& Health Care Marketing Dr. Shih-Shin Chen Health Care Marketing Dept. Health Care Management NTUNHS

Marketing as Defined by AMA The process of planning and executing (規劃與執 行)the conception, pricing, promotion, and distribution of ideas, goods, and services to create exchanges that satisfy individual (consumers) and organizational (providers) objectives p. 4

Social Marketing 利用商品行銷的概念與技術 來促進人們在某些重要的社 會行為上的改變，如非法藥 物的使用，抽菸、飲酒過量、 性行為等

HIV Pro Bono Advertising EACH TIME YOU SLEEP WITH SOMEONE, YOU ALSO SLEEP WITH HIS PAST. GET TESTED FOR HIV AREYOUATRISK.CA l

Health Care Marketing Hospitals, nursing homes, home delivery, cyberspace Insurers Patients Providers Medical care and prevention health promotion, pharmaceuticals, equipment Advertising, DM, PR, sales promotion, WOM, corporate design, annual report

Cyberspace: Health Care

Restriction on Health Care Ads. Prior to 1975, AMA had within its codes of ethics a prohibition against advertising. Communication to facilitate the exchange occurred by word of mouth Code of Ethics (倫理準則)

Restriction on Health Care Ads. AMA was sued by Federal Trade Commission in 1982 Restriction on healthcare advertising deprived(剝奪) consumers of the free flow of information regarding healthcare alternatives and services

Restriction on Health Care Ads. By 1982, American Medical Association removed all the restriction regarding healthcare advertising

AMA Codes of Ethics: Opinion 5.02 – Advertising and Publicity There are no restrictions on advertising by physicians except those . . .that can be justified to protect the public from deceptive practices (保護消費者免於被欺騙)

醫療法 醫療法 第一章 總則 醫療法 第五章 醫療廣告 醫療法 第一章 總則 第9條: 本法所稱醫療廣告，係指利用傳播媒體或其他方 法，宣傳醫療業務，以達招徠患者醫療為目的之行為。 醫療法 第五章 醫療廣告 第84條：非醫療機構，不得為醫療廣告。 第85條：醫療廣告之內容限制 (第一項計六款) 第86條：醫療廣告不得以下列方式為之(七款) 第87條：內容暗示或影射醫療業務者，視為醫療廣告。 醫學新知或研究報告之發表、病人衛生教育、學術性刊物，未涉及招徠醫療業務者，不視為醫療廣告。

醫療法第85條第一項 醫療廣告，其內容以下列事項為限： 醫療機構之名稱、開業執照字號、地址、電話及交通路線。 醫師之姓名、性別、學歷、經歷及其醫師、專科醫師證書字 號。 全民健康保險及其他非商業性保險之特約醫院、診所字樣。 診療科別及診療時間。 開業、歇業、停業、復業、遷移及其年、月、日。 其他經中央主管機關公告容許登載或播放事項。

醫療法第85條第二、三項 利用廣播、電視之醫療廣告，在前項內容範圍內，得以口 語化方式為之。 但應先經所在地直轄市或縣 (市) 主管機 關核准。 醫療機構以網際網路提供之資訊，除有第103條第2項各 款所定情形 外，不受第一項所定內容範圍之限制，其管 理辦法由中央主管機關定之。

醫療法第86條 醫療廣告不得以下列方式為之： 假借他人名義為宣傳。 利用出售或贈與醫療刊物為宣傳。 以公開祖傳秘方或公開答問為宣傳。 摘錄醫學刊物內容為宣傳。 藉採訪或報導為宣傳。 與違反前條規定內容之廣告聯合或並排為宣傳。 以其他不正當方式為宣傳。

醫療法第103條第二項 內容虛偽、誇張、歪曲事實或有傷風化。 醫療廣告違反第85條、第86條規定或擅自變更核准內容者 ，除依前項規定處罰外，其有下列情形之一者，得處一個月 以上一年以下停業處 分或廢止其開業執照，並由中央主管 機關吊銷其負責醫師之醫師證書一年 ： 內容虛偽、誇張、歪曲事實或有傷風化。 以非法墮胎為宣傳。 一年內已受處罰三次。

判例一 要 旨： 對於醫療廣告內容之限制，依據醫療法第 86 條 7 款規定，醫療廣告不得以其他不正當方式為宣傳。 要　　旨： 對於醫療廣告內容之限制，依據醫療法第 86 條 7 款規定，醫療廣告不得以其他不正當方式為宣傳。 查本件受處分人刊登於網頁之廣告訊息，強調「特效療 法」、「專治」等聳動用語，顯為以不正當方式宣傳醫 療業務之醫療廣告。受處分人雖辯稱上開訊息均非刊登 於對外公開網址而不構成廣告云云，惟查該網址並未設 有帳號密碼等加密措施，而屬不特定人得瀏覽之公開狀 態。

判例二 要　　旨： 醫療法第 85 條第 3  項規定，醫療機構以網際網路 提供之資訊，除有第 103 條第 2 項各款所定情形 外，不受第 1 項所定內容範圍之限制，其管理辦法 由中央主管機關定之。 中醫診所於網路上刊登「您的酸痛麻痺一直醫不好嗎？ 小針療法免開刀，一針病除‧‧‧」廣告，其內容確有涉 及誇張，屬違規醫療廣告，依醫療法第103條第 1 項第 1 款規定，處以10 萬元罰鍰，並無違誤

醫療法   第 85 條   相關行政函釋 發文字號：衛署醫第 0980264150 號 發文日期：民國 99 年 01 月 11 日 要 旨：公告醫療法第 85 條第 1 項第 6 款所稱經中央主管 機關容許登載或播 放之醫療廣告事項，並自民國 99 年 1 月 11 日生效 （原行政院衛生署 97.12.30 衛署醫字第 0970219507 號公告停止適用）

醫療法   第 85 條   相關行政函釋 公告事項： 一、 醫療廣告之內容，在符合醫學倫理，傳遞正確醫 療資訊，提供就醫指引，維護病人安全為原則下， 得予容許登載或播放之項目如下 疾病名稱。 診療項目、檢查及檢驗項目。 醫療儀器及經完成人體試驗之醫療技術。 醫療費用。

醫療法   第 85 條   相關行政函釋 二、醫療機構得就國際醫療服務有關事項，以非本國語 文登載或播放下列 內容範圍之廣告，並應就其內 容事前報由所在地主管機關核轉中央主 管機關許 可： 分項醫療服務或組合式醫療服務項目、費用及其優 惠措施之說明。 結合相關業者共同提供之服務項目、費用及其優惠 措施之說明。 其他有關服務特色之說明。

Evolution of Marketing Concepts Production Sales Marketing

Production Era Assumption 薄利多銷期 Marketing Focus Consumers buy products or services that are low in price, easy to find, with high quality Marketing Focus Improving efficiency in production and distribution (分 銷管道) Improving quality 薄利多銷期

Sales Era 業務掛帥期 Assumption Marketing Focus If we leave customers alone, they will not buy enough of your product Marketing Focus Promoting and advertising products aggressively

Marketing Era 市場導向期 Assumption Marketing Focus Consumers will buy your products if you meet their needs Marketing Focus Identifying and satisfying their needs better than competitors

Sales vs. Marketing Oriented Selling promotion Provider Production Sales era Existing Products Profit through sales Integrated marketing Market Marketing era Customer needs 整合所有行銷資源以滿足顧客需求 Profit through customer satisfaction

Marketing is the identification and satisfaction of consumers’ needs Customer needs

A Word of Caution However Consumer needs can be very elusive (難以捉摸的) Consumers may or may not be able to articulate those needs (明白的說明這些需求) Consumers may or may not know what will satisfy them

*A method of marketing research “It‘s really hard to design products by focus groups (焦點團體*). A lot of times, people don't know what they want until you show it to them” Steve Jobs *A method of marketing research

“If I had asked the public what they wanted, they would have said (當初可能 會說要 . . .) a faster horse” Henry Ford

* Founder and CEO of SONY (from 1946-1994) “Our plan is to lead the public with new products (以新產品引領群眾) rather than ask them what kind of products they want. The public does not know what is possible, but we do” Akio Morita* 盛田昭夫 * Founder and CEO of SONY (from 1946-1994)

“Carefully watch how people live, get an intuitive sense as to what they might want and then go with it (根據這 個直覺去做). Don’t do market research” Akio Morita 盛田昭夫

Providing people what they want is a smart tactic; giving people something they didn’t know they need is an even smarter strategy.

Follow or Lead Consumers? Unarticulated needs Past innovation T-model Walkman i-Phone Future innovation Articulated needs Today’s business Future business Served Unserved

Follow or Lead Consumers? Unarticulated needs Past innovation T-model Walkman i-Phone Future innovation Articulated needs Today’s business Future business Served Unserved

Marketing Process Analyzing Market Setting Strategies Taking Action 5C analysis Setting Strategies Customize market Taking Action Marketing mix

Analyzing Market: 5C Analysis Company Collaborators PEBP Competitors Customers Context PEST

Setting Marketing Strategies Product positioning 產品定位 Deciding what you want your product to stand for in customers’ minds Market selection 選擇目標市場 Selecting target markets based on certain criteria Segmentation 市場區隔 Dividing the heterogeneous market into smaller and homogeneous markets

Take Action: Marketing Mix The process that the consumer goes through to receive the service What does it look like? Is it classy, basic, rundown? Physical environment Process Place Price Products Promotion People The staff employed to perform the service

Pricing and Therapeutic Efficacy JAMA. 2008; 299(9): 1016-1017 Pricing and Therapeutic Efficacy Context Marketing actions of medications may influence patients’ expectation and the efficacy of medical therapies (藥物的療效) Objective To examine the effect of price on analgesic response (鎮痛反應) to placebo pills (安慰劑)

Research Design Electrical shocks Rate how painful Opioid analgesics Regular ($2.5) Discount prices ($0.1) Before taking pills Electrical shocks After taking pills Before taking pills Rate how painful After taking pills

Method Participants received electrical shocks in 2.5-V increments before and after taking the pill Asked to rated the pain on a computerized pain scale

Results Experiencing pain reduction 85.4% of the regular- price ($2.5) group 61.0% of the discount- price ($0.10) group

Results 前後測的疼痛指數差異 For different shock intensities, mean pain reduction was greater for the regular-price pill

Explains the popularity of high- cost medical therapies (高價藥物 治療) over inexpensive, widely available alternatives

Also explains why patients switching form branded medications may report that their generic equivalents (學名藥) are less effective.

Clinical studies of real-world effectiveness need to consider how medications are sold in addition to how they are formulated Clinicians may be able to harness (利用/駕馭) quality cues (e.g., low-priced, generic) in beneficial ways

Pricing and Performance J. Of Marketing Research. 2005; 42: 383-393 Pricing and Performance Energy drink Regular Discount prices Try to solve word puzzle Number of puzzle solved

Results Placebo Effects Consumers who pay a discounted price solved fewer puzzles Due to lower expectation of the efficacy of the product Maybe an unconscious process

Implications Price affects not only perceived quality, but also actual quality If a marketer repackage a product and significantly increase its price and suggests this new product has greater efficacy Can people tell the difference? Ethical dilemma?

Marketing and Health Care Marketing