Download Market Profile of U.S. Dermatologists

Market Profile of U.S. Dermatologists
OneKey Market Insight Report
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Market Profile of U.S. Dermatologists
Overview: Profile of U.S. Dermatologists
▪
Dermatologists by Number, Region and Move Rate
▪
Practice Size and Patient Volume
▪
Ownership, Affiliations and Specialty Associations
▪
Affiliations to Hospitals for Admitting Privileges
▪
IHS Employment and ACO Participation
▪
Physician Access and Drug Acceptance Rates
▪
Government Insurance Acceptance
▪
Electronic Health Records Adoption Rate
▪
Annual Compensation of Dermatologists
Promotional Spend Towards Dermatologists Q1 - Q4 2014
▪
Total Market Spend
▪
Promotions by ATC3 Drug Class
▪
Channel Mix - Details, Samples and Meetings
▪
Total Product Details
Copyright © Cegedim 2015, Market Profile of U.S. Dermatologists
Introduction
Skin cancer is one of the most commonly diagnosed cancers in the U.S. According to the American
Cancer Society, the most recent study on non-melanoma skin cancer in 2006 estimated 3.5 million
cases diagnosed among 2.2 million people. Melanoma incidence rates have also risen rapidly over
the past 30 years. In 2015, an estimated 73,870 new cases of melanoma will be diagnosed. These
caseloads will be shared among 13,847 dermatologists, which make up only one percent of physicians
in the U.S.
Dermatologists are in great demand not only for the treatment of cancer, but also for skin conditions
ranging from acne to psoriasis. The Affordable Care Act (ACA) has contributed to additional demand
for dermatology services - dermatologists are among the top five specialists booked by ACA
patients1. This issue of the OneKey Market Insights series provides comprehensive details on this
group of physicians including their participation in Integrated Health Systems and Accountable Care
Organizations, physician access policies and top drug categories promoted to them.
Dermatologists by Number, Region and Move Rate
Dermatologists represent a very small number of the total number of physicians in the U.S. There are
currently 13,847 dermatologists practicing across the country. Most dermatologists focus on a single
specialty; only 13.5 percent have a secondary specialty. The number of dermatologists has certainly
not kept up with demand. Since 2010, there has only been about a 10 percent increase in the number
of dermatologists.
Number of Dermatologists in the US
14000
13800
13600
13400
13200
13000
12800
12600
12400
12200
12000
11800
13,650
13,725
13,847
2013
2014
13,011
12,597
2010
2011
2012
Source: Cegedim Relationship Management, Jan 2015
1 No rush to high-cost care among newly insured Obamacare patients.(2015, Jan 15). Reuters. Retrieved from http://www.reuters.com/
article/2015/01/15/us-usa-healthcare-zocdoc-exclusive-idUSKBN0KO1W920150115
Copyright © Cegedim 2015, Market Profile of U.S. Dermatologists
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The southern states have the highest concentration of dermatologists. A third of the country’s
dermatologists practice in the south, outweighing the northern states by about 70 percent.
U.S. Dermatologists by Region
Source: Cegedim Relationship Management, Jan 2015
Dermatologists moved to new locations, changed jobs, retired or passed away at average rate of 9.6
percent annually for the past six years, lower than the average physician move-rate of 13.8 percent.
Dermatologists Move Rate
(Deceased, Moved, Retired)
20%
18.2%
15.0%
15%
10%
12.4%
12.9%
9.5%
5%
0%
2008
2009
14.5%
11.8%
12.1%
8.4%
8.0%
9.0%
2010
2011
All Physicians
2012
12.4%
10.6%
2013
8.9%
2014
Dermatologist
Source: Cegedim Relationship Management, Jan 2015
Copyright © Cegedim 2015, Market Profile of U.S. Dermatologists
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Practice Size and Patient Volume
Dermatologists generally seem to prefer smaller office settings. A vast majority – nearly three quarters
of dermatologists prefer to work in offices with five or less physicians. Nearly a third of dermatologists
prefer to work as solo practitioners.
Office Size of Dermatologists
8%
5%
1
29%
14%
2
3 to 5
6 to 10
11 to 25
26%
Office Size
(No. of Doctors)
Total
1
18%
2
4,088
2,517
3 to 5
3,618
26 plus
6 to 10
1,906
11 to
25
1,079
26 or
more
639
Total
13,847
Source: Cegedim Relationship Management, Jan 2015
Nearly half of dermatologists see 50 or fewer patients per day, corresponding to the number of solo or
small practices.
