460,000+ NPs/PAs see over 2 billion patients each year in over 60 specialties.

Prescribing rates and patient outcomes of NPs/PAs are similar to those of MDs (according to multiple studies).

In 28 states, NPs can open their own practice.

PAs/NPs write over 1 billion prescriptions each year.

NPs/PAs write an average of 10 to 20 prescriptions per day, and can prescribe in all 50 states and D.C.

PAs/NPs make up one out of every three providers, and by 2030 are expected to make up 45% of all providers. (Bureau of Labor Statistics).

Over 60% of pharma brand managers plan to include NPs/PAs in their 2022 marketing plans.

90% of brand managers appreciate that PAs/NPs play active independent roles in diagides, procedures, and prescriptions.

The NP/PA-to-physician ratio has increased from 0.42:1 in 2012 to 0.60:1 today. The vast majority of brand managers believe that NPs/PAs are critical HCPs to target. (Source: the Medical Group Management Association's DataDive Cost and Revenue dataset).

The VA permits NPs working within the VA system, to practice at the top of /their licenses independent of physician supervision. (Federal Register, December 2016)

Over 95% of NPs/PAs make prescribing decisions independent of the physician working in the same office.

PAs/NPs report that email is their preferred way to receive pharmaceutical information.

Over 250,000 NPs/PAs in primary care make up nearly half of primary care providers.

In a national survey, NP listening skills were superior to MDs` with 80% of NP patients reporting NPs always listened carefully compared to 50% of MD patients.

PAs` generalist medical training enables them to provide a wide spectrum of patient care and treat the `whole patient.`

Office visits to PAs/NPs increased 129% while office visits to PCPs declined 18% over a recent four year period (in a study of adults < 65 with employer-sponsored health insurance).

NPs/PAs treat medically complex patients - one study found NPs/PAs are almost twice as likely to be involved in specialist care when the patient has four or more chronic conditions.

Almost half of NPs play a role in the purchase of medical supplies, 36% devices and 29% technology for their practice, as PAs and NPs sit on purchasing and formulary boards.

More than 36,000 new NPs entered the healthcare provider workforce last year.

70% of NPs work in primary care. It is anticipated that the majority of primary care patients will be receiving their care from NPs and PAs by 2030 given the expected exponential growth of NPs and PAs.

NPs/PAs report that they value information about pharmaceutical products from drug companies.

Studies have found PAs/NPs provide more patient education compared to MDs.

The most significant difference between a PA and a NP is in their educational preparation. A PA attends an intense, three-year graduate-level program with many of the same courses taken by physicians, and receives a master`s degree. An NP is a registered nurse who attends graduate-level, advanced clinical training beyond their initial professional registered nurse preparation. NPs either have a master`s or doctoral degree.

Experienced PAs/NPs train and influence new doctors. In one study, 75.8% of surgical residents felt NPs/PAs contribute to resident education. In another study 60.3% of residents said PAs/NPs taught them protocols and guidelines.

NPs/PAs provide primary and specialty care services similar to those of a physician. Both PAs and NPs can diagide, treat and prescribe for acute and chronic health problems such as diabetes, hypertension and asthma.

While the roles of PAs/NPs and MDs are similar, NPs/PAs need a separate marketing strategy as they are a distinct patient-centric group with their own concerns/needs, conferences, social media groups, and publications/websites.

NP and PA influence increases as evidenced in a National Ambulatory Medical Care Survey of CHCs where there were no differences among MDs, NPs, and PAs in the percentages of visits in which drugs or immunizations were prescribed and labs or other tests were ordered.

Evidence shows PAs/NPs have key leadership positions in hospitals

Studies found that NPs have a positive attitude toward pharmaceutical marketing efforts. According to the American Journal of Managed Care, 90% of NPs believe it is acceptable to attend lunch and dinner events sponsored by the pharmaceutical industry. Almost half (48%) stated they were more likely to prescribe a drug that was highlighted there.

To improve ROI, pharmaceutical and medical device companies can target PAs and NPs by list match, billing codes, specialty and other criteria to ensure campaign dollars are specifically spent on those PAs and NPs who influence the success of their business.

The PA clinical areas with the largest percentage growth over the past four years:` 157% increase in pain medicine PAs` 57% increase in psychiatry PAs` 46% increase in critical care PAs` 33% increase in neurology PAs` 32% increase in oncology PAs` 30% increase in ENT PAs` 28% increase in geriatrics PAs

NPs/PAs prescribe more frequently than MDs for certain drugs including psychotropic meds, antibiotics and pain medications.

The number of PAs/NPs is growing 10 times as fast as MDs.

