ageless song from 1966 undoubtedly has nothing to do with section 6002 of the Affordable Care Act of 2010, aka, the “Physician Payment Sunshine Act”. Nonetheless, this statute potentially wields some muscle of its own. This provision mandates that any company that markets a pharmaceutical, biological, medical device or medical equipment report all payments to physicians and teaching hospitals of over $10 or such equivalents to the Department of Health and Human Services who will then make this information publically available via a website. Realistically speaking, this includes anything from a pizza lunch to funding for a large clinical trial.

The mere mention of the Physician Payment Sunshine Act fuels extremely strong opinion, on both sides of the argument. On one hand, groups such as the Pew Health Group have actively been calling for such transparency. They feel that such financial relationships between industry and health care professionals may likely result in conflict of interest directly impacting patient care decisions. On the opposing side it has been asserted that such a measure poses significant risk to innovation as the valuable collaboration between industry and physicians may be tempered.

We decided to evaluate the Physician Payment Sunshine Act from one perspective, that of prominent physicians. We often engage physician experts in order to assist us with analysis of products and services for life-science companies. Over the years we have literally worked with thousands of physicians and other health care providers. Therefore, understanding their views of this mandate is of great interest to us.

In an effort to get a diverse physician understanding of the multifaceted nature of the issue we spoke with fifty physicians from across the United States. We asked them three basic questions around the Physician Payment Sunshine Act:

  1. Are you familiar with the Physician Payment Sunshine Act?
  2. Do you feel it is good for medicine?
  3. How do you think it will impact your interactions with life science companies moving forward?

Not surprisingly, the first question, are you familiar with the Physician Payment Sunshine Act generated almost universal awareness. In fact, fifty out of fifty physicians were aware of the Act.

The second question around whether the Physician Payment Sunshine Act was good for medicine was far more nuanced. Overall, 28% (14 out of 50) of physicians thought that the Physician Payment Sunshine Act was good for medicine. We received multiple comments from physicians. A typical comment from the Act’s supporters, “I have no problem with it; most patients are not going to look at it; transparency is important.” Several physicians also commented on the potential for undue influence of money with comments such as, “if someone has received a lot of money from pharma that may influence their decisions” which is exactly what the Act is meant to address.

There was also a relatively large undecided camp which represented 36% (18 out of 50) physicians. In general, this group of individuals thought the spirit of the act was correct but the implementation of the act is flawed. One physician commenting on the Act stated the pros and cons as follows, “the pro is that individuals receiving large payments make you wonder if they are using products because they are good for patients or the payments they are receiving. The con is that every little gift gets reported which is too much.” Another physician commented that, “I’m on the fence – does it help or hurt, it is far from clear.”

An equally large group as the undecided group, 36% (18 out of 50) physicians, thought the Physician Payment Sunshine Act was bad for medicine. In general, physicians were quite concerned about the misperception that Physician Payment Sunshine Act may generate. Our physician sample voiced multiple comments about the high cost of conducting clinical trials how this level of funding might affect public perceptions. As one physician noted, “I understand the spirit of it, but the public will have a difficult time understanding it”. Another remarked that “doctors work in different capacities; if I do a research study, the budget for it may be $750M the public may misperceive where and how that money came about and what I personally received.” Several physicians commented on the Act’s potential to limit educational opportunities by casting “a stigma that limits education which is bad for medicine.”

Last but not least, we learned that the Physician Payment Sunshine Act will likely have little bearing the interactions between leading physicians and the life sciences industry moving forward. Of the physicians with whom we spoke, 76% (38 out of 50) thought it would not affect their interactions with life sciences companies. A number of dissenters felt that the Act would impede the ability to have open dialogue with the industry, “it gets in the way of the conversation between the physicians and industry.”

While 72% of the leading physicians with whom we spoke are either neutral or negative on the Physician Payment Sunshine Act, the positive news is that the vast majority will maintain their current level of interaction with industry. This implies minimal impact of this mandate on research, educational opportunities and overall innovation. Indeed physicians in general support transparency in medicine and other professions. The devil is how to assess those interactions and ensure that the required reporting paint a true picture.
Dave Fishman is President of Snowfish, a strategy consulting firm focused exclusively in the life sciences industry.

We welcome your comments!

Posted by Dave Fishman  |  Comments Off on Is the Physician Payment Sunshine Act Super for Physicians?  |  in Management Consulting