Drug Marketing Analysis

Part
01
of nine
Part
01

Otezla & Enbrel

Although these products have a presence in Canada, Otezla and Enbrel do not market to their Canadian consumers and this is significantly due to the country's regulations. However, the products are sold to Canadian consumers via online, different packaging, and third-party sales.

Otezla

Enbrel

Research Strategy

We started our findings by looking through available marketing to Canadian consumers by Otezla and Enbrel by looking through the products' and the manufacturers' websites. After combing through the websites, including the media, support, and review pages, we couldn't find any information to suggest there was marketing to Canadian consumers. On Celgene (manufacturer and distributor of Otezla), its Canadian website, the product has no website of its own. But there is a website for US audiences only.

Secondly, we looked through third-party marketers like Amgen and online pharmaceutical retailers like Canada Pharmacy Online and Canada Drugs Direct. The intent here was to find out if Otezla and Enbrel are marketed to Canadian consumers. Although Amgen has a dedicated Canadian website, there was nothing to suggest marketing of either product to Canadian consumers. On its approved webpage for approved products in Canada, the company acknowledged that the existence of Canadian regulations put a limit on "the amount and scope of information" it can provide. The public is advised to consult with qualified health professionals for more information. Nothing on its media page is also indicative of the products' marketing to Canadian consumers. The sales of these products on online pharmaceutical platforms in Canada is not a pointer to marketing to the country's consumers. Like Canada Pharmacy Online pointed out, the sales of genuine Otezla "is neither endorsed nor authorized by the Celgene Corporation."

Lastly, we attempted using the social media handles of these two products to see how they market to their Canadian consumers. On Twitter, the #otezla and #celgene are associated significantly with the US market and none for Canadian consumers. While there is no known Facebook account for the product, it has six followers on Instagram with no reference to Canada. For any marketing available for Enbrel on Twitter, it is categorically stated on its page that such information is for "US residents 18 years of age or older." The product's Facebook and Instagram accounts did not also refer to Canadian consumers.

We concluded that these products do not market to their Canadian consumers essentially because of Canadian regulations guiding such practice.

However, we determined that the two products are marketed to their Canadian consumers via online and third-party marketing. While Otezla can be shipped directly after an order is placed online, Enbrel has to be picked up physically at a local store due to the need for refrigeration. Also, the acknowledgment of Canadian packaging for Otezla and multiple brand names for Enbrel suggests a similarity in sales delivery to their Canadian consumers.

The examples provided for the sales of these products are believed to have been used in the last 12 months because these examples are constant factors in the continuous sales delivery to Canadian consumers.
Part
02
of nine
Part
02

Stelera & Cosentyx

Novartis and Johnson & Johnson promote and market Cosentyx and Stelara, respectively on a global level. However, there is not enough evidence in the public domain to prove that Stelara and Cosentyx are marketing to their Canadian consumers specifically. Additionally, marketing or advertising of biologics and biosimilars are highly regulated in Canada and require authorization which can raise various challenges.

RELEVANT FINDINGS

  • In 2018, the total net sales of Cosentyx were US$2,837 million while the net sales of Stelara were US$5,156 million.
  • In 2017, Stelara spent $9.9 million in advertising and Cosentyx’s ad spent was $64 million in 2018.
  • Cosentyx’s most recent advertisement was published in 2019 while Stelara’s most recent ad was released in 2016 which is currently inactive.
  • Stelara and Cosentyx have been approved by Health Canada in the treatment of psoriasis in Canada.
  • In Canada, advertising of biologics and biosimilars are regulated by the Food and Drugs Act, Food and Drug Regulations, and Safety of Human Cells, Tissues, and Organs for Transplantation Regulations.
  • The market authorization of a product requires product monograph and the list of intended uses put forth by Health Canada.
  • A comparative study conducted by CLARITY reported that Cosentyx delivered clear skin in 12 weeks while Stelara took 16 weeks to show results.
  • Additionally, the study found that “found Cosentyx was superior to Stelara®* in achieving sustained skin clearance (PASI 90) at 52 weeks”.

