Background
DMD’s Email Year in Review features data from millions of emails sent to
healthcare professionals (HCPs) in 2020 by pharmaceutical, medical device,
and diagnostic companies. This report provides healthcare marketers with
benchmarks and insights to guide their planning and execution of email
marketing in the year ahead.
SM
The analysis draws from DMD’s True Identity database, the only database
of first-party sourced, opted-in, and legally compliant HCP identity data. This
database also includes records of the digital engagement (web and email) for
all participating HCPs.
For this report, email data from October 31, 2019 to October 31, 2020 was
analyzed, covering 32 million emails to U.S.-based physicians, nurse
practitioners, physician assistants, nurses, and pharmacists on behalf of
healthcare brands.
This analysis also includes a deeper dive into the email performance of
several therapeutic specialties. With data for 27 medical specialties and 114
subspecialties, DMD can provide additional analyses to meet your needs.
Contact DMD if you would like a custom analysis.
Contents
Background ..................................... 1
Email Marketing to HCPs: The
COVID-19 Impact............................. 2
Open Rates in a Pandemic .......... 2
Personal Email Addresses vs
Professional Address................... 3
COVID Email Campaigns.............. 3
Target List Coverage........................ 4
Email Engagement Metrics ............. 5
Open Rate
...................... 5
Click-To-Open Rate (CTOR) ......... 5
Read Time ................................... 6
Bounces and Unsubscribes ......... 6
Deployment and Deliverability ....... 7
Deliverability ............................... 7
Inbox Challenges in 2020 ............ 7
Gmail ....................................... 7
Yahoo ...................................... 8
Send Time Optimization ............. 8
Predicting 2021 ............................... 8
www.dmdconnects.com
©2020 DMD Marketing Corp. | Proprietary and Confidential
1
Email Marketing to HCPs: The COVID-19 Impact
Open Rates in a Pandemic
In 2019, emails deployed to HCPs by DMD on behalf of pharmaceutical, medical device, and diagnostic companies had
an average open rate of 9.4%. However, as COVID began to receive coverage in the professional and lay press as early as
January 2020, open rates began to climb. At the peak of the COVID-19 outbreak in April 2020, the open rate average was
18.9% [Figure 1], a nearly 300% increase compared to the April 2019 average open rate of 7.0%.
Figure 1.
The increase in open rates may have been the result of:
•
•
Reduced sales rep visits leading to more reliance from HCPs on email to obtain drug and brand information.
Medical professionals seeking COVID information from credible sources, including pharma.
While not all pharma email during this period mentioned COVID, pharma email did experience an unprecedented lift in
opens, suggesting HCPs were investigating all sources for relevant information. Whether driven by COVID or other
factors, the open rate for 2020 is holding at several points higher than 2019, suggesting a new normal for this audience.
www.dmdconnects.com
©2020 DMD Marketing Corp. | Proprietary and Confidential
2
Personal Email Addresses vs Professional Address
Historically, emails sent to HCPs at their opted-in personal addresses have a higher open rate than the same message
sent to a business address. This remained consistent during the initial COVID period [Figure 2]. However, by July 2020
open rates at personal addresses had returned to their traditional levels, while professional addresses remained
elevated.
Figure 2.
COVID Email Campaigns
From March 2020 to June 2020, DMD deployed 21 pharma campaigns that included COVID in the subject line. By July,
the mention of COVID in these emails had dropped to almost zero. For comparison, DMD’s hospital clients still routinely
include COVID content in outbound emails.
Takeaway
The COVID-19 pandemic seemed to have a dramatic effect on the engagement rates of email sent by
pharmaceutical, medical device, and diagnostic companies to their HCP audiences. While metrics such as open
rates have come down from the highs seen early in 2020, they remain elevated over previous years.
COVID-19 is still a highly relevant and engaging topic to HCPs. DMD’s AIM® XR data, which monitors physician
activity across 2,100-plus medical websites, continues to show that stories related to COVID are among the most
read content, regardless of specialty. If your brand or company has any COVID content, DMD’s recommendation
is to include it in your HCP email marketing.
www.dmdconnects.com
©2020 DMD Marketing Corp. | Proprietary and Confidential
3
Target List Coverage
A key to successful HCP email marketing is reaching as many individuals as possible from a target list. During the
reporting period, DMD received 273 target lists from pharma companies, and matched them to the DMD True IdentitySM
database to determine how many target prescribers could be reached via email.
