As life sciences professionals, we are all aware of the macro trends that point toward a more prominent role for mid-level prescribers (nurse practitioners and physician assistants). The growing demand for mid-levels is driven by:
- An aging population
- More individuals with health care coverage as a result of the Affordable Care Act (ACA)
- Efforts to control costs
- Fewer medical school graduates entering primary care
As consumers, many of us can point to at least one office visit in which we’ve only interacted with a nurse practitioner or physician assistant, and news coverage of the Affordable Care Act is priming us to expect even more of these interactions in the coming years.
Against this backdrop, it is imperative that brands understand the role that these prescribers play, if any, in driving sales for their products. Anecdotally, it is acknowledged that mid-level prescribers generally spend more time with patients, relative to physicians, but does this translate into diagnosis and initiation of treatment? Or, is the impact more likely to be seen with adherence and identification of switch opportunities? At the same time, brands must assess the extent to which these roles may shift in the future. In terms of understanding the opportunity, it is important to consider the geographic variations in disease prevalence and concentration of mid-level prescribers—both in absolute terms and in relation to the number of PCPs and specialists. (Current estimates put the number of NPs and PAs at around 180,000 and 80,000, respectively, with expectations for above-average growth in the coming years, but there are distinct differences in urban vs. rural areas of the country.)
From a promotional standpoint, there is evidence that mid-level prescribers respond similarly to marketing messages as compared with physicians. Further, the sunshine provisions of the Affordable Care Act would appear to exempt mid-level prescribers, applying only to physicians and teaching hospitals. As such, there is a real opportunity to shift promotional activities to mid-levels, who aren’t subject to reporting and other constraints on consulting fees, entertainment, food, etc., and are often more accessible than physicians. From a marketing perspective, the rules are the same – tailor communications with this audience in a manner that reflects their needs, interests and preferences. And invest according to their value to your brand.