Who Makes the Rules?
In 1996, the Health Insurance Portability and Accountability Act (HIPAA) was passed to protect sensitive patient health information from being disclosed without consent. When it comes to understanding HIPAA for uses of health information for advertising, there’s lots of room for interpretation leaving advertisers unsure if certain marketing capabilities are compliant and ethical. This especially holds true for pharmaceutical advertisers using health information to target audiences for prescription drugs, medical devices and other pharmaceutical brands through media. To provide an industry standard and best practices, there are committees devoted to providing this direction to advertisers like the National Advertising Initiative (NAI), the Interactive Advertising Bureau (IAB), the Digital Advertising Alliance (DAA) and others.
One of the leading bodies in defining the regulations for digital advertising is the NAI. Founded in 2000, the NAI published a set of code for advertisers to abide by that is supported by the U.S. Federal Trade Commission. The most recent revisions to the code enables advertisers to reference media targeting best practices according to the NAI, including a definition for Sensitive Health Information to provide pharmaceutical advertisers with more concrete direction.
What Does This Mean?
The first step in determining targeting capabilities for your brand is to understand if the brand falls under the ‘sensitive’ category. According to the NAI, there are two subsets of sensitive information:
- Data about a health condition or treatment derived from a sensitive source
- Data about certain sensitive conditions regardless of the source of the data
Determining whether a health condition is considered ‘sensitive’ is unclear in the industry. The NAI provides only a few categories that define as sensitive which include drug addiction, sexually transmitted diseases, mental health, pregnancy termination, and all conditions predominantly affecting or associated with children not treated by OTC and Cancer.
There are resources to help guide the analysis of determining whether the brand falls into the sensitive category. The NAI provides a multi-step guidance for members on their best practice to help determine whether any targeting efforts or data segments are considered sensitive: https://www.networkadvertising.org/sites/default/files/nai_healthtargeting2020.pdf
However, this guidance does not give advertisers a clear list of the targeting capabilities that are compliant. Coegi recommends to use the guide to help drive direct conversations with the client in coming to a mutual agreement on whether the brand falls into either the sensitive or non-sensitive category to influence targeting solutions that are compliant.
Because there is no clear list provided by any regulatory source, Coegi recommends working with the client to align on the brand’s definition of sensitivity as this will greatly affect compliant targeting capabilities.
The Trade Desk (a member of the NAI) also takes precautions and has implemented a healthcare policy to ensure all targeting efforts are safe. Because there is no official, comprehensive list from the NAI to deem health conditions sensitive or non-sensitive, The Trade Desk has its own process in defining whether a condition is deemed high, medium or low in the sensitive category to see what targeting capabilities are permitted for each brand. This policy uses a multi-factor analysis to take into account many considerations when calculating each condition’s category.
Other advertising platforms have similar protocols for brands in the healthcare space. Before running paid ads through Facebook, advertisers must apply for permission according to its Promotion of Prescription Drugs policy and first gain approval from Facebook.
How to Approach Targeting a Pharmaceutical Audience?
Once alignment on whether the brand falls into either the sensitive or non-sensitive condition category is achieved, below are the different ways to target both consumers and HCPs within the pharmaceutical vertical:
- This form of targeting is typically not a compliant way to reach a consumer given it’s ‘data about a health condition or treatment’. However, there are third party data providers that use de-identified information which is considered compliant according to the NAI.
- It is critical to understand how the data is being collected if using any third parties to reach a patient audience. Coegi will always do a detailed analysis to determine whether a data provider is compliant according to industry best practices.
- From a blog post by Yeehooi Tee of PulsePoint, not all audience models are created the same and there are key factors to understand when evaluating health data segments. These factors include the source of the seed data, the attributes used to model the data, understanding the seed to output ratio and among many other factors.
- There are no known regulations for using contextual targeting for a consumer audience. This is a popular approach in reaching a patient and caregiver audience in a compliant manner.
- For both sensitive and non-sensitive conditions, geo-targeting a consumer audience is not compliant. According to the NAI, unless the user’s opt-in consent is given to target by precise location data (like a health care provider’s office), this form of targeting falls outside of best practice.
- While using precise location data requires opt-in, there are other forms of targeting that could reach a patient audience using geographic data. This data would need to be further vetted to ensure it’s not precise location data.
- According to the 2020 code, retargeting is a form of Tailored Advertising. For sensitive health segments, an opt-in consent is required from users in order to retarget a consumer audience.
- Even for other non-sensitive health segments, Coegi still recommends having a conversation with the brand team to gain alignment prior to executing this form of targeting.
- Because you’re targeting by profession, there are fewer restrictions when trying to target a HCP audience (while still using de-identified information). It’s an industry norm that an audience-first approach in reaching HCPs is best practice and compliant.
- Various forms of audience targeting for HCPs can include:
- Dx Targeting – ICD-10 code for specific diagnosis
- Rx Targeting – prescription code for specific drugs
- Specialty Targeting – target HCPs by specific medical specialty
- List Match Targeting – target HCPs by specific NPI number
- Depending on a particular client’s goals, Coegi will provide a recommended targeting strategy to reach a HCP audience
- However, even with it being less restricted, Coegi still recommends investigating and understanding the source of the data segments associated with NPIs and still having a conversation with the brand team to gain alignment on certain targeting efforts especially forms of retargeting.
Insights from Colin Duft, Account Strategy Director at Coegi
Be sure to check out our webinar: Best Practices from the Frontline of Healthcare and Pharma Marketing