RESEARCH STRATEGY

Despite a comprehensive search, we were unable to discover information that proved Stelara and Cosentyx market to their Canadian consumers. The following research strategies were deployed to identify the required information:
During our preliminary search, we found information about the marketing of Stelara and Cosentyx on a global level but nothing specific to the Canadian audience turned up. In the course of our search, we discovered that the advertising of biologics and biosimilars is highly regulated in Canada and requires several authorizations. Further, after being authorized or approved for advertisements, there are several limitations on the content of the advertisements. Although both Stelara and Cosentyx have been approved by Health Canada in the treatment of psoriasis, there is no information on how the products are marketed to Canadian consumers.
We searched advertisement databases such as iSpot and found several spots released by Cosentyx targeting psoriasis patients. Some of them are still active and were released quite recently. As for Stelara, we found only three spots and they are all currently inactive. Subsequently, we visited the official website of Stelara and Cosentyx to examine their annual reports to find information on their marketing and advertising efforts to promote their respective biologics. Nevertheless, we were unable to identify any annual reports. Following this, we checked the official websites of the parent companies — Novartis and Johnson & Johnson and found their 2018 annual reports. Here, we discovered the net sales of the two products and other information that was extraneous or irrelevant to the question.
Next, we looked into reputed media sources such as Dermatology Times, Endpoint News, FiercePharma, Rheumatology Network, PMLiVE, and other similar sites that publish content on medications, drugs, and biologics. Some of the sources provided a few relevant insights, which were added to the findings ,but nothing relevant to whether Stelara and Cosentyx market to Canadian consumers, or how they market, was found.
Finally, we scanned popular social media platforms such as Twitter and Instagram. We were unable to locate any relevant information. We only found consumers sharing their personal experience with the products. Cosentyx occasionally posts on Twitter and Instagram to promote the product but we couldn’t determine if they are specific to Canadian consumers. Stelara, on the other hand, is not available on social media.
To conclude, there is no information available in the public domain on how Cosentyx and Stelara market to their Canadian consumers.
Part
03
of nine
Part
03

Taltz & Xeljanz

Taltz and Xeljanz have both been approved for sale in Canada. However, Canada's strict pharmaceutical marketing regulations prohibit direct-to-consumer marketing, making it difficult to identify how these products are marketed to consumers.

Pharmaceutical Companies Marketing Regulations in Canada

  • Direct-to-consumer advertising/marketing (DTCA) of prescribed drugs is prohibited in Canada.
  • However, direct-to-consumer information (DTCI) is allowed in Canada, which lets pharmaceutical companies inform the public about medical conditions.

1. Taltz

Target Audience

  • "Taltz® is a registered trademark owned or licensed by Eli Lilly Canada & Company, its subsidiaries, or affiliates."
  • Taltz was first approved in Canada in 2016 for "the treatment of moderate-to-severe plaque psoriasis in adults who are candidates for systemic therapy or phototherapy."
  • In 2018, Health Canada approved the use of Taltz (ixekizumab) for the "treatment of adult patients with active psoriatic arthritis (PsA), a form of chronic, immune-mediated inflammatory arthritis." Based on these findings, marketing for Taltz is likely targeted to Canadians adults with psoriasis (or its forms such as plaque psoriasis and psoriatic arthritis) and their doctors.
  • Estimates indicate that up "to one million Canadians are affected by psoriasis, and up to 30 % of people with psoriasis will develop psoriatic arthritis."

Comparative Advertising

  • Comparative advertising is a marketing strategy "where a company’s offer is presented as far better than their competitors’."
  • Comparative advertising to doctors is a common way that pharmaceutical companies market their products. Doctors "hold the key to consumer sales and establishing a relationship with them is a good way to communicate with a much wider audience."
  • There are indications that Eli Lilly Canada practices comparative advertising due to frequent press releases and presentations of head-to-head studies to doctors.