NPs/PAs want to hear from NP/PA KOLs about new treatment options: "PAs/NPs want to hear from NP/PA KOLs... we really crave hearing from our own." (Amanda Shelley, PA-C)

University of Michigan researchers found that counties with the greatest need for healthcare had approximately 50% more NPs. One out of six PAs also work in high-need rural areas.

PAs/NPs see about 40 million patients across the country each week.

Over 10,000 new PAs enter the workforce each year.

98% of NPs recommend or have no reservations recommending OTC medications to their patients. 90% of consumers report typically purchasing an OTC medication recommended by their provider.

PAs/NPs work autonomously or as partners with physicians. "When I worked alongside a physician, I was influencing his prescribing just as much as he might talk to me or influence mine." (Wendy Wright, Owner of two NP operated clinics and Past President of NPACE)

The NP/PA-to-physician ratio is expected to increase from current levels of 10 NPs/PAs for every 17 physicians, to projected levels of 10 NPs/PAs for every 11 physicians by 2033 - a nearly 1:1 ratio.

NP/PA prescribers can improve patients` adherence to medications because they provide more patient education and counseling than MDs. Some reports estimate the pharmaceutical industry loses $250 billion each year in the U.S. to non-adherence.

NP employment is forecasted to grow at a rate of 26% from now until 2028, PA employment is expected to grow at a rate of 31%, but physicians are only expected to grow at 3%.

One of the top information sources for PAs/NPs is from their PA/NP colleagues. 70% report they turn to other PAs/NPs. "We want to hear from our own experts." (Angela Goldman, Past AANP President)

NPs/PAs see both new and existing patients in all settings - often without physician involvement.

NPs/PAs are taking on the majority of patient care in many areas - which will expand even further in the next few years as more than two of five active physicians will be 65 or older within the next decade.

NPs rose above physicians on the list of most recruited providers in the 2021 report on recruiting trends. 18% of search assignments were for NPs/PAs - up from 13% the previous year.

Attendance at pharmaceutical sponsored dinner meetings is significantly lower for PCPs compared to PAs/NPs and specialists.

Physicians reported lower levels of influence from pharmaceutical sources compared to NPs and PAs in one study. Specifically, NPs report significantly higher influence from sources such as sponsored talks compared to both PCPs and specialists. Similarly, PAs report significantly higher influence from industry sources of information compared to PCPs and were also more influenced compared to physician specialists.One possible reason that NPs/PAs may be more open than physicians to learning about new pharmacological treatment options is that 46,000+ new NPs/PAs graduate and enter the workforce each year. In contrast, the physician profession is growing much slower and many physicians have been prescribing the same treatment for years as 44.9% of active physicians in the U.S. are 55 or older.

PAs/NPs are more open to data from pharma reps, drug websites and sponsored talks which influence prescribing decisions compared to physicians who rated these sources lower.

While NPs/PAs are more open to recieving data to inform prescribing decisions, they are less targeted with information compared to MDs. PAs (40%) and NPs (41%) were significantly more likely to report they were either not as familiar as they could be with accelerated approval drugs or not as comfortable prescribing them compared to MD specialists (24%) and PCPs (30%). This knowledge gap means there is opportunity for life sciences companies to educate and influence this growing group of prescribers in order to increase access to new treatment options for serious conditions.

Pharma and med device companies too often miss getting their messaging to NPs/PAs: "It is very common for PAs and NPs to be forgotten or left out, and that makes us less likely to hear your messaging - the pharma's messaging." (Amanda Shelley, PA-C, Co-founder - PAs in Virtual Medicine and Telemedicine)

NPs/PAs are growing exponentially to fill the provider shortage that will continue through the next ten years. By 2033, the U.S. will suffer a shortage of more than 55,000 primary care physicians and 86,000 specialty physicians, according to the Association of American Medical Colleges (AAMC).

PAs/NPs improve access to care and address unmet patient needs. 67% of Better Performer practices employ NPs/PAs - which means they are in the top percentiles nationally in operations, revenue, productivity, or value.

Another 400,000 PAs/NPs are expected to enter the workforce by 2033 - nearly doubling the 475,000 NPs/PAs in 2022 who already make up two out of every five providers.

Patients ask NPs/PAs questions on specific drugs, procedures, and devices. Most NPs/PAs get asked for this information on a daily basis.

PAs/NPs see approximately 19 to 20 patients per day on average - which is comparable to physicians.

More patients are choosing NPs/PAs as their primary care providers. Patients who prefer NPs/PAs over MDs often cite bedside manner or interpersonal skills.

In a survey of directors of over 300 U.S. critical care fellowship training programs, 54% said PAs/NPs perform procedures traditionally done by fellows. In a separate recent study comparing PAs/NPs to residents in an ICU, PAs/NPs inserted more radial, brachial, and femoral artery catheters and had a higher success rate at first attempt with central venous and arterial catheters compared to residents. PAs/NPs also performed more intubations than residents who were at times supervised by PAs/NPs.

AAPA`s House of Delegates voted to change the profession`s title to physician associate last May. The new title directly addresses the common misperception that PAs merely `assist` physicians and more accurately reflects the responsibilities of PAs in all medical settings ` caring for patients, developing treatment plans, and prescribing medications. "PA" should be used until states formally adopt the new title, but Amanda Shelley, PA-C advises pharma and device companies: "if you`re going to be trying to market to us as a profession, it`s important to educate yourself" on this move.

After receiving pharma information, younger clinicians are more likely to: (1) change a patient`s treatment, (2) try a new product, and (3) do more research. Other studies also found that female clinicians may be early adopters and more likely to prescribe from a new drug category. This is significant because compared to MDs, the average age of NPs/PAs is younger and there is a much higher percentage of female clinicians in the NP/PA professions.

Last year 67% of healthcare organizations increased the number of PAs/NPs they employ (7% higher than expected).

In a recent survey, nearly three-quarters of 158 healthcare organizations have their NPs/PAs serving in leadership/management roles.

Numerous patients are sharing stories of PAs and NPs saving their lives due to their unique listening and communication skills, attention to detail, close patient-provider relationships, and focus on patient advocacy. A young girl named Sophie, whose NP diagided her Kawasaki`s Disease, says, `My NP saved me from a life-long heart condition.` A woman named Sasha, whose NP manages her life-threatening diabetes, says, `She prescribed the right medicine ` I will always be grateful.` A patient named Robert, whose NP identified his blocked arteries feels he wouldn't be here today without his NP. A young mother named Stephanie with a life-threatening eating disorder credits her PA with saving her life by not only getting her the care she needed, but also showing deep compassion and going above and beyond to follow-up with daily calls to see how she was feeling and discuss symptoms.

Many clinics are owned and operated by NPs and PAs. Research shows there are over 8,500 NP/PA practice owners, and NPs in private NP practices prescribe an average of 29 RXs per day.

PAs/NPs make up two out of every five healthcare providers.

In primary care, most NPs/PAs see their own patients and only consult when necessary. In all specialties three out of five NPs/PAs have their own distinct set of patients (whom the physician does not typically see).

35% of Americans say they had trouble finding a doctor in the past two or three years. The 10-point jump from when the question was asked in 2015 shows the physician shortage is growing as patients are increasingly seeing PAs/NPs for their care. The medical director of the Bellevue Hospital in NY recently called PAs `the scaffolding that holds up our hospital.`

The AAMC expects the supply of NPs/PAs to more than double over the next 15 years.

PAs/NPs are in every single specialty and primary care. "I don`t think there`s a single disease process that the NP is not going to touch." (Angela Golden, past AANP President)

55% of healthcare administrators in leadership positions say their practice will add new NPs/PAs this year.

PAs/NPs rate higher than MDs on patient education.

A unique NP/PA strategy is more effective. To have both an immediate impact and to build long-lasting relationships, develop messaging and resources created specifically for NPs/PAs. "Respect NP/PA roles by specifically mentioning their titles and avoid making these prescribers feel overlooked, slighted, or misunderstood by lumping them in with physicians or nurses.` - PM360 Magazine

PAs/NPs hold key leadership positions in hospital management. As Laurie Benton, PhD, PA-C, System Director of APPs at Baylor Scott & White Health (the largest nonprofit health system in Texas) explains, `pretty much any of the committees we have here, I`m invited to be on.`

NP beneficiaries receive, on average, approximately one more 30-day prescription per year than PCP beneficiaries.

The top five PA areas of practice include family care, surgery, emergency medicine, dermatology and cardiology.

Data shows NPs and Primary Care Physicians have similar prescribing frequency and patterns with the same top 20 types of medications written including antihypertensives, antihyperlipidemics, antidiabetics, and antidepressants among others. The two provider types were also found to write similar proportions of generic medications vs. brand-name medications. The prescribing behavior of PAs also parallels that of physicians by the number of medications per visit, and the types of therapeutic classes.

Pharma and device companies are alienating PAs and NPs when they run TV commercials that say "talk to your doctor" which frustrates many PAs/NPs who feel overlooked by this language. "There are 400,000 people you can `talk to` who can write a prescription, and you just dissed them." (Dave Mittman, DMSc (h.d.), PA-C, DFAAPA and Past AAPA President) `Every time a commercial comes on that says ask your doctor or your physician, they make sure I don`t have anything in my hands that I can throw at the TV." (Angela Golden, DNP, FNP-C, FAANP and Past AANP President)

Top clinical focus areas of NPs include primary care, psychiatry, cardiovascular specialties, and oncology.

71% of family medicine MDs, 66% of gastroenterologists and 73% of urologists work with PAs/NPs.

93% of NP/PAs have tried a new product and 96% say they have changed a patient`s treatment after getting information from pharma compared to 89% of physicians that have either tried a new product or changed a patient`s treatment. This suggests that compared to physicians, NPs and PAs are just as likely to try a new product or change a patient`s treatment after receiving clinical data from a pharmaceutical company.

NPs and PAs make up a larger portion of primary care providers than physicians.

514,000+ NPs/PAs see patients in all specialties.

NP/PA providers are growing exponentially.

135,000 additional NP/PA providers see patients in 2023 compared to just five years ago (a 36% increase).

Researchers found a 40% increase in evaluation and management services, and a 74% increase in imaging services performed by radiology-employed NPs and PAs in a new study comparing 2017 and 2019 Medicare claims submission data.

23% of pharma, biotech and med device marketers increased their NP/PA marketing budget last year.

Experienced NPs/PAs help train new doctors. 75.8% of surgical residents say NPs/PAs contribute to resident education.

NPs are valued by patients as reliable, helpful and empathic according to researchers in a recent qualitative study. 88% of NPs say patients' reactions to NPs practicing independently are favorable.

NPs/PAs often treat idependently with no physicians on-site and may be first to diagide or recommend a new treatment. When working as partners on a team with physicians, NP/PA medical opinions are typically respected. 57% of NPs and 52% of PAs occasionally question a physician's treatment decision. NP Quotes:"When I worked alongside a physician, I was influencing his prescribing just as much as he might talk to me or influence mine." "MDs respect my opinion.""It's usually a collegial discussion as to why I might have chosen a treatment option. Both sides are understood. Rarely if ever am I asked to change my decision."

Only 16.5% of surveyed patients said they've never been treated by a PA. 93.9% of those treated by a PA were satisfied or very satisfied with PAs' care.

"Similarities in the patterns of patient encounter characteristics across provider types suggests that NPs and PAs function more as physician substitutes than as physician complements" in a VA clinic study

The percent of hospital medicine groups (HMGs) that employ NPs/PAs has increased from 66% in 2014 to 83% today.

NPs/PAs are essential targets for brand managers in many different therapeutic areas. For example, the dermatology NP/PA to dermatologist ratio is nearly 1:1, and NPs/PAs see patients in 81% of oncology practices.

Over a third of NPs/PAs (232,000) collectively received $118 million in nonresearch payments from pharma and device in a one year period. Payments were most commonly for food, consulting and other services. Previous studies examining industry payments to clinicians have found associations between payments and clinician prescribing patterns and formulary recommendations.

NPs/PAs are growing in specialty practices as well as primary care. For example, three quarters of urologists partner with NPs/PAs, 48% of whom reported 3 or more NPs/PAs seeing patients in urology practices.

NPs/PAs often score higher at patient communication - something pharma marketers should consider. For example, 90% of oncology NPs/PAs report confidence in communicating empathically while patients report feeling empowered, at peace, and in control as a result of the support, guidance, and attention given to them by NPs/PAs.

The average age of PAs and NPs is lower than the mean age of physicians. In some studies younger prescribers were more likely to quickly adopt a new drug.

The likelihood of recommending antipsychotic medications was generally consistent between psychiatrists and psychiatric NPs/PAs in a recent study. 59% of psychiatrists and 61% of psychiatric NPs/PAs also indicated they would be very or extremely likely to seek out information on new or emerging schizophrenia therapies meaning that NPs/PAs are an open and important group to reach.

Tens of thousands of NPs work at private practices and 83.3% of hospital groups employ NPs. Nurse practitioner hospitalists provide full coverage and work in hospital intensive care units; medical, surgical, and observation units; and a wide range of specialty units, such as neurology, oncology, burn, orthopedics, and palliative care.

In a survey of more than 1,200 patients who had received clinical care from an NP or PA, the satisfaction score exceeded 90%. Some studies suggest patients feel even more satisfied with NP/PA care than physician care, particularly in areas of education and support.

A study of NPs/PAs from Washington, DC, reported that NPs and PAs who received gifts from the pharmaceutical industry had higher cost prescription drug claims. In addition, qualitative research suggests that NP/PAs have positive sentiments toward companies marketing to clinicians. Since NPs/PAs make up a growing proportion of the medical workforce, pharma and device marketers should be paying attention.

95% of NP hospitalists prescribe drugs to a majority of their patients.