October 16, 2008

Health Under
Pressure
 3

Health Demands Mount

Populations aging

Behavior-related chronic conditions

Global pandemics

Diseases of poverty

Expensive innovations
 4

License to Operate at Risk

Companies' and organizations' license

to operate is harder to earn and keep

Trust and confidence are down

Demands are high – for transparency and

social responsibility

Safety concerns create skepticism

and distrust

Pivotal relationships stressed

 5

Financial Meltdown Exacerbates A Health Crisis Already In Force

People forego or postpone

essential health care

Loss of insurance or failure to pay

Health behaviors erode

Cost trumps quality

Mental health issues emerge

 6

Democratization of Information

Stakeholders are more connected –

changing the relationship dynamic

Dispersion of authority

Health information revolution

Desire to socialize -- share opinions

and thoughts
 7

Toward Health Engagement

There is no simple or quick solution.

But the way forward calls for all stakeholders –

institutional and individual –
to build trusting relationships,
participate actively and assume responsibility –
that is, engage.
 8

Health Engagement

Health engagement is the interaction among

stakeholders in health – on the topics that matter,
and through the channels and sources where
information and opinions are gathered,
formed and shared.
 9

Five-Country Study of General Population

Twenty-minute online survey conducted by StrategyOne in September 2008 among

5,183 adults, 18-75 years old

Global US UK Germany Russia China

Sample size 5,183 1000 1078 1000 1081 1024

Margin of Error: +/- 1.4% +/- 3% +/- 3% +/- 3% +/- 3% +/- 3%

Total

Margin of Error: +/- 2.9% +/- 6.9% +/- 8.3% +/- 6.5% +/- 5.1% +/- 6.7%
Health Info-
entials

Representative Gender Gender Gender Urban Urban

on Age Age Age areas: areas:
Income Income Income Gender Gender
Education Education Age Age
Region Region Income Income
Ethnicity
 10

Health
Engagement –
Increasingly
Important
 11

Health Engagement on the Rise

I am becoming more actively engaged in 63%

Health Issues

I am becoming more actively engaged with

60%
Health Products and Services

I am becoming more actively engaged with

Companies and Organizations 40%
involved in health

Base = Adults
Please indicate how much you agree or disagree with each of the following statements. (strongly/somewhat)
 12

People Crave Even More Health Engagement

It’s increasingly important that

Companies and Organizations 70%
involved in health engage with me

It’s increasingly important that

Health Products and Services 75%
engage with me

Base = Adults
Please indicate how much you agree or disagree with each of the following statements. (strongly/somewhat)
 13

A Highly
Engaged Group
is Leading in
Health Influence
Health Engagement Barometer
 14

We Looked at People Through Three Lenses

Health Involved:
How involved are you with health issues?

Health Informed:
How often do you read or gather information about health issues?
How often do you share information about health issues?

Health Engaged:
What best describes how you typically engage with
health issues?
 15

4 out of 5 People are Health Involved

Health Involved
80%

Base = Adults
In general, how involved are you with health issues? (very/somewhat)
 16

1 out of 3 People Is Health Informed

Read or Health Share info with

gather info others more
more than
Informed than once a
once a week 33% week

Base = Adults
How often do you read or gather information about health issues?
How often do you share information about health issues you see, read, or hear about?
 17

2 out of 5 People are Health Engaged

Health
Engaged
39%

Base = Adults
Which, if any, of the following best describes how you typically engage with health issues?
 18

1 out of 5 People Is A Health Info-ential

Health Info-entials
22%

Base = Adults
In general, how involved are you with health issues? (very/somewhat)
How often do you read or gather information about health issues? (few times a week or more)
How often do you share information about health issues you see, read, or hear about? (few times a week or more)
Which, if any, of the following best describes how you typically engage with health issues? (actively seek/share; actively seek/share/advocate)
 19

Health Info-entials: Most in China, Fewest in UK

35%

CHINA

23%

GERMANY

20%

U.S.