Example 1: Taltz vs. Humira

  • Head-to-head trials, which compare the efficacy of two medicines, are becoming more common. This can help give physicians the confidence to try new medications, especially in psoriatic arthritis where there is limited evidence. Additionally, head-to-head trials are required in Canada to support comparative advertising claims.
  • In November 2019, Lilly presented a study showing that Taltz outperformed Humira in clearing new psoriatic arthritis patients' skin and improving joint function.
  • Lilly's vice president of immunology development, stated: "the 52-week data provided doctors with clear evidence Taltz stayed effective after a year of use in patients."
  • With evidence of its long effectiveness, Lilly hopes that doctors may be more willing to try out new patients on Taltz rather than their competitor Humira.

Example 2: Taltz vs. Tremfya

  • In August 2019, Eli Lilly Canada and Company evaluated the "efficacy and safety of Taltz versus Tremfya in people living with moderate to severe plaque psoriasis (PsO)," in another head-to-head trial.
  • Eli Lilly "demonstrated the superiority of Taltz in the proportion of patients achieving complete skin clearance compared to Tremfya."
  • Lilly also listened to and tried to identify and address the needs of patients with plaque psoriasis, who wanted a treatment that can completely clear skin quickly, which is also important when marketing to patients.

2. Xeljanz

  • Xeljanz is a rheumatoid arthritis drug that was approved for use by Health Canada 2014. It was also approved in 2018 for the treatment of Ulcerative Colitis (UC) and active Psoriatic Arthritis (PsA) in adult patients.
  • Based on these findings, marketing for Xeljanz is likely targeted to Canadians adults with either rheumatoid arthritis, ulcerative colitis, and active psoriatic arthritis, and their doctors.
  • Xeljanz has global sales of around "$2 billion and accounts for only 4% of Pfizer's total sales. "
  • Health Canada is currently conducting a safety review of Xeljanz/Xeljanz XR (tofacitinib) after an ongoing clinical trial found an "increased risk of blood clots in the lungs and death when the drug was taken at a high dose of 10 mg twice a day."
  • Health Canada is collaborating with Pfizer to "evaluate the available safety information for tofacitinib and will inform the public of any new safety findings as needed, once the review is complete."

Marketing

  • In general, Pfizer has been spending a lot on "direct to consumer (DTC) advertising to boost Xeljanz's share and awareness." In January 2019, they took the No. 1 position in DTC ad spending, beating out promotion efforts by AbbVie’s Humira.
  • According to Kantar Media, Pfizer "spent $274 million on total DTC for Xeljanz, up from $257 million", in 2018. TV accounted for almost $209 million that same year.
  • As mentioned, Canada prohibits direct-to-consumer advertising/marketing (DTCA) of prescribed drugs, so Pfizer's DTC marketing efforts were likely not implemented in the same way in Canada.
  • Pfizer Canada's website specifically notes that "Canadian regulations limit the scope of the information they are permitted to give on prescription drugs via the Internet or other means."
  • A Pfizer spokesman also noted that the "company does not comment on issues related to marketing strategy."

Research Strategy

We started our research by reviewing how Taltz and Xeljanz market to their customers in Canada. We reviewed the products' and their respective manufacturers' websites (Eli Lilly and Pfizer). After combing through the websites, including the media, industry reports, and review pages, we found that these products were sold in Canada, however, information relevant to their marketing methods did not appear available.

Next, we looked through online pharmaceutical retailers like Canada Pharmacy Online, CanadianPharmacyWorld, and Canada Drugs Direct to identify possible marketing advertisements or marketing leads for Taltz and Xeljanz to see how they were advertised, but no information appeared available.

