1. ROI STUDIES
Proven Effectiveness
BulletinHealthcare’s Data Insights & Analytics team works with advertisers to create customized evaluations of ad effectiveness.
BH uses reputable third-party vendors to perform two kinds of advertising effectiveness studies:
Attitudinal studies measure the impact of ad exposure on HCP attitudes. A research provider fields a survey to HCPs who have seen our ads and to similar HCPs who have not. The attitudes of each group are compared. Each survey is custom-designed to capture the objectives of a given campaign.
Prescription lift ROI studies directly measure the change in prescribing benchmarks such as TRx, NRx, and NTB. IMS, Symphony Health, and other vendors can compare prescribing behaviors among BulletinHealthcare’s audience to those of similar prescribers.

2. Increased Awareness of Specialty Medication
GASTROENTEROLOGY
Increased Awareness of Specialty Medication
Campaign Objective
Increase awareness of a branded specialty gastroenterology drug in the middle of its patent life among a well defined audience of potential prescribers.
Media Plan
Five briefings used: AMA Morning Rounds (weekday and weekend editions), AGA’s Today in Medicine, the Cleveland Clinic IM Daily Brief, and TMA’s Daily Headlines.
Campaign ran 286 insertions targeted to 8,380 physicians, resulting in a total of 458,585 impressions.

3. Increased Awareness of Specialty Medication (cont.)
Unprompted Recall
HCPs asked to name preferred drug in category
280% higher recall in group that had seen BH ads
GASTROENTEROLOGY
Increased Awareness of Specialty Medication (cont.)
Measuring Awareness
According to a study fielded by Sermo, HCPs who were exposed to the ad campaign had higher recall and self- reported prescription volume.
Unprompted recall increased from 10.4% to 39.6%.

4. Increased Awareness of Specialty Medication (cont.)
Prescription Volume
HCPs asked to name preferred drug in category
80% higher amongst group that had seen BH ads
GASTROENTEROLOGY
Increased Awareness of Specialty Medication (cont.)
Measuring Awareness
According to a study fielded by Sermo, HCPs who were exposed to the ad campaign had higher recall and self- reported prescription volume.
Unprompted recall increased from 10.4% to 39.6%.
Respondents who had seen BH’s ads reported writing 80% more prescriptions than the control group.

5. Brand Awareness Achieved
Oncology
Brand Awareness Achieved
Campaign Objective
Leading international pharmaceutical company entering the U.S. market turned to BulletinHealthcare to increase awareness of the company name and brand among hematologists
Media Plan
Briefing selected: American Society for Clinical Oncology’s Cancer in the News
Creative focused on the company name/brand rather than discrete drugs
Campaign launched in June 2014 and ended October 2014
Frequency: approximately three insertions per week

6. Brand Awareness Achieved (cont.)
Lift Results
15 point lift in familiarity with company
22 point lift in familiarity among the non-academic, patient-seeing population
ONCOLOGY
Brand Awareness Achieved (cont.)
Measuring Awareness
Online surveys of physicians were conducted by WorldOne’s MedLive physician panel platform
Pre-campaign survey was conducted from May 27 to June 2, 2014; post- campaign survey was fielded from November 6 to November 17, 2014
n=63 (pre) n=65 (post)
Overall lift significant at 80% CL, patient-seeing lift significant at 90% CL

7. Strong Incremental Rx from Higher Exposure
INFECTIOUS DISEASE
Strong Incremental Rx from Higher Exposure
Campaign Objective
Drive awareness of an infectious disease treatment option and increase prescription writing behavior among target HCPs
Media Plan
Two briefings used: Cleveland Clinic Foundation’s IM Daily Brief, as well as American Medical Association’s AMA Morning Rounds, targeting infectious disease specialists and PCPs
Diverse mix of ad sizes and messaging
Campaign launched in January 2014 and ended December 2014
Frequency: approximately two insertions per week

8. 132.8% lift in TRx due to 37+ exposure frequency*
Lift & ROI Results
ROI (incremental revenue) from TRx
ROI of 18:1 among HCPs overall (~$2,700,000)^
INFECTIOUS DISEASE
Strong Incremental Rx from Higher Exposure (cont.)
Measuring Awareness
Study by Symphony Health paired test and control prescribers (n=4,100+) on product/market volume, geography, specialty, writing decile, and plan types
Pre-program conducted between January and December 2013; qualify period fielded between January and December 2014
HCPs exposed to the brand’s messaging 37 times or more had a TRx lift of %
132.8% lift in TRx due to 37+ exposure frequency*
^ Based on wholesale acquisition cost per SHS ($2,457), detail next page
* Lift significant at 90% CL