21%

RUSSIA

13%

U.K.
Base = Adults
In general, how involved are you with health issues? (very/somewhat)
How often do you read or gather information about health issues? (few times a week or more)
How often do you share information about health issues you see, read, or hear about? (few times a week or more)
Which, if any, of the following best describes how you typically engage with health issues? (actively seek/share+ actively seek/share/advocate)
 20

Health Info-entials: More Stakes in Health

More likely to More likely to have More likely More likely to take
work in the severe or chronic to be a prescription
health field health conditions caregiver medications

26% vs. 18% 41% vs. 34% 17% vs. 11% 47% vs. 41%

Health Info-entials vs. Adults

 21

Health Info-entials: From All Walks of Life

No differences in age

No differences in income levels

No differences in marital status

Slight differences (Health-Info-entials vs. Adults):

• More likely to be women
(50% vs. 46%)
• More likely to have children
(41% v. 35%)
• More likely to employed
(71% vs. 65%)
 22

I Share Most With People I Know

With which of the following do you typically share information or opinions about health issues?
 23

I Speak Up and Act On My Opinions About

Companies and Organizations

Thinking about companies and organizations involved in health that you are engaged with, which, if any, of the
following actions have you taken in response to a company or organization?
 24

I Speak Up and Act On Health Issues

Thinking about health issues you are involved with, which, if any, of the following
actions have you taken in relation to an issue? (very/somewhat)
 25

The Trust-
Health Engagement
Virtuous Circle
 26

Trust is Most Important Factor in Health Engagement

71%
Trust
67%

68%
Authenticity
58%

61%
Satisf action
53%

37%
Long-term commitment
30%

30%
Personalized interaction
26%

26%
Shared purpose
19%

25%
Collaboration
19%

16%
Frequent contact Health Inf o-entials
12%
Adults

Thinking about the engagement you want to have with companies and organization involved in health,
which characteristics of that engagement are most important to you?
 27

Health Info-entials in 5 Countries Want Trust, Authenticity

and Satisfaction

TRUST 71% TRUST 77%

AUTHENTICITY 68% SATISFACTION
SATISFACTION 45%
Global U.K.
SATISFACTION 61% AUTHENTICITY 41%

TRUST 79% TRUST 71%

SATISFACTION 54% SATISFACTION 70%
U.S. GERMANY
AUTHENTICITY 52% AUTHENTICITY 48%

AUTHENTICITY 79% SATISFACTION 82%

TRUST 67% AUTHENTICITY 77%

CHINA RUSSIA
SATISFACTION 66% TRUST 66%

Base = Health Info-entials

Thinking about the engagement you want to have with companies and organizations involved in health,
which characteristics of that engagement are most important to you?
 28

Health Info-entials: More Engaged and More Trusting

Distrust Trust

Companies and Organizations

36 % 58%
29% 69%

Products and Services

33% 61%
28% 70%
Adults

Health
Info-entials

Please indicate how much you agree or disagree that you “trust what you hear from companies and organizations involved in
health/…from health products and services?” (strongly/somewhat agree vs. strongly/somewhat disagree)
 29

Health Engagement Power Consistent

Distrust Trust Distrust Trust
Global U.K.

Companies and Organization Companies and Organization

36% 58% 38% 53%
29% 69% 36% 60%
Products and Services Products and Services
33% 61% 35% 54%
28% 70% 36% 61%

U.S. GERMANY

Companies and Organization Companies and Organization

34% 58% 43% 51%
30% 68% 44% 53%
Products and Services Products and Services
33% 59% 43% 51%
30% 68% 44% 52%

CHINA RUSSIA

Companies and Organization Companies and Organization

26% 72% 38% 58%
19% 80% 26% 73%
Products and Services Products and Services
22% 77% 37% 61%
17% 82% 23% 76%

Adults Health Info-entials

 30

Health Engage Me:

The Power
of Personal
 31

If You Want To Engage Me, Start With My Health

And Give Me the Whole Story

Help me address health issues that affect me personally 54%

42%

Communicate both positive and negative news to me 52%

44%

Inform me about health conditions that I am concerned about 52%

41%
Inform me about the risks and benefits of their products and services 50%
43%
Communicate with me openly and transparently 48%
41%