We then attempted to understand the pharmaceutical marketing and advertising regulations in Canada, which led us to government sites and organizations such as Health Canada, Ministry of Health Canada, and the Canadian Public Health Association. Through this method, we found that direct-to-consumer advertising/marketing (DTCA) of prescribed drugs is prohibited in Canada, while direct-to-consumer information (DTCI) is allowed. Direct-to-consumer (or D2C) advertising typically refers to "print, social media, TV, radio, and other forms of media to inform a customer about a product or reminding them of a need for such a product," which is why no information on their advertising or marketing appeared available. From there, we then tried to find direct-to-consumer information (DTCI) examples for both Pfizer's Xeljanz and Lilly's Taltz, to see if we could find any leads on how they market in Canada, but nothing specific came about.

We came across a report by the International Comparative Legal Guides (ICLG), which noted that comparative advertising to healthcare professionals or the public in Canada is allowed for pharmaceutical advertising. A requirement of this was to support advertising with head-to-head trials. We looked for examples of comparative advertising for both Taltz and Xeljanz, however, no specific marketing examples also came up. We did find example head-to-head trials for Taltz, which are described above. No similar examples appeared available for Pfizer's Xeljanz in Canada.
On Pfizer's Canadian website, they specifically note that "Canadian regulations limit the scope of the information they can give." No other information on their site or press releases led to information on marketing to Canadian consumers. Additionally, a Pfizer spokesman stated that the company, in general, does not comment on its marketing strategy.
While both Taltz and Xeljanz have been approved by Health Canada in the treatment of psoriasis and rheumatoid arthritis, direct information on how the products are marketed to Canadian consumers do not appear available.
Part
04
of nine
Part
04

Moderate to Severe Psoriasis Demographic

The average moderate to severe psoriasis patient in Canada was diagnosed in their late twenties to early thirties. The average patient is 46 years old, Caucasian, and could be either male or female. They most likely have a history of being overweight and possibly some cardiovascular and mental health issues.

Moderate to Severe Psoriasis Statistics

  • 2-3% of the total world population has psoriasis.
  • 10-30% of the population affected with psoriasis will go on to develop psoriatic arthritis.
  • In 2018, there were approximately 1 million Canadians suffering from some form of psoriasis.

Age

  • The average patient is 46.4 years old.

Age of Onset

  • Analysis of multiple studies would indicate the average age of onset is from the late twenties into the early thirties.
  • According to a study conducted in 2015 by the Department of Dermatology in Oregon University, typical onset for patients was at 28 years old.
  • A much older study completed in Canada (2009), put the onset age as 28 as well. 31% of their participants had their diagnosis prior to the age of 18.
  • The National Psoriasis Foundation states that is most usually is diagnosed between the ages of 30 and 50, but can develop at any age.
  • The World Health Organization states that their average onset is 33 years of age and that 75% are diagnosed by the age of 46.

Duration

  • The average patient has endured moderate to severe psoriasis for 18 years.

Race

  • The majority of patients are Caucasian.
  • Psoriasis is more prevalent in Caucasians with 2.5% of the population affected, whereas African Americans have 1.3% occurrence rate.

Gender

  • A 2019 study on psoriasis in Ontario discovered that the disease was spread almost equally between men and women.
  • The Psoriasis Longitudinal Assessment and Registry (PSOLAR) is a global registry for psoriasis patients. 74% of the patients are from the US, and 16% are from Canada. A study of the demographics was performed on the collected data. They discovered that male and female occurrences were almost 50/50. 50.8% were male, and 49.2% were female.
  • The World Health Organization confirmed these results in 2016. Their study revealed that it was just slightly more prevalent in men than women.
  • Being female has been associated with earlier onset than men.

Health History

  • Patients tend to be overweight. In the Oregon study 32.5% were overweight, 18.9% were obese, and 25.5% were morbidly obese.
  • In the PSOLAR study, 85% were overweight, 44.4% had cardiovascular issues, and 26.3% had psychiatric issues.

