Jaap E. Wieringa

Understanding Customer Switching Behavior in a Liberalizing Service Market An Exploratory Study

In recent decades, many service markets have been liberalized, which means incumbent service firms face new competitors and must address customer switching—which from a public policy perspective, is necessary to ensure that liberalization succeeds. In this article, the authors conduct an exploratory study in which they investigate determinants of customer switching in the liberalizing Dutch energy market. Their results suggest that relationship quality, switching costs, and current demand for products and services from the energy supplier (e.g., usage rate, number of contracts) represent important determinants for all customers. In a subsequent analysis that accounts for customer heterogeneity, the results indicate a large inertia segment (71%) but a relatively small (6%) disloyal segment. The authors discuss implications for both incumbent service firms (former monopolists) and public policy officials.

Why do firms invest in consumer advertising with limited sales response? A shareholder perspective

Marketing managers increasingly recognize the need to measure and communicate the impact of their actions on shareholder returns. This study focuses on the shareholder value effects of pharmaceutical direct-to-consumer advertising (DTCA) and direct-to-physician (DTP) marketing efforts. Although DTCA has moderate effects on brand sales and market share, companies invest vast amounts of money in it. Relying on Kalman filtering, the authors develop a methodology to assess the effects from DTCA and DTP on three components of shareholder value: stock return, systematic risk, and idiosyncratic risk. Investors value DTCA positively because it leads to higher stock returns and lower systematic risk. Furthermore, DTCA increases idiosyncratic risk, which does not affect investors who maintain well-diversified portfolios. In contrast, DTP marketing has modest positive effects on stock returns and idiosyncratic risk. The outcomes indicate that evaluations of marketing expenditures should include a consideration of the effects of marketing on multiple stakeholders, not just the sales effects on consumers.

Early marketing matters: A time-varying parameter approach to persistence modeling

Are persistent marketing effects most likely to appear right after the introduction of a product? The authors give an affirmative answer to this question by developing a model that explicitly reports how persistent and transient marketing effects evolve over time. The proposed model provides managers with a valuable tool to evaluate their allocation of marketing expenditures over time. An application of the model to many pharmaceutical products, estimated through (exact initial) Kalman filtering, indicates that both persistent and transient effects occur predominantly immediately after a brands introduction. Subsequently, the size of the effects declines. The authors theoretically and empirically compare their methodology with methodology based on unit root testing and demonstrate that the need for unit root tests creates difficulties in applying conventional persistence modeling. The authors recommend that marketing models should either accommodate persistent effects that change over time or be applied to mature brands or limited time windows only.

Muscle strength in patients with chronic pain

Objective: To analyse the in‘uence of chronic pain on muscle strength. Design: Muscle strength of patients with unilateral nonspecific chronic pain, in an upper or lower limb, were measured according to a standardized protocol using a hand-held dynamometer. Before and after muscle strength measurement, a visual analogue scale for pain intensity was assessed. Results: Forty patients were measured and the muscle strength of the painful side was 20–30% less than that of the nonpainful side. Strength reduction was seen in the whole limb. A significant correlation between pain intensity and reduced muscle strength in the painful limb existed for hip ‘exion, knee ‘exion, knee extension and three-point grip. Conclusions: A strength reduction of 20–30% in a painful limb seems to be ‘normal’ in chronic pain patients.

Visual Outcome, Treatment Results, and Prognostic Factors in Patients with Scleritis