9. Strong Incremental Rx from Higher Exposure (cont.)
INFECTIOUS DISEASE
Strong Incremental Rx from Higher Exposure (cont.)
ROI Calculation (Overall)
Raw sample NRx increase = NRx projected increase (projected out to full prescribing database) = 459
Average refill rate (total TRx / total NRx) = 2.4
Projected TRx = 459 * 2.4 = 1,102
Wholesale Acquisition Cost = $2,457, Incremental Revenue = 1,102 * $2,457 = $2,708,560
Media Investment = $150,000, ROI = $2,708,560 / $150,000 = 18:1

10. Strong ROI for Branded Pain Medication
Campaign Objective
Increase prescriptions among rheumatologists and other relevant HCPs
Media Plan
Targeted a client list match (mainly rheumatologists); ran across 16 different BulletinHealthcare briefings
Branded creative featured drug name
Custom ad unit with ISI
Campaign launched in January 2014 and ended June 2014
Frequency: approximately two insertions per week

11. Lift & ROI Results Measuring Awareness
PAIN
Lift & ROI Results
ROI (incremental revenue) from TRx
ROI of 4.4:1 among HCPs overall (~$944,000)^
ROI of 7.6:1 among rheumatologists (~$178,000)^
Strong ROI for Branded Pain Medication (cont.)
Measuring Awareness
Study by Symphony Health paired test and control prescribers (n=23,000+) on product/market volume, geography, specialty, writing decile, and plan types
Pre-program conducted between June and December 2013; qualify period fielded between January and June 2014
^ Based on wholesale acquisition cost per SHS ($122), detail next page
* Lift significant at 90% CL
NTB = “New to Brand” – based on medical claims database; patient not seen on brand in last 12 months

12. Strong ROI for Branded Pain Medication (cont.)
ROI Calculation (Overall)
Raw NRx increase = 947, NRx projected increase (projected out to full prescribing database) = 3,381
Average refill rate (total TRx / total NRx) = 2.3
Projected TRx = 3,381 x 2.3 = 7,741
Wholesale Acquisition Cost = $122, Incremental Revenue = 7,741 x $122 = $944,366
Media Investment = $214,924, ROI = $944,366 / $214,924 = 4.4:1
ROI Calculation (Rheumatologists)
Raw NRx increase = 179, NRx projected increased (projected out to full prescribing database) = 639
Projected TRx = 639 x 2.3 = 1,460
Wholesale Acquisition Cost = $122, Incremental Revenue = 1,460 x $122 = $178,067
Media Investment = $23,500, ROI = $178,067 / $23,500 = 7.6:1

13. Exposure Drives Rx Lift
Psychiatry
Exposure Drives Rx Lift
Campaign Objective
Increase prescriptions for a psychiatric treatment option by messaging to the specialty target via a BHC briefing
Media Plan
Briefing selected: American Psychiatric Association’s Headlines, targeting psychiatrists in the U.S.
Campaign featured both branded and unbranded ads, insertion volume weighted towards branded messaging
Standard 300x250 ad units and large format ad with full ISI
Campaign launched in January 2014 and ended December 2014
Frequency: approximately one insertion per week

14. Lift & ROI Results Measuring Awareness Exposure Drives Rx Lift (cont.)
Psychiatry
Lift & ROI Results
ROI (incremental revenue) from TRx
ROI of 69:1 among HCPs overall (~$7,600,000)^
Exposure Drives Rx Lift (cont.)
Measuring Awareness
Study by Symphony Health paired test and control prescribers (n=7,500+) on product/market volume, geography, specialty, writing decile, and plan types
Pre-program conducted between January and December 2013; qualify period fielded between January and December 2014
^ Based on WAC per SHS ($1,072), detail next page
** Lift significant at 90% CL
NTB = “New to Brand” – based on medical claims database; patient not seen on brand in last 12 months

15. Exposure Drives Rx Lift (cont.)
Psychiatry
Exposure Drives Rx Lift (cont.)
ROI Calculation (Overall)
Raw sample NRx increase = 2,358, NRx projected increase (projected out to full prescribing database) = 4,137
Average refill rate (total TRx / total NRx) = 1.72
Projected TRx = 4,137 x 1.72 = 7,120
Wholesale Acquisition Cost = $1,072, Incremental Revenue = 7,120 x $1,072 = $7,630,149
Media Investment = $110,200, ROI = $7,630,149 / $110,200 = 69:1

16. Driving NRx Lift Via Multichannel Campaign
Oncology
Driving NRx Lift Via Multichannel Campaign
Campaign Objective
Drive an increase in prescriptions among targeted oncologists
Media Plan
BulletinHealthcare executed a multichannel program including
Exposure to targeted messaging within BulletinHealthcare’s eNewsletters
Direct Mail outreach
Exposure to the relevant Cleveland Clinic Physician’s Guide

17. Study Objective & Design
Oncology
Study Objective & Design
Assess impact of branded advertising through different tactic means:
prescribers exposed to a Bulletin’s Healthcare ad
prescribers exposed to ad through direct mail
prescribers exposed to the RCC drug’s condition guide
IMS Health conducted a study to measure NRx lift for participating prescribers
Paired test and control prescribers on product and market volume, specialty, geography, writing decile
Participants were exposed to the program between October 2012 and April
ANCOVA was used to measure statistical significance of the NRx lift between Test and Control prescribers

18. Oncology
NRx Comparison
During the seven month test period, Test prescribers prescribed 183.7% more NRx compared to Control prescribers. This change in prescribing behavior is statistically significant (cl=100%).
Note: Control NRX during the pre-periods and post periods is adjusted to remove aggregate differences between test and control groups in the pre-period.