Family History

  • Individuals with a family history of moderate to severe psoriasis are more likely to develop it themselves, and are more likely to develop it at an earlier age. 45.3% in the Oregon study had a family history of psoriasis. In the PSOLAR study, 28.9% had a family history of psoriasis.
  • If the patient has one parent with psoriasis, they have a 10% greater chance of also having psoriasis. If both parents have psoriasis, there is a 50% greater chance.

Habits That Affect the Disease

  • Alcohol use and tobacco use are factors that are seen in 72% and 19% of patients respectively.
  • NSAID use is seen in many patients.

Suggested Reading

  • Psoriasis: Journey To Stability was a Canadian report published in 2018. It did not reveal any useful demographics, but did contain a wealth of information about Canadians living with this disease.

Research Strategy

To obtain the best demographic analysis, we combined studies from the US and Canada. Canada and US have very similar demographics. We also did this to support the few statistics we were able to obtain for Canada alone. Overall, demographics in Canada are consistent with US and global demographics. Some studies were dated, but we used them due to their exact reporting methods and then verified the statistics with other research that was newer to make sure we had the correct demographics.

Part
05
of nine
Part
05

Moderate To Severe Psoriasis Journey

After being diagnosed, most psoriasis patients in Canada (94.22%) use topical corticosteroids to treat the disease.

CUSTOMER JOURNEY

  • In a study by the Canadian Association for Psoriasis Patients and Canadian Psoriasis Network, 42% of the people had moderate psoriasis, and 28.67% reported having a severe condition.
  • About 13.29% of those living with the disease uncontrolled or unstable for less than a year might be doing so because they were recently diagnosed or because the disease is getting worse.
  • People newly diagnosed with psoriasis in Canada report feeling embarrassed and overwhelmed. As no two patients are the same, the manifestation of psoriasis is often unique to each individual. As such, the patients are tasked with discovering their personal triggers and symptoms.
  • Patients are increasingly making use of telemedicine to access care treatment for psoriasis.
TREATMENT METHODS CONSULTED
  • While about 75% of them attempt to self-control the disease without any medical intervention, the remaining 25% consult a broad range of doctors and other medical entities, including acupuncture and naturopaths, among others to help manage their condition.
  • In Quebec, 80.56% of psoriasis patients consult a dermatologist, rheumatologist (13.9%), family physician (5.56%), and 11.1% self-manage the condition.
  • After being diagnosed, many customers try different medications. About 94.22% of them applied topical corticosteroids, with 82.66% using over-the-counter creams, lotions, shampoos, and nail products.
  • Respondents also experimented with ultraviolet (UV) light therapy (55%), biologics (39.91%), and biosimilars (3.47%).
  • Other specific treatments consulted include "dead sea salts, acupuncture, antihistamines, diet, and home remedies." However, no evidence shows whether the patients used these alternative treatments in conjunction with prescribed treatments if they were prescribed by a physician or the result of personal research.
DECISION-MAKING PROCESS
  • About 56.65% of the people with not properly controlled moderate-to-severe psoriasis conditions did not discuss biologics or biosimilar treatments with their physicians because they were okay with their treatments, their physicians had not recommended the procedure, and/or they did not know about it, the doctor was not specialized in psoriasis treatment, and because of the side effects.
  • Over 20% of respondents consider their psoriasis conditions to be well controlled or stable within the first year of diagnosis. However, about 73.4% of the respondents feel involved in the choice for their use of prescribed medication.
  • The majority of them speak to their physicians when they feel the need to change their medication (86.71%), while some would inform their employers (8.09%).
BARRIERS
  • Psoriasis patients in Canada typically experience three barriers in their customer journey, including access to phototherapy, dermatologists, and choice of treatment.
  • Most Canadians diagnosed with psoriasis are aware of over-the-counter treatment options, as well as prescribed creams and lotions, but many of them do not know about newer treatment options. As such, it is possible to conclude that they rely more on medical consultation than research.