PURPOSE To analyze the visual outcome, systemic associations, effectiveness of treatment, and predicting features of 104 scleritis patients. DESIGN Retrospective case series. PARTICIPANTS One hundred four patients treated for scleritis at the University Medical Centers of Groningen and Utrecht, The Netherlands. METHODS The clinical records of 104 patients diagnosed with scleritis between 1992 and 2011 at the University Medical Centers of Groningen (n = 64) and of Utrecht (n = 40) were analyzed retrospectively. MAIN OUTCOME MEASURES Loss of visual acuity, ocular complications, related systemic disease, type of treatment, time to treatment success, and predictive features. RESULTS Mean age ± standard deviation (SD) was 51.5 ± 13.6 years, and 63 (60.6 %) patients were female. Mean follow-up ± SD was 38.2 ± 33.8 months. A loss of more than 2 lines of Snellen acuity was observed in 23 patients, 3 of whom had a final visual acuity of no light perception. In general, patients with necrotizing scleritis (n = 15) had a poorer outcome. Ocular complications were observed in 88 (84.6%) patients. Underlying systemic disease was identified in 34 (32.7%) patients. Steroid-sparing immunosuppressive medication was used in 47 patients, 36 of whom were treated with methotrexate (MTX). This treatment was successful in 17 (47.2%) patients over the course of a mean ± SD of 103.7 ± 83.7 weeks. Mycophenolate mofetil was the treatment in 10 patients, and in 5 of these patients, treatment success was achieved in a mean ± SD of 65.3 ± 37.4 weeks. Treatment with tumor necrosis factor α (TNF-α) antagonists led to treatment success in a mean ± SD of 32.6 ± 21.8 weeks in 5 of the 11 treated patients. Patients with loss of visual acuity or those treated with steroid-sparing immunosuppressive drugs more often had an underlying associated disease, bilateral scleritis, and a longer duration of symptoms at presentation. CONCLUSIONS Scleritis is a severe ocular inflammatory disease often associated with ocular complications. In this population, roughly half of the patients were treated with systemic immunosuppressive medication. Mycophenolate mofetil and TNF-α antagonists can be used in case of MTX failure. Tumor necrosis factor α antagonists seemed to be more effective than MTX. Within this group, an underlying associated disease, bilateral scleritis, and a longer duration of symptoms at presentation were predictive features for a more severe disease course.

Impact of Safety-Related Regulatory Action on Drug Use in Ambulatory Care in the Netherlands

The effect of Direct Healthcare Professional Communications (DHPCs) informing health‐care providers of serious drug safety issues has been questioned. The aim of this study was to evaluate the impact of DHPCs on drug use. Nationwide dispensing data for the period 2000–2008 for new users of 46 drugs with one or more DHPCs were assessed. Impact on short‐term volume of use was evaluated with regression models, and the presence of long‐term changes in use was evaluated with interrupted time series analyses incorporating preexisting trends. The short‐term prescription level was lower post‐DHPC in 28 (48.3%) of 58 cases. Twenty (34.5%) DHPCs resulted in long‐term changes in use. A long‐term mean reduction in use was observed in 26.7% of cases (95% confidence interval, −15.2 to −38.2%). Long‐term changes in use were not significantly related to preexisting trends in use. Although short‐ and long‐term decreases in use were observed after only half and a third of DHPCs, respectively, the decrease was substantial.

Modelling the effects of promotion expenditures on sales of pharmaceuticals

The successful innovation of pharmaceuticals requires a substantial amount of marketing support, despite concerns about the effects of these marketing efforts. This study considers prior findings that indicate that higher marketing expenditures for a brand reduce its price elasticity of demand, which may lead to higher prices, in the context of the Dutch pharmaceutical market. The authors find that parameters are heterogeneous across brands, and that marketing effects differ across product life cycle stages. They propose a separate analysis of established and new brands. For established brands, marketing efforts neither have a positive effect on sales, nor do they affect the price elasticity. For new brands, several proposed models might capture their diffusion pattern; the diffusion-of-innovation models provide the best results. Marketing accelerates the rate of diffusion and leads to a higher baseline level of sales.

Validation and Testing

Two critical steps in the model building process are model specification and model estimation. In this chapter we turn to the next stage in model building: validation (also verification or evaluation) .

Building Models for Markets

Managers often use rules of thumb for decisions. For example, a brand manager may have defined a specific set of brands as the competitive set within a product category. Usually this set is based on perceived similarities in brand characteristics, advertising messages, etc. If a new marketing initiative occurs for one of the other brands, the brand manager will have a strong inclination to react. The reaction is partly based on the manager’s desire to maintain some competitive parity in the marketing variables. An economic perspective, however, would suggest that the need for a reaction depends on the impact of the marketing activity for the other brand on the demand for the manager’s brand. The models we present and discuss in this book are designed to provide managers with such information.

Improving pharmacy store performance: : the merits of over-the-counter drugs

Purpose – This study aims to increase understanding of the factors that affect retail pharmacy performance. This paper investigates how various product-, store-, customer- and competitor characteristics affect over-the-counter (OTC) drug sales and thus store performance. Design/methodology/approach – This paper specifies and estimates a hierarchical model comprising scanner-based information, as well as individual-level data from a customer survey. Findings – Results indicate that the drivers of retail pharmacy performance in OTC categories are different from those identified in traditional retailing research. Originality/value – This is the first study that determines which factors impact the sales of OTC drugs in pharmacies.