19. Oncology
NRx Volume
NRx increased with statistical significance for every tactic, the largest lift was among prescribers who were exposed to messages in multiple channels.
*Conf Level >90% program is significant, ** Conf Level 80-90% program is directional
3,820 test prescribers and 3,820 control prescribers included in study
Pre period: Feb-Jul 2012, Test period: Oct 2012-Apr 2013
Analysis conducted : ANCOVA

20. Rx Lift/ROI Summary Lift in NRx due to program 183.7%*
Oncology
Rx Lift/ROI Summary
Lift in NRx due to program %*
Share change due to program %
Penetration change due to program %*
Lift in TRx due to exposure to ads ,176
Estimated revenue per Rx $5,492.18
Incremental revenue due to program $66,872,783
Media investment at standard rate card $750,000
Return on investment :1
3,820 test prescribers and 3,820 control prescribers included in study
Pre period: Feb-Jul 2012, Test period: Oct 2012-Apr 2013
* Conf Level >= 90% program is significant
TRx values based on projected IMS NRx, refill rates and lift metrics

21. Strategy Drives Rx, Defends Market Share
Cardiology
Strategy Drives Rx, Defends Market Share
Campaign Objective
Drive an increase in prescriptions among cardiologists and PCPs through partnership with Cleveland Clinic’s Disease Management Project
Stem a decrease in market share driven by the launch of a new generic cardiology drug
Media Plan
BulletinHealthcare executed a multi-channel program, including direct mail, briefing advertising, alerts, and a dedicated microsite
In terms of briefing ads, the selected publications included the American Medical Association’s AMA Morning Rounds and the American College of Cardiology’s CV News Digest
Included digital tactics and print components delivered via targeted direct mail
Advertising on a dedicated microsite for chapter download
Launched in October 2012, ended December 2012

22. Strategy Drives Rx, Defends Market Share (cont.)
Lift & ROI Results
ROI (incremental revenue) from TRx
ROI of 10.6:1 among HCPs overall (~$9,300,000)^
ROI of 15:1 on briefing advertising (~$1,650,000)^
Cardiology
Strategy Drives Rx, Defends Market Share (cont.)
Measuring ROI
IMS Health paired test and control prescribers (n=16,000+) on product/market volume, geography, specialty, writing decile, and plan types
Pre-program conducted between April and September 2012; qualify period fielded between October 2012 and February 2013
^ Based on average product price of $ per IMS NPA Plus
* Lift significant at 80-89% CL
** Lift significant at 90% CL
0.7% increase in market share due to multi-channel exposure*

23. Lift Observed in Office-Based Treatment
Oncology
Lift Observed in Office-Based Treatment
Campaign Objective
Drive use of a cancer treatment via in-office administration (measurement conducted via medical claims database)
Media Plan
The American Urological Association’s AUA Daily Scope and American Society for Clinical Oncology’s Cancer in the News were the two briefings used for this campaign
Branded creative in three standard IAB ad sizes
Campaign launched in January 2014 and ended December 2014
Frequency: between one and two insertions per week

24. Lift Observed in Office- Based Treatment (cont.)
Lift & ROI Results
ROI (incremental revenue) from MX*
ROI of 19:1 among HCPs overall (~$1,200,000)^
Oncology
Lift Observed in Office- Based Treatment (cont.)
Measuring ROI
Study by Symphony Health paired test and control prescribers (n=3,300+) on product/market volume, geography, specialty, writing decile, and plan types
Pre-program conducted between January and December 2013; qualify period fielded between January and December 2014
* Based on medical claims as Rx is administered in-office
^ Based on wholesale acquisition cost per SHS ($1,763), detail next page
** Lift significant at 90% CL
NTB = “New to Brand” – based on medical claims database; patient not seen on brand in last 12 months
29.7% lift in NTB for mobile only**
32.0% lift in NTB among oncologist specialty target**

25. Lift Observed in Office-Based Treatment
Oncology
Lift Observed in Office-Based Treatment
ROI Calculation (Overall)
Raw sample MX increase = 389, MX projected increase (projected out to full prescribing database) = 688
Average refill rate (total TRx / total NRx) = N/A – administered in-office
Wholesale Acquisition Cost = $1,763, Incremental Revenue = 688 x $1,763 = $1,213,059
Media Investment = $63,800, ROI = $1,213,059 / $63,800 = 19:1