RESEARCH STRATEGY

We searched for the typical customer journey for a newly diagnosed patient with moderate-to-severe psoriasis in Canada by evaluating studies and media reports about the same from the Canadian Psoriasis Network, PR Newswire, and the National Center for Biotechnology Information, among others. One study provided useful information for the customer journey of people living with moderate-to-severe psoriasis in the country. However, it did not categorically state whether they were newly diagnosed but gave some insights for that category. It also did not provide whether they search for support groups or carry out medication research. However, we deduced that since a physician generally recommends their treatment options, they might rely more on medical consultations than research. With the limited available information, we have outlined the customer journey of moderate-to-severe psoriasis patients in Canada in terms of the treatment methods consulted, their decision-making process, and barriers.
Part
06
of nine
Part
06

Traditional Media Habits- 20-40-year-olds

Statistics show that 20-40-year-olds are watching less television, but are active listeners to AM and FM radio. They also are receptive to both print and outdoor advertising as an alternative to digital advertising overload.

Television

  • Millennials choose YouTube videos over traditional television by a two-to-one margin. This means that they are watching less television than previous generations.
  • Just 78% of the 18-34-year-old age group watches television on a weekly basis. This is compared with 90% of the 35-49-year-old age group. This shows that generation X, the generation prior to millennials, watches significantly more television than the younger generation, likely due to the numerous digital options available to them.

Radio

  • According to Nielsen, 92% of the 18-34-year-old age group and 95% of the 35-49-year-old age group tune in to AM or FM radio each week. This means that radio is one of the best ways to reach these age groups.
  • Millennials are the generation with the second-most radio listeners at 71.6 million monthly listeners. Only Generation X is higher, at 80.5 million monthly listeners. Millennials are clearly exposed to radio advertising due to the number of people who listen to the radio on a monthly basis.

Print Advertising

  • In the last 12 months, 23% of millennials purchased an item as the result of receiving printed direct mail. This means that print advertising has a place with millennials, even though they are known to engage more with digital devices.
  • A recent USPS study found that 54% of millennials would rather neighborhood businesses provide them with printed materials rather than use telemarketing or email. This shows that millennials are tired of telemarketing tactics and email spam, and would rather be given printed ads, which are rarer in today's digital world.

Billboards

  • Nielsen found that 56% of millennials trust outdoor media, which means they are significantly influenced by billboards and other types of OOH advertising.
  • Additionally, 17% of millennials are more likely to engage with brands when presented with OOH advertising. This means that because 63% of millennials use ad blockers on their digital devices, they hare receptive to other forms of advertising, including billboards.

Research Note

In 2019, millennials were between the ages of 23 and 38, which encompasses the majority of the requested 20-40-year-old demographic. Therefore, we used millennials as a proxy for the 20-40-year-old age bracket.
Part
07
of nine
Part
07

Digital Media Habits- 20-40-year-olds

20-40-year-olds are highly involved in nearly every form of digital media. They consume more music digitally than any other age group. 90.4% of 20-40-year-olds use social media daily and 40% use a video streaming service daily. Further information is below.

KEY FINDINGS

Digital Media Advertisements
Digital Video Streaming
  • 40% of 20-40-year-olds watch digital online video entertainment through a streaming service at least once a day, with 70% watching at least once a week.
  • With the cord-cutting trend gaining popularity among all age groups, 14% of 20-40-year-olds moved from cable providers to streaming services between 2018 to 2019.
  • In 2019, 88% of 20-40-year-olds had at least one subscription to an online video streaming service, reporting that such services are more affordable, more convenient, and more personalized than cable TV.
  • When consuming digital media, 68% of 20-40-year-olds use a second screen.
Digital Music Streaming
  • Compared to other age groups, 20-40-year-olds are most likely to spend money listening to music digitally with 91% of 20-40-year-olds subscribing to a music streaming service.
  • The age group listens to music streaming services such as Spotify, Pandora, and Apple music because of the convenience and scalability they offer.
  • 20-40-year-olds listen to an average of 18.8 hours of music each week, more than any other age group.
  • Music streaming services allow for more nuanced, fractured genres and markets, which appeal to 20-40-year-olds' desire for customization.
Podcasting
Social Media
  • 90.4% of 20-40-year-olds used social media on a daily basis, spending an average of about 2.3 hours per day on the platforms.
  • The two platforms most popular with 20-40-year-olds are Facebook (81%) and Instagram (59%).
  • Their activity on these platforms is highly influenced by their peers, being motivation by a fear of missing out (FOMO).
  • The most popular reason for using social media among 20-40-year-olds is to keep up with their peers with 71% saying that's what brings them to the platform.
  • Entertainment (58%) and consuming news media (47%) are the next two most popular reasons why people between 20-40 use social media platforms.

Part
08
of nine
Part
08

Moderate To Severe Psoriasis Disease Overview

Psoriasis is a chronic inflammatory disease that typically affects the scalp, elbows, and knees and causes patches on the skin. Moderate psoriasis means that 3-10% of the patient's body is covered with patches, while severe psoriasis means that over 10% of the skin is affected. The disease can have a significant impact on the patient, depending on the severity and the area of the skin affected. The typical treatment for moderate to severe psoriasis includes a combination of systemic and biologic drugs.

Psoriasis Overview

  • Psoriasis is a complex inflammatory disease that causes "raised, red, scaly patches" on the surface of the skin. It is a chronic disease that typically appears on the scalp, elbows, and knees, but it can also manifest on the other areas of the skin.
  • Although the cause of psoriasis is unknown, scientists have determined that genetics and the immune system have a significant role in the development of the disease as well as the environmental conditions.
  • The development of the psoriasis lesions is caused by the increased growth of skin cells.
  • Each person has a different set of symptoms and signs such as small scaling spots, dry and cracked skin, "red patches of skin covered with thick, silvery scales", swollen and stiff joints and thickened nails.
  • There are several common types of psoriasis such as chronic stationary psoriasis, plaque psoriasis, psoriatic arthritis, and inverse psoriasis among others.
  • Erythrodermic psoriasis is a rare type of psoriasis, that affects around 3% of people with the disease and can cover over 75% of the skin. It can also have a negative impact on the chemical processes of the body.

Impact of Psoriasis on the Patient

  • Psoriasis can have a great impact on the quality of life depending on the area of the skin affected by the disease. For example, some studies indicate that if palms and soles are affected, the impact on the quality of life can be greater compared to the patients that have a more severe psoriatic infection "not involving the palms and soles".
  • People with psoriasis have a higher risk of developing other types of serious illnesses such as chronic lung disease, diabetes, and kidney disease. The risk is 15% for patients with moderated psoriasis and 35% for people with a severe type of disease.
  • Some patients indicate that the skin affected by psoriasis is "itchy, burns and stings", while others can experience a "physical and mental disability" that can be compared to some chronic illnesses such as heart disease, hypertension, and cancer.
  • The disease is also associated with alcohol, smoking, depression, metabolic syndrome and some types of skin cancers.
  • According to Medscape, men and women with severe psoriasis died 3-4 years earlier compared to people that don't have the disease.

Moderate and Severe Psoriasis

  • "Psoriasis can be mild, moderate or severe", depending on how much skin on the patient's body is affected by the disease. Moderate psoriasis can affect up to 3-10% of the body, while severe psoriasis covers over 10% of the body.
  • Psoriasis can be deemed as moderate if it has a "significant impact" on the patient's quality of life or it can't be contained by using medication.
  • If psoriasis has a severe impact on the patient's quality of life and psoriatic patches cover large areas of the body such as face, palms, soles, and feet, then the disease is considered to be severe.
  • The "Psoriasis Area and Severity Index (PASI) score" is used to determine the severity of the disease. The range is between 0 and 72 and it uses the severity and the surface area of the body that is affected by psoriasis to calculate the score.
  • Patients that have a PASI score over 10 are considered to have a moderate to severe psoriasis, while people rarely get a score of 40 and more. People with a higher PASI score have a lower quality of life.

Typical Treatment

  • The treatment for psoriasis depends on the severity and type of the disease and the area of the body affected. Although most people can be treated by a general practitioner (GP), in cases when symptoms are severe or patients don't respond to the treatment they are referred to a dermatologist.
  • The typical treatment of moderate to severe psoriasis often includes a combination of different treatments such as phototherapy, systemic and biologic medications.
  • The American Academy of Dermatology (AAD) and the National Psoriasis Foundation (NPF) recommends using a combination of drugs such as Etanercept, Infliximab, and Adalimumab for treating moderate-to-severe plaque psoriasis.
  • Some commonly used systemic drugs for treating psoriasis in the United Kingdom are methotrexate, acitretin, and ciclosporin.
  • The National Institute for Health and Care Excellence (NICE) recommends biologic medications such as Adalimumab, Enbrel, Stelara, and Taltz for treating patients with severe psoriasis who didn't respond well to systemic drugs.
  • According to the 2013 international consensus report on treatment for the "moderate-to-severe plaque psoriasis", the recommended therapy includes Methotrexate, if it is well tolerated by the patient; and Cyclosporine, which is used irregularly over the course of 3-6 months to cause a clinical response. It also suggests using a biologic agent instead of a commonly used systemic therapy, switching biologic agents, combinations of different agents and combination therapy.
Part
09
of nine
Part
09

Successful Drug Campaigns- Canada

Two successful drug campaigns that have been run in Canada are Practice Kids and Don't Drive High. Details regarding these campaigns have been provided below and the screenshots for each can be found in the attached document.

Practice Kids

  • Practice Kids is an online campaign by Drug Free Kids Canada and FCB that helps families navigate through tough conversations about cannabis use. The campaign enables parents to practice conversations that they intend to have with their children with other teenagers.
  • The campaign recruited and trained a group of teenagers between 13 and 17 years on how to engage with real parents who want to have the cannabis talk with their children. A seminar between the teenagers and parents was conducted and documented, which created the content to launch Practice Kids, an online resource hub that parents can use.
  • The initiative was followed up by Facebook Live sessions, which ensured that the content was available to every parent in Canada.
  • Practice Kids advertised online through social media and banners ads. Also, the campaign used out-of-home (OOH) advertisements, television, radio, and print media.
  • Practice Kids won the Public Service, Best in Social Media Award by Media in Canada.

Don't Drive High

  • Don't Drive High is a campaign by the federal government whose goal is to create awareness about the risks of driving while high among young people. The campaign sensitizes the youth about the consequences of driving while impaired since it is illegal in Canada.
  • Don't Drive High provides solutions on ways of arriving at one's destination without driving impaired. In addition, the campaign advises parents on the actions they should take to prevent the habit.
  • The campaign was advertised on television and a tailor-made digital mobile game was created. In addition, the campaign used Spotify advertising, social media advertising, and Music Video Awards sponsorship assets.
  • The campaign was successful in reaching its target audience and generating conversation. In addition, the campaign exceeded all the KPIs it set for the channels it used.

Research Strategy

To determine the successful drug campaigns in Canada, we ensured that they were recognized through awards or had generated conversation from the target audience. We made sure that the two campaigns we identified met at least one of the above criteria. We then attached two screenshots for each campaign in the attached document.
Sources
Sources

From Part 01
Quotes
  • "adult patients with active psoriatic arthritis."
Quotes
  • "Enbrel should be refrigerated at 36°F to 46°F (2°C to 8°C) and should not be shaken."
Quotes
  • "the amount and scope of information"
From Part 02
From Part 03
From Part 07