Did you know Google charges you more if it decides your patient recruitment ads are of poor quality? And that it places poor quality ads further down the page where they get fewer clicks?

It does this to give users a good search experience. What constitutes a good search experience? One in which the most relevant results are given greatest prominence. Therefore, when Google measures the quality of your ad, the thing it’s trying to judge is how relevant it is to the needs of the person doing a search.

Once it identifies the relevance of your advertising, Google assigns you a Quality Score. This is what influences how much you pay each time someone clicks on your ad. And where your ad will be located on the page.

So, how is your Quality Score judged? The first thing you need to know is this: it’s calculated every time the keyword you want your ad to appear against is searched.

For example, let’s say your patient recruitment campaign is for a type 2 diabetes study. And you’ve instructed Google to show your ad each time someone searches the keyword ‘type 2 diabetes’. In this scenario, Google will determine your ad’s Quality Score every time someone undertakes that search.

How your Quality Score is determined

To measure your ad’s relevance, Google uses several yardsticks. The most influential is how often people have clicked on it when searching the current keyword. This is called the click-through rate (CTR). The higher your ad’s CTR, the higher your Quality Score.

Google also looks at other data to establish your Quality Score. In particular:

•    The CTR of all the other advertising you’ve run.
•    The quality of the web page your ad sends people to (this is judged manually by Google employees).
•    The relevance of your ad to the keyword you’ve purchased against.
•    The relevance of your ad and the keyword you’ve purchased to whatever the user is actually searching for.
•    The performance of all your ads in the geographic area in which you want your ad to be shown.
•    The historical CTR of the URLs (i.e. web addresses) you’ve displayed in other ads (all Google ads include a URL at the bottom).

How your costs are affected by your Quality Score

While Google doesn’t provide detailed information about this, analysis by third parties suggests the impact is significant. For example, according to ClickEquations, if your ad achieves the highest Quality Score possible, your cost per click will fall by about 30%. Conversely, they believe the lowest Quality Score will increase your cost per click by a whopping 600%.

Final thoughts

When thinking about Quality Score, don’t forget that it’s not the only factor that decides how much you pay every time someone clicks your ad. The amount you bid  - and the amount your competitors bid – is also key.

Likewise, your position on the page isn’t just down to your Quality Score. Rather, it’s a combination of your Quality Score and your bid.

Got a question for me about Quality Score? Leave it in the comments section below.

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Advertising on Google and other search engines can be an effective patient recruitment tactic. However, it can deliver a poor return on investment if you don’t understand how to get the pricing right.

Before I show you how to do this, it’s worth summarizing the pricing model used by Google, Yahoo and Bing.

 

When you recruit patients via traditional media (e.g. TV, radio and newspapers) you typically pay a fixed fee regardless of how effective your ads are. In contrast, when you advertise on a search engine, you only pay for results. In particular, you only pay when someone clicks on your ad.

Importantly, you decide how much you’ll pay every time someone does this. You do this by bidding on a certain keyword. For example, if you want your patient recruitment ad to appear when someone searches ‘metastatic melanoma’, you tell Google how much you’re prepared to pay if that user clicks on your ad.

Given that other organizations also want their patient recruitment ads to appear when someone searches for ‘metastatic melanoma’, you have to bid against them. The more you bid, the higher up the page your advertisement will appear compared to your competitors (in practice, another factor known as your Quality Score also determines your position).

If money is no object, you’ll probably pay anything to outbid your competitors in order to beat them to the top position. After all, the top position typically enjoys the most clicks.

However, an effective search engine advertising campaign isn’t just about getting lots of clicks. To deliver value, it obviously must result in eligible patients going on to sign an Informed Consent document. The percentage of patients who do this determines your conversion rate.

The higher your conversion rate, the better. After all, as the conversion rate goes up, the amount you have to spend to consent each patient goes down.

According to Google, two identical ads will generate the same conversion rate, regardless of where on the page they appear relative to each other. However, as the one higher up the page will generate more clicks, it will also generate more enquiries.  And, therefore, more enrolled subjects. But, as the one higher up the page will have a higher cost per click, the cost of acquiring each subject will be higher. In fact, it may be so high that it isn’t commercially viable for you.

On that note, how do you select an appropriate cost per click? The answer lies in following these steps (Note: the random values I’ve used are for explanation only – they don’t reflect real world numbers):

Step 1: Identify the value of a consented subject

Let’s say its $1000. With this figure in mind, you must work out how many patient enquiries you need before you get one consented subject. Let’s say you need 10 enquiries. That means each enquiry is worth $100.

Step 2: Identify the value of a click

Knowing that an enquiry is worth $100, you must next work out what percentage of patients clicking on your ad will enquire. Let’s say it’s 10%.

You then multiple $100 x 10% = $10. In other words, the value to you of a click on your ad is $10.

Step 3: Decide how much you’ll pay to receive that $10 click

To do this, identify how much advertising money you’re prepared to spend to acquire a consented subject worth $1000. Let’s say you’ll spend 20% of the subject’s value (i.e. $200).

Next, multiply the value to you of a click ($10) by the amount you’re prepared to spend on advertising to generate one subject (20%): $10 x 20% = $2.

$2 is the maximum you should spend per click. This may or may not result in your ad appearing at the top of the page. However, it will ensure you enjoy the position that best meets your business objectives.

If you have a question for me about any of the above points, please leave it in the comments section below.

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When you use paid search engine marketing as a patient recruitment tool, careful keyword selection is vital. That’s because it will largely make or break your campaign.

Before I explain why, it’s worth clarifying what a ‘keyword’ is. Put simply, it’s the word or phrase that a person searches on Google, Yahoo or Bing.

One of the strengths of paid search engine marketing is that you decide which keywords you want your advertisement to appear against. For example, if you’re recruiting patients for a type 1 diabetes trial, you can have your ad appear every time someone searches the keyword ‘type 1 diabetes’. Meanwhile, you can ensure your ad doesn’t appear when someone searches ‘type 2 diabetes’.

When selecting your keywords, the goal is to choose ones used by the people you’re targeting. That includes patients plus their friends and family.

How to choose the right keywords

The first thing you need to bear in mind is that many of the people you’re targeting may not be actively looking for a clinical trial. They may not even know what a clinical trial is.

Therefore, your recruitment campaign must largely target people who might be interested in a clinical trial – but who’re currently looking for other forms of information about a given disease. For example, a patient wanting information about treatment options.

On that note, you should start by making an educated guess about which keywords your target audience are searching against. Once you’ve got some initial ideas, the next step is to test them with Google’s keyword tool.

Google's keyword tool

You’ll find the tool useful for two reasons. Firstly, it will give you a ballpark figure of how often the keywords on your initial list are searched. Secondly, it will also highlight related keywords you hadn’t thought of. And it’ll show you how often these are searched, too.

When finalising your list, it’s important to remember that the more focused the keyword, the more likely it is to draw in relevant people. That means you generally want keywords with at least two words.

For example, if you’re recruiting type 1 diabetes patients, you should avoid advertising against the generic word ‘diabetes’. Otherwise, you’ll waste loads of money as people with the more common type 2 diabetes click enthusiastically on your ad.

Another benefit of keywords that contain multiple words is that they are generally cheaper to advertise against. That’s because there are fewer advertisers bidding against each other to appear.

I’ll discuss keyword selection and it’s relationship to price in my next post. In the meantime, if you have a question for me about keyword selection, please leave it in the comments section below.

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Does your patient recruitment activity include advertising on search engines like Google, Yahoo and Bing? If not, it probably should. After all, 44 million Americans search the internet for experimental treatments and medicines each year.*

In this series, I’ll give you an overview of how paid search engine advertising works. And how you can use it to recruit patients faster.

In this first article, I’m going to give you an introduction to the basics.

What is search engine advertising?

Search engine advertising – also known as ‘paid search’ – appears when you do a search on Google, Yahoo or Bing. The ads appear on the search results page at the top and down the right-hand side of the page. Google calls these ‘Sponsored links’. Yahoo calls them 'Sponsored results'.

Benefits of search engine advertising

Search engine advertising helps you in several important ways.

A highly targeted audience

When you buy advertising space on a search engine, your ad is only shown to patients you think might be interested in your study. That’s because you control:
•    Which search words and phrases your ad appears against.
•    Which geographic areas your ad will appear in.
•    What times of the day your ad will appear.

Performance pricing

When you advertise using traditional media like TV and radio, you pay a flat fee regardless of how effective your ad is. In contrast, when you advertise your clinical trial on a search engine, you only pay when a patient clicks on your ad. If they see your advertisement but don’t click on it, you don’t pay anything. As a result, paid search is often called ‘pay per click’ advertising – or ‘PPC’ for short.

Appearance on the first page of search results

Having your patient recruitment ad appear on the first page of search results is critical to success. That’s because only a handful of people bother to look at the results on the subsequent pages. Getting a ‘natural’ (i.e. unpaid) search result onto the first page is always hard – and often virtually impossible. However, by launching a paid advertising campaign, you can be there instantly.

You control your spend

Search engines allow you to set a daily budget. Once that’s been achieved, your ads stop appearing. As a result, you know in advance what your total spend will be.

It’s fully measurable

It’s easy to track your search advertising campaign’s ROI. That’s because you can see:
•    How many people have clicked on your ads.
•    What percentage of those people pass an online or phone-based pre-screen.
•    What percentage of them then sign an informed consent document.

Potential risks

A search advertising campaign isn’t guaranteed to get you results. For example, it's possible that few people will click on your ads. Or lots of people might do so, but few of them pass pre-screening (which will do awful things to your ROI).

To avoid these problems, you need to manage your campaign actively. In following articles, I’ll highlight what you must do to get the best outcome.

*Pew Internet and American Life Project ‘The Social Life of Health Information’, June 2009.

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