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VISUALIZED BY:PsoriasisSocial Media TrendsA study from Inspire andManhattan Research

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Psoriasis is the most prevalent autoimmune disease in the United States, afflicting an estimated sevenand a half million people. Depending on the severity and location of the disease, psoriasis can causeboth extreme physical discomfort in patients as well as psychological issues, especially in social anddating scenarios.Healthcare market research and strategic advisory firm Manhattan Research and online patient communitynetwork, Inspire, partnered on a study to explore the role of social media in the lives of psoriasis patients.The study was conducted online among 317 psoriasis patients from the Inspire/National PsoriasisFoundation’s TalkPsoriasis community (http://www.inspire.com/groups/talk-psoriasis) in Q2 2012. “Psoriasis is a serious disease that impacts the individual physically, socially, financially, and psychologically. The more that people with psoriasis are able to connect with others and find support through platforms like social media, the less isolating the disease can be.” —Catie Coman, Vice President of Marketing Communications at the National Psoriasis FoundationKey questions explored in the research include —To what extent are psoriasis patients incorporating social media into their lives, and for whatreasons are they using it?How do older and younger patients differ in their use of social media?Does psoriasis severity and perceived support from others affect social media reliance?

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Health social media landscape Social health adoption 2012 Adoption of health-related social media “The National Psoriasis Foundation was an early adopter of social media. We founded theIn millions of U.S. adults(ages 18+) 2011 NPF online patient community nearly 10 years ago and it 2010 continues to be very active. 2008 107 109 TalkPsoriasis receives nearly 1 million unique visitors 2007 89 each year who come to the 63 site in search of connection, 38 information, and support.” —Catie Coman, Vice President of Marketing and Communications at the National Psoriasis Foundation Source: Manhattan Research, Cybercitizen Health® U.S. 2007-2012 Consumer adoption of health-related user-generated content has grown steadily over recent years as this type of media has become more integrated into the consumer experience online. Additionally, research shows that consumers are at least open to, if not in favor of pharma’s participation in social media. According to Manhattan Research’s ePharma Consumer® study, 42 percent of online consumers (and 48 percent of online psoriasis patients) agree that pharmaceutical companies should be involved in online health communities for consumers.

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Overview of surveyed respondents What is your gender? What is your gender? 70.7% 29.3% Which type of psoriasis were you diagnosed with? 72.9% 8.8% 4.4% 2.5% 0.9% 10.4% Gluttate Inverse Other type psoriasis psoriasis of psoriasis Plaque Pustular Erythrodermic psoriasis psoriasis psoriasisAmong surveyed psoriasis patientsfrom the TalkPsoriasis community

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Overview of surveyed respondents How severe is your psoriasis, or that of the person you care for? How severe is your psoriasis? Mild Severe Have you, or the person you care for, had a psoriasis flare-up in the past three months? Moderate Not Have you had a psoriasis flare-up in 19.2% 30.9% Sure the past three months? 3.5% 46.4% 82.3% NO YES 17.7% Yes — there has been No — there have been a flare-up in the past no flare-ups in the three months past three monthsAmong surveyed psoriasis patientsfrom the TalkPsoriasis community

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To what extent are psoriasis patients incorporating social mediainto their lives, and for which reasons are they using it? Surveyed psoriasis patients are avid users of both general and psoriasis-related social media, with 70 percent of this audience using any type of online community, social network, message board, or blog at least several times per week, and 44 percent using psoriasis-specific social media multiple times per week. How often do you use online communities, social networks, message boards, or blogs for information and support related to psoriasis? 3.2% 3.5% 6.9% A few times a year Never Several times per day 8.8% A few times 13.2% a month 12% A few times 16.7% About once a week 15.1% A few times a year 20.5% Several times a monthAmong surveyed psoriasis patients per weekfrom the TalkPsoriasis community About once a day

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To what extent are psoriasis patients incorporating social mediainto their lives, and for which reasons are they using it? Once surveyed psoriasis patients sign up for a community, they tend to remain engaged with it. More than two-thirds of this audience uses psoriasis-related communities regularly on a long- term basis after joining, and another quarter turn to communities when a medical situation, such as a flare-up, occurs. In contrast, only 13 percent say they rarely return to these types of communities after initially signing up. Thinking of your use of online communities and networksnetworks for information“They let me speak to Thinking of your use of online communities and for information and support related to related to psoriasis, which statement best describes you? others who suffer from and support psoriasis, which statement best describes you? After I initially sign up for a community... After I initially sign up for a community… the same problem as I do, they make me Other feel better about my I rarely return condition, and they to use it 6.0% provide insight from 12.9% other sufferers who have tried similar treatments and can provide firsthand I use it regularly on a long-term basis 34.1% 22.4% but then stop or only use it rarely I use it regularly for a few weeks feedback on what works for them and what might help me.” —Surveyed psoriasis patient 24.6% I only use it when a medical situation occurs “Q17: You mentioned you regularly use at leastAmong surveyed psoriasis patients (such as a flare-up related to psoriasis) one online community for information and supportfrom the TalkPsoriasis community related to psoriasis. Why do you regularly use these websites — what value do they provide to you?”