Daily Patient Volume
23%
45%
1 to 50
51 to 75
76 to 100
17%
101 plus
15%
Source: Cegedim Relationship Management, Jan 2015
Copyright © Cegedim 2015, Market Profile of U.S. Dermatologists
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Ownership, Affiliations and Specialty Associations
Dermatologists maintain a relatively high level of ownership, with over half being independent. Over 40
percent of physicians in the U.S. are employed by IHSs or hospitals. In comparison, less than a fifth of dermatologists have moved towards integrated health systems or hospitals.
Source: Cegedim Relationship Management, Jan 2015
Top 4 Specialty Associations
About 15 percent of dermatologists are associated with internists, and 10 percent are associated with
family practitioners.
Top 4 Specialty Associations
4000
3500
3,379
3000
2500
2,184
2000
1,335
1500
1000
956
500
0
Internist Family Practitioner Pediatrician Obstetrician/Gynecologist Source: Cegedim Relationship Management, Jan 2015
Affiliation to Hospitals for Admitting Privileges
Copyright © Cegedim 2015, Market Profile of U.S. Dermatologists
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Compared to other specialties, dermatologists have less affiliation to hospitals. A quarter have
no admitting privileges at hospitals and less than half have admitting privileges to one hospital.
Affiliations to Hospitals
0
1
2
3
4
Total
No. of Doctors
3,705
6,101
3,181
721
139
13,847
% of total
26.8%
44.1%
23.0%
5.2%
1.0%
100.00%
Source: Cegedim Relationship Management, Jan 2015
Government Insurance Acceptance
Dermatologists have a higher acceptance rate of Medicare relative to the general physician population,
but a much lower rate of Medicaid acceptance compared to their counterparts in other specialties.
Dermatologist Medicare and Medicaid
Acceptance
Medicaid
42.3%
Dermatologists
73.1%
All Physicians
93.7%
Medicare
0.0%
85.5%
50.0%
100.0%
Source: Cegedim Relationship Management, Jan 2015
Copyright © Cegedim 2015, Market Profile of U.S. Dermatologists
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IHS Employment and ACO Participation
Employing over 9,000 MDs and DOs in 33 hospitals and 900+ medical offices, Kaiser Permanante is
the largest employer of healthcare professionals among integrated health systems. The system hires
the most number of dermatologists, twice as many as the next top top employer.
Top 5 IHSs Employing Dermatologists
168
Kaiser Permanente
81
Partners Healthcare System
University Of Utah Healthcare
University Of Texas Health System
Sutter Health
59
53
50
Source: Cegedim Relationship Management, Jan 2015
At least 15 percent of dermatologists participate in ACOs. While Health Choice of Utah is not one of
the largest ACO in terms of total physician participation, it has the highest dermatologist participation
in its network. Next in place is Palo Alto Medical Foundation Cigna ACO, which has a network of over
580 facilities and over 3,300 total participating physicians in 2014.
Top 5 ACOs with Dermatologists Participation
59
Health Choice Of Utah
Palo Alto Medical Foundation Cigna
ACO
49
Mount Auburn Cambridge Independent
Practice Association MACIPA
St Lukes Episcopal Hospital
Independent Practice Association…
Weill Cornell Physician Organization
45
38
37
Source: Cegedim Relationship Management, Jan 2015
Copyright © Cegedim 2015, Market Profile of U.S. Dermatologists
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Physician Access and Drug Sample Acceptance Rates
Dermatologists like sales reps. Only 10 percent have a no-see policy, much lower than the average
no-see rate of 28.5%. Nearly half welcome sales reps to drop by anytime.
Physician Access
2%
10%
access any time
45%
call f or appointment
no access
unknown
43%
Source: Cegedim Relationship Management, Jan 2015
In terms of sampling preferences, two-thirds of dermatologists like to receive drug samples by both
mail or sales rep drop-off.
Drug Sampling Preference
3%
15%
17%
No Pref erence or
Unknown
Both
Drug rep drops of f drugs
65%
Mail
Source: Cegedim Relationship Management, Jan 2015
Copyright © Cegedim 2015, Market Profile of U.S. Dermatologists
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Electronic Health Record Adoption of Dermatologists
Dermatologists are among the specialties with relatively high electronic health records (EHR) adoption
rate. At 63 percent, EHR adoption rate of dermatologists is in line with the general physician population.
Electronic Health Record Adoption Rate of
Dermatologists
EHR Adoption Rate
70.0%
60.0%
50.0%
40.0%
30.0%
20.0%
10.0%
0.0%
2010
2011
2012
2013
2014
Dermatologists
38.0%
46.2%
55.0%
65.5%
63.0%
All Physicians
36.1%
40.4%
45.6%
50.3%
61.0%
Source: Cegedim Relationship Management, Jan 2015
Annual Compensation of Dermatologists
Depending on where they work, there could be a huge discrepancy in the earnings of dermatologists. According to Medscape’s 2014 dermatologist compensation report, physicians working in healthcare
organizations or group practices earned significantly more than their counterparts who work in
outpatient clinics or hospitals. The highest earning group made twice as much as those in the lowest
earning group.