Overall Match
93.3%
Average match rate of opted-in emails on a target list
Therapeutic Categories with Highest Match Rate
96.0%
Rheumatology average match rate of opted-in emails on a
93.7%
Blood disorders (non-oncology) average match rate of opted-
93.5%
Oncology average match rate of opted-in emails on a target
target list
in emails on a target list
list
Match Rates for Most Requested Therapeutic Categories
93.5%
Oncology average match rate of opted-in emails on a target
92.4%
Respiratory average match rate of opted-in emails on a
90.5%
Dermatology average match rate of opted-in emails on a
list
target list
target list
Takeaway
Expect a 93% email address match for your target list with a variance of ±3%. Medical specialties with less target
list demand may have a slightly lower match rate. Target lists with NPs and PAs might have a lower match rate.
www.dmdconnects.com
©2020 DMD Marketing Corp. | Proprietary and Confidential
4
Email Engagement Metrics
Email is an important channel for every brand’s marketing goals, playing a crucial role in a brand’s strategy and
communication efforts. To understand the effectiveness of email campaigns, three engagement metrics are commonly
used: open rate, click-to-open rate, and read time.
Open Rate
Opens by Device Type
Definition: Total opens divided by total delivered emails
Average open rate for all therapeutic areas
12.28%
Average open rates for 3 most requested
therapeutic areas
Oncology
10.29%
Respiratory
12.74%
Dermatology
14.7%
Click-To-Open Rate (CTOR)
Definition: Total clicks divided by total email opens
Average CTOR for all therapeutic areas
3.10%
Average CTOR for 3 most requested therapeutic
areas
Oncology
2.64%
Respiratory
3.86%
Dermatology
3.33%
www.dmdconnects.com
©2020 DMD Marketing Corp. | Proprietary and Confidential
5
Read Time
Definition: The percent of email recipients who had the email open for one of three time ranges.
Read
Glanced
Skimmed
more than 8 sec.
2-8 sec.
less than 2 sec.
All therapeutic areas
51.82%
16.16%
32.02%
Oncology
56.59%
14.41%
29.02%
Respiratory
53.22%
15.95%
30.82%
Dermatology
51.86%
15.93%
32. 21%
From 2016 to 2019, the Read category (more than 8 seconds) averaged 36% of email opens. Read time engagement is up
significantly in 2020.
Bounces and Unsubscribes
DMD-measured trends for bounces and unsubscribes have been consistent year over year.
All Pharma emails
Hard Bounce
0.39%
Unsubscribe Rate
0.29%
Unsubscribes/Opens Rate
3.33%
Takeaway
Due in large part to peaks in email engagement resulting from COVID information-seeking in the first half of the
year, all engagement metrics are up over last year. However, it should also be noted that engagement during
the June to October period remains up over the same period last year. This implies that either email activity
during COVID has had a lasting effect or that other factors are contributing to increased engagement this year.
Going into 2021, these higher engagement rates appear to be the new norm.
www.dmdconnects.com
©2020 DMD Marketing Corp. | Proprietary and Confidential
6
Deployment and Deliverability
During the reporting period, DMD deployed 84,969,830 emails to HCPs, of which 32,288,532 were on behalf of
pharmaceutical, medical device, and diagnostic companies.
DMD uses a deployment architecture custom-built for healthcare consisting of:
•
•
•
•
3 email software platforms (ESPs):
o Adobe Campaign, Oracle Responsys, and Acoustic Marketing Cloud
7 sending domains
14 IPs
o Specific IPs dedicated to leading email service providers such as Gmail and Yahoo
o Specific IPs dedicated to the delivery of email to consumers (i.e. patients)
Included on the whitelists of 93 health and hospital systems
Deliverability
To estimate inbox deliverability, DMD uses a service provided by eDataSource (https://www.edatasource.com/).
86%
Average inbox
deliverability score
Inbox Challenges in 2020
Because of the challenges posed by email delivery to email service providers, such as Gmail and Yahoo/AOL, some
pharmaceutical companies have abandoned sending to these addresses (which is, unfortunately, a significant missed
opportunity: on average, 22% of HCPs are excluded when Gmail addresses are not used). Here is what DMD observed
regarding these two leading platforms during this reporting period:
Gmail
Gmail continues to be a challenge for anyone sending promotional email. In 2020, Gmail made frequent changes to their
filtering algorithm, including moving away from looking at the last time a recipient engaged with the sender, to adopting
a message stream view. This approach contextualizes emails from a sender into distinct marketing streams, then places
the emails within a folder structure in Gmail based on the last time a recipient engaged with that specific stream. During
the course of the reporting period, DMD adapted its Gmail sending strategies to work with this new message stream
approach. These adaptations were possible because DMD maintains a dedicated Gmail delivery IP/domain, coupled with
the unique ability to select the most active email addresses on a daily basis.
Between March and May, Gmail, like many other commercial inbox providers, loosened their overall filters to allow for a
more fluid transfer of pandemic information. COVID-related emails, in particular, saw very high inbox placement and
engagement in Gmail during this time. However, by mid-July Gmail returned to their pre-COVID filtering practices, and
typical challenges with Gmail inbox deliverability returned.
www.dmdconnects.com
©2020 DMD Marketing Corp. | Proprietary and Confidential
7
Yahoo
The Yahoo/AOL platform is only slightly less challenging than Gmail. In 2020, Yahoo/AOL continued to tighten its filters
to become more like Gmail. However, unlike Gmail, Yahoo/AOL is still using the traditional last-engagement-with-sender
method. DMD anticipates that in 2021 Yahoo/AOL will move towards a message stream approach. To deal with these
new and evolving changes, and to maintain email deliverability, DMD dedicated additional IPs/domains to Yahoo/AOL in
2020, as well as throttled deployment volumes more aggressively.
Send Time Optimization
Because of the challenges of delivery and engagement, DMD invested many more resources during this reporting period
into send time optimization (STO). STO is a data-driven technique to place an email into an HCP inbox when they are
most likely to be able to open it. STO typically drives a 2-percentage point improvement in open rates, i.e. 10% goes to
12%. In addition to the obvious benefit for engagement, the improved open rates affect delivery algorithms, leading to
more email successfully placed in the inbox. DMD strongly recommends using STO for maximum engagement and
deliverability.
In 2021, DMD will launch an advancement to STO called strategic send time optimization (SSTO). Any healthcare
marketers already using STO should consider adopting SSTO to further enhance email performance.
Takeaway
All healthcare marketers need to monitor inbox placement for their email campaigns, and continually optimize
to achieve the best results. Strive for at least an 80% deliverability rate as measured by a third-party service. Do
not give up on consumer platforms like Gmail and Yahoo/AOL. Although it takes more work to achieve optimal
delivery on these platforms, you are likely to lose a portion of your audience if you don’t. If you are not
achieving the open rates you expect, look to deliverability as an area of opportunity for improvement.
Predicting 2021
2020 was a year of uncertainty and change in the United States, and this was reflected in the email channel.
Engagement rates are up and historic learnings about things like optimal delivery times have changed. We do not yet
know if the results observed in 2020 will hold for 2021 or will return to their previous levels. Deployment to email
addresses at consumer email service providers will continue to be a challenge and will require constant monitoring and
adjustment to ensure optimal deliverability. For those brands willing to do this, they will reach more of their target
audience than their competitors.
However, given the low cost, high engagement and target-level reporting, along with uncertainty around personal
promotion, email may be the most important marketing channel to HCPs in 2021.
We are predicting that 2021 will be the year of triggered email. Many brands are already doing these types of campaigns
but we think that triggered email will become mainstream in pharma and healthcare in the coming year. When
combined with traditional broadcast email delivery, triggered campaigns are returning the highest engagement rates
that DMD has measured in this industry.
www.dmdconnects.com
©2020 DMD Marketing Corp. | Proprietary and Confidential
8
Another trend we saw gain traction in 2021 is matching programmatic and social segments with the corresponding email
segment, to serve timely and related ads or social campaigns during email campaigns. This creates an opportunity to
surround the HCP with brand messaging, and offers many opportunities for triggered engagements. Due to its
effectiveness, DMD strongly believes this omnichannel trend will continue to increase in 2021.
While many brands are already using send time optimization (STO), we see this also becoming mainstream in 2021. For a
minor investment, STO consistently adds two percentage points to open rates. Leading edge brands will transition to
strategic send time optimization (SSTO) this year.
Email continues to bring value to HCP omnichannel strategies. Successful optimization of email marketing campaigns
should return significant dividends in 2021. Engagement rates are up (and expected to stay up), while unsubscribes have
stayed consistently low, and costs remain flat.
Never before has there been a more important time for pharmaceutical, medical device, and diagnostic marketers to be
data-driven in their HCP email marketing. Not only do marketers need to collect and analyze data generated by each
email deployment, but they must also act quickly on learnings. To realize even greater email success, it is crucial to have
email experts available to your brand. The channel is in flux and requires daily monitoring and optimization.
Now is the time to evaluate how the transforming landscape of HCP email will affect your 2021 goals – and DMD can
help. Contact us today to discuss.
www.dmdconnects.com
©2020 DMD Marketing Corp. | Proprietary and Confidential
9