Actively listen and respond to my concerns and requests 47%

37%

Inform me about how to prevent a disease that their products and … 46%
36%
Inform me about how to properly use their products and services 43%
36%
Ensure I have access to their products and services 40%
34%

Offer a variety of ways for me to communicate with them 35%

28%

Inform me about the science and technology behind their products and … 34%
26%
Help me address health issues affecting the world today 32%
21%
Have an active presence on popular social networking sites where I … 23%
14%

Partner with other organizations to address issues important to me 21%

16%
16% Health Inf o-entials
Allow employees other than the CEO or spokespeople to communicate … 12%
Adults
In which of the following ways do you want companies and * Indicates significant difference to corresponding audience
organizations involved in health to engage with you?
 32

My Body Comes First

Engagement Priorities: Rx Medicines, Hospitals and Other Healthcare Products

85%
Healthcare products I purchase with a prescription
76%
My Body

83%
Hospitals
73%

81%
Healthcare products I purchase without a prescription
69%

76%
Companies in health
61%

74%
Government health agencies
63%

72%
Nonprof it health organizations and f oundations/ NGOs
58%

Health Inf o-entials

Adults

Please rate each of the following on how engaged you want them to be with you. (very/somewhat)
 33

Medicines and Hospitals Top Engagement Preferences

in Most Countries

Rx Products 85% Hospitals 86%

Hospitals 83 % Rx Products 85%
Global OTC products 83 % U.K. OTC products 79%
Companies 76 % Government 74%
Government 74 % NGOs 72%
NGOs 72 % Companies 69%

Rx Products 91% Rx Products 77%

Hospitals 87% OTC products 74%
U.S. OTC products 82% GERMANY Companies 67%
Companies 81% Hospitals 65%
Government 78% Government 63%
NGOs 75% NGOs 61%

Hospitals 95% Companies 84%

Rx Products 91% OTC products 79%
CHINA Government 88% Hospitals 78%
RUSSIA
OTC products 86% Rx Products 76%
NGOs 79% NGOs 65%
Companies 76% Government 59%

Base = Health Info-entials

Please rate each of the following on how engaged you want them to be with you. (very/somewhat)
 34

Everything Matters to My Health and Well-Being

Base = Health Info-entials

Thinking about your overall health and well-being, how important would you say each of the
following factors plays in influencing it? (extremely/very important)
 35

My Health More Important Than Our Health

My Health
Our Health

Base = Health Info-entials

Which, if any, of the following best describes your typical engagement with the issue of …?
(High engagement = actively seek out/share info or actively seek out//share info and advocate point of view)
 36

Power of Personal Health is Universal

Global U.K.

Maintain health and well-being 74% Solve chronic health problems 64%
Solve chronic health problems 66% Maintain health and well-being 58%
Prevent disease Provide access to 46%
61%
affordable healthcare
Provide access to Understand benefits of alt. med. 46%
58%
affordable healthcare

U.S. GERMANY

Maintain health and well-being 76% Maintain health and well-being 63%
Solve chronic health problems 61% Provide access to
affordable healthcare
62%
Provide access to
affordable healthcare
57% Prevent disease 60%
Prevent disease 53% Solve chronic health problems 58%

CHINA RUSSIA

Maintain health and well-being 87% Prevent disease 65%

Ensure access to health information 80% Maintain health and well-being 62%
Solve chronic health problems 79% Solve chronic health problems 56%
Provide access to
Prevent disease 71% affordable healthcare
47%

Base: Health Info-entials

Which, if any, of the following best describes your typical engagement with the issue of …? (high engagement =
actively seek out/share info or actively seek out//share info and advocate point of view)
 37

Personal and Public Health Priorities Align for Health Info-entials

60
Public Health Priorities

60
0
Personal Health Priorities
Base = Health Info-entials
Thinking about these same health issues, which THREE do you believe are the highest priority health issues that need to be addressed today?
Thinking about these same health issues, which THREE would you say you are most concerned about in terms of their personal impact on you?
 38

3 Way Alignment: Health Info-entials Want Companies and

Organizations to Address Same Personal and Public Health Issues
60
Should Be Company Priorities

60
0
Personal Health Issues
Base = Health Info-entials
Thinking about these same health issues, which THREE would you say you are most concerned about in terms of their personal impact on you?
Which THREE of the following health issues do you believe are the most important for companies and organizations involved in health to address?
 39

Wanted:
Health Expertise
 40

Credibility Drivers: Personal Connection and Health Expertise

My doctor or healthcare professional 96%

Doctor or healthcare professional 95%
My pharmacist 93%
Scientist or researcher 91%
My friends and family 91%
Leading medical center or provider 90%
Professional medical associations 90%
A person like me 88%
Someone personally affected by a disease or medical … 88%
Public health organization or foundation 88%
Government health agency 82%
Advocacy group 74%
Spokesperson for a company or organization involved in … 72%
Health journalist 71%
Senior executive of a health or healthcare company 68%
Regular employee of a health or healthcare company 66%
Government official or regulator 59%
Health blogger 59%
My employer 52%
Celebrity or famous athlete 41%

Base = Health Info-entials

If you read or heard information about a health issue from each of the following types of people and
organizations, how credible would the information be? (very/somewhat)
 41

Health Expertise Drives Credibility Globally

Global U.K.

My doctor or healthcare professional 96% My pharmacist 96%

Doctor or healthcare professional 95% My doctor or healthcare professional 96%
My pharmacist
93% Doctor or healthcare professional 96%
Scientist or researcher
91% Professional medical association 95%

U.S. GERMANY

Doctor or healthcare professional 97% My doctor or healthcare professional 98%

My pharmacist 96% Doctor or healthcare professional 96%
My doctor or healthcare professional 96% Someone affected by the disease 93%
Leading med center/Public health org/
Someone affected by the disease 91% My pharmacist 93%

CHINA RUSSIA

My doctor or healthcare professional 96% Doctor or healthcare professional 98%

Public health organization 95% My doctor or healthcare professional 96%
My friends and family 95% Scientist or researcher 92%
Scientist or researcher 94% My friends and family 91%

Base = Health Info-entials

If you read or heard information about a health issue from each of the following types of people and
organizations, how credible would the information be? (very/somewhat)
 42

Personal and Health Expert Channels Becoming More Important

Health companies’ Web sites

TV News coverage
Articles in magazines
Web sites for specific brands of medication
Films or documentaries
Online message boards, forums or newsgroups
Articles in newspapers
Radio news coverage
Net becoming
Personal blogs
more important
Social networking websites
Web-based video sharing sites Net becoming
Corporate and product advertising less important
Base = Health Info-entials
For each of the following sources of health information, please indicate whether that source is becoming more important to you,
less important to you, or remaining the same. (Net = becoming more important – becoming less important)
 43

The New Second Opinion

88% 88%
I usually turn I usually turn
to my physician to other sources
to validate info to validate info
I get online I get from
my doctor

Base = Health Info-entials

Please indicate how much you agree or disagree with each of the following statements.
(strongly/somewhat agree)
 44

The New Health Access: Immediate Information

Access to more up-to-date health information

42%

Access to new information

40%

More immediate access to health information

38%

Easier to communicate with people who care about similar health issues
19%

More empowered to take action on health issues or personal health topics I

care about 15%

Increased communications with my friends and family members about health

issues or personal health topics 15%

Increased communications with my doctor or healthcare provider

15%

More empowered to express my opinions about health issues or personal

health topics 10%

More difficult to determine the accuracy of information

18%

More likely to receive contradictory information

17%

More overwhelmed with the sheer amount of information available

12%

Made me more concerned about the privacy of my health information

10%

Less face-to-face sharing of information

7%
Base = Health Info-entials
Which, if any, are the THREE most important ways that digital communications (e.g. e-mail, the internet,
mobile phones) has changed how you receive or share information about health issues?
 45

In Search of the New Rules of Health Engagement

Health engage me

Health expertise is prime

My health and well-being come first

Interact everywhere

Engage with Health Info-entials