Dermatologists Annual Compensation by Setting
Multispecialty Group Practice
$361,000
Healthcare Organization
$336,000
Single Specialty Group Practice
$323,000
Solo Practice
$306,000
Academic
$232,000
Outpatient Clinic
$211,000
Hospital
$169,000
Source: Medscape’s Dermatologist Compensation Report 2014
Copyright © Cegedim 2015, Market Profile of U.S. Dermatologists
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Pharma Promotional Spend Towards Dermatologists Q1- Q4 2014
Total Market Spend
The pharmaceutical industry spent over $549 million promoting drugs to dermatologists during the last
four quarters. Spending peaked slightly in Q3 2014, but remained fairly consistent in other quarters.
Promotional Investment: Dermatologist Share of
Total Spending ($M)
180
156
160
140
120
137
130
126
100
80
60
40
20
2014 Q1
2014 Q2
2014 Q3
2014 Q4
Source: Cegedim Strategic Data, U.S.Dermatologist Data, Jan 2015
Promotions by ATC3 Drug Class
Nearly a fifth of pharma’s total promotional spend went to topical anti-acne preparations. Next on the
list of top drug categories promoted to dermatologists is plain topical corticosteroids – about 13.5% of
total spend went towards this category.
100%
90%
% of Promotional Spend by ATC3 Class: Dermatologists
3%
4%
6%
4%
4%
4%
5%
5%
6%
4%
5%
5%
5%
5%
5%
7%
9%
9%
8%
14%
14%
12%
18%
19%
19%
28%
30%
5%
80%
6%
70%
60%
14%
50%
40%
19%
7%
6%
4%
4%
5%
5%
5%
D10B - ORAL ANTI-ACNE PREPARATIONS
D05X - OTHER NONSTEROIDAL PRODUCTS FOR
INFLAMMATORY SKIN DISORDERS
L04B - ANTI-TNF PRODUCTS
D05A - TOPICAL ANTIPSORIASIS PRODUCTS
J01A - TETRACYCLINES AND COMBINATIONS
D01A - ANTIFUNGALS, DERMATOLOGICAL
30%
D07A - PLAIN TOPICAL CORTICOSTEROIDS
20%
30%
10%
0%
D05B - SYSTEMIC ANTIPSORIASIS PRODUCTS
30%
D10A - TOPICAL ANTI-ACNE PREPARATIONS
OTHERS
2014 Q1
2014 Q2
2014 Q3
2014 Q4
Source: Cegedim Strategic Data, U.S. Dermatologist Data, Jan 2015
Copyright © Cegedim 2015, Market Profile of U.S. Dermatologists
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Channel Mix – Details, Samples and Meetings
A huge proportion of pharma promotional spend - 75 percent - went towards detailing. Compared to
this channel, pharma spent considerably less on the next most popular channel – only 17 percent on
samples. % of Promotional Spend by Channel Mix - Dermatologists
100%
90%
80%
SP DETAILING
70%
75%
76%
60%
75%
75%
SAMPLES
MEETINGS
MAILING
50%
CLINICAL TRIALS
40%
30%
20%
17%
17%
10%
7%
3% 1%
6%
2% 1%
2014 Q1
0%
17%
17%
7%
3%
7%
2% 1%
2014 Q2
2014 Q3
1%
2014 Q4
Source: Cegedim Strategic Data, U.S. Dermatologist Data, Jan 2015
Total Market Details
In the last four quarters there were over 2.5 million details. Corresponding to the spike in promotional
investments in 2014 Q3, more details took place during this quarter.
Total Detailing on Dermatologists ('000)
800
700
Details ('000)
600
729
622
589
610
500
400
300
200
100
0
2014 Q1
2014 Q2
2014 Q3
2014 Q4
Source: Cegedim Strategic Data, U.S. Dermatologist Data, Jan 2015
Copyright © Cegedim 2015, Market Profile of U.S. Dermatologists
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For more information about U.S. Dermatologists, please contact:
Jack Schember, Senior Director of Marketing
Cegedim Relationship Management
[email protected]
949-476-2051
Cegedim Relationship Management Corporate Headquarters
1405 U.S. Highway 206
Bedminster, NJ 07921
908-443-2000
888-336-3748
www.cegedimrm.com
Copyright © Cegedim 2015, Market Profile of U.S. Dermatologists
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