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To what extent are psoriasis patients incorporating social mediainto their lives, and for which reasons are they using it? Surveyed psoriasis patients tend to rely on communities more for practical advice related to their disease rather than emotional support. About 8 in 10 say they used psoriasis social media because they wanted to read how others managed the disease as well as to get tips and ideas that they couldn’t find elsewhere. Which of the following reasons describe why you use online communities, social networks, message boards, or blogs related to psoriasis? I think others can give me tips and ideas I cannot find elsewhere 84.5% I wanted to read 77.6% 65.9% I wanted to find how others have differing opinions managed a condition about a health issue or treatment regimen or treatment option I wanted to see 60.6% how other people rate or review a prescription drug 45.5% I came across these websites 28.1% 4.1% Other when I was using I wanted to a search engine connect with others forAmong surveyed psoriasis patientsfrom the TalkPsoriasis community emotional support

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To what extent are psoriasis patients incorporating social mediainto their lives, and for which reasons are they using it? While surveyed psoriasis patients are considerably engaged in social media, the data indicates that there is a limit to how many active social profiles/personas one can maintain online. Less than one-third of this audience regularly visits more than one online community or network for information and support for their disease. How many online communities or networks do you belong to for information and support related to psoriasis? 6+ online communities or networ 1 online communities or networks [TalkPsoriasis] More than 2 Online communities or networksAmong surveyed psoriasis patientsfrom the TalkPsoriasis community

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How do older and younger psoriasis patients differ in their use of social media? While younger psoriasis patients are more frequent users of social media in general, older psoriasis patients are more frequent users of psoriasis-related social media. How often do you use online communities, social networks, message boards, or blogs for information and support related to psoriasis? How often do you use online communities, social networks, message boards, or blogs for information and support related to psoriasis? 5.2% Several times per day 8.0% 14.7% About once a day 23.9% 16.4% Several times per week 16.9% 12.1% About once per week 13.9% 16.4% A few times a month 14.4% 7.8% About once per month 9.5%19.0% A few times per year 8.0% 6.0% About once per year 1.5% 4.0% Never 2.6% Psoriasis patients 13-44 Psoriasis patients 45+ Among surveyed psoriasis patients from the TalkPsoriasis community

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How do older and younger psoriasis patients differin their use of social media? After initially signing up for a Thinking of your use of online communities and networksnetworks Thinking of your use of online communities and for information and community, older psoriasis patients related to psoriasis, which statement best describes you? After I initia support for information and support related to psoriasis, which are more likely to use them regularly sign up for a community... statement best describes you? After I initially sign up for a community... on a long-term basis, while younger psoriasis patients are more likely to Patients 13-44 Patients 45+ use them only when prompted by a medical situation. 13.8% I rarely return to use it 12.4% to use it I rarely return 19.9% for a few weeks 26.7% I use it regularly for a few weeks I use it regularly but then stop or only use it rarely but then stop or only use it rarely 20.9% I only use it when a medical 31% situation occurs (such as a flare up related to psoriasis) I only use it when a medical situation occurs(such as a flare up related to psoriasis) 39.8% 24.1% I use it regularly on a long-term basis I use it regularly on a long-term basisAmong surveyed psoriasis patientsfrom the TalkPsoriasis community 4.3% 7% Other Other

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How do older and younger psoriasis patientsdiffer in their use of social media? Younger psoriasis patients feel they have more family support than their older counterparts, however younger psoriasis patients are more 1.7% Other apt to seek emotional support from psoriasis social media. 5.5% I think others can give 25.0% me tips and ideas I cannot find elsewhere 29.9% Which of the following reasons describe why you use online communities, social networks, message boards, I wanted to find differing 54.3% or blogs related to psoriasis? opinions about a health issue or treatment option 40.3% Patients 13-44 I wanted to see how other 56.0% Patients 45+ “It’s important to have a support people rate or review a prescription drug 63.2% system. I know others are suffering with the same thing I am, so don’t feel all alone in your fight. You learn about I wanted to connect with 68.1% others for emotional support products and treatments that you may 64.7% have not known of before.” —Surveyed psoriasis patient I came across these websites when I was 77.6% using a search engine 77.6% 88.8% “Q17: You mentioned you regularly use at least one online community I wanted to read how others for information and support related to psoriasis. Why do you regularly have managed a condition use these websites — what value do they provide to you?” or treatment regimen 82.1%Among surveyed psoriasis patientsfrom the TalkPsoriasis community

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Does psoriasis severity and perceived supportfrom others affect social media reliance? Moderate to severe psoriasis patients are involved in more psoriasis social networks than mild psoriasis patients. Thirty-five percent of surveyed moderate to severe psoriasis patients belong to more than one online community or social network for psoriasis, compared with just 15 percent of surveyed mild psoriasis patients. How many online communities or networks do you belong to for information and support related to psoriasis? How many online communities or networks do you belong to for information and support related to psoriasis? 34.7% 14.8% 85.2% 65.3% Moderate to severe MildAmong surveyed psoriasis patients 1 (TalkPsoriasis) 2 to 5from the TalkPsoriasis community

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Does psoriasis severity and perceived supportfrom others affect social media reliance? “When I could not leave my house Moderate to severe psoriasis patients are more apt to because of the severity of my disease, rely on psoriasis user-generated content for emotional it provided a link to the outside world.” support than their counterparts suffering from mild forms of psoriasis. Half of surveyed moderate to severe —Surveyed psoriasis patient psoriasis patients say they use psoriasis social media for connecting with others for emotional support, compared with one-third of surveyed mild psoriasis patients. “Q20: You mentioned that online communities and social networks are essential resources to you when it comes to dealing with and managing psoriasis. Can you please describe why you feel this way?” Which of the following reasons describe why you use online communities, Which of the following reasons describe why you use online communities, social networks, message boards, or blogs related toto psoriasis? social networks, message boards, or blogs related psoriasis? 82.0% 85.3% 70.5% 79.2% 59.0% 67.8% I wanted to read how others have managed I think others can give me tips and ideas I wanted to find differing opinions about a condition or treatment regimen I cannot find elsewhere a health issue or treatment option 47.5% 64.1% 32.8% 48.2% 27.9% 26.5% I wanted to see how other people rate I wanted to connect with others for I came across these websites when or review a prescription drug emotional support I was using a search engine 4.9% ? 4.1% OtherAmong surveyed psoriasis patientsfrom the TalkPsoriasis community Mild Mod to Sev

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Does psoriasis severity and perceived supportfrom others affect social media reliance? “Because you basically feel all alone with your disease and desperate for information and to talk with others who understand what you are Lack of support from family and friends drives use of social going through and to share media to an extent. Among surveyed psoriasis patients who information. It has become disagree they have lots of support from family and friends when the new ’support group’ for it comes to dealing with and managing psoriasis, half say they many of us.” use psoriasis online communities regularly on a long-term —Surveyed psoriasis patient basis, compared with just under one-third of surveyed psoriasis patients who agree they have this type of support. “Q20: You mentioned that online communities and social Which of the following reasons describe why you use online communities, networks are essential resources to you when it comes to dealing with and managing psoriasis. Can you please social networks, message boards, or blogs related to psoriasis? describe why you feel this way?” 12.1% I rarely return to use it 12.0% “While my family is an Agrees with having lots of excellent support group, I use it regularly for a few support from family and friends 24.9% Disagrees with having lots they just don’t understand. weeks but then stop or only use it rarely 26.0% of support from family and friends I can connect with other Ps sufferers online. I can also I only use it when a medical get some alternative relief 28.9% situation occurs (such as a suggestions that I can try in flare up related to psoriasis) 8.0% between Dr. appointments.” 31.2% —Surveyed psoriasis patient I use it regularly on a long-term basis 48.0%Among surveyed psoriasis patients 2.9% “Q20: You mentioned that online communities and socialfrom the TalkPsoriasis community Other networks are essential resources to you when it comes 6.0% to dealing with and managing psoriasis. Can you please describe why you feel this way?”

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About Manhattan ResearchManhattan Research (www.manhattanresearch.com), a Decision Resources Group company,conducts annual research studies covering digital health trends among healthcareprofessionals and consumers in the Americas, Europe, and Asia.Topics covered in Manhattan Research’s consumer studies include:n Technology profile and digital behaviorsn Health touch points and a resources mix, including pharmacists and retailersn Influence of digital on health decisionsn Internet reliance throughout the patient journeyn Health-related social media and online health videon Smartphone and tablet health activitiesn Remote health monitoring and patient portalsn Online prescription drug information seekingn Role of pharma at the point of caren Demand for online pharma resources and support servicesConsumer research can also be segmented to gain insights for key patient categories.For more information, please contact sales@manhattanresearch.com.

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About InspirePrinceton, NJ-based Inspire creates safe, moderated online communities, organized bymedical condition, for patients to share information and to support each other. Inspirebuilds and manages these communities in partnership with more than 80 nationalpatient advocacy and support organizations. Among the organizations are the NationalOsteoporosis Foundation, the Ovarian Cancer National Alliance, and the Asthma andAllergy Foundation of America. For more information, go to http://corp.inspire.com or callus at 800/945-0381.About the National Psoriasis FoundationThe National Psoriasis Foundation (NPF) is a non-profit, voluntary health agency dedicatedto finding a cure for psoriasis and psoriatic arthritis and eliminating their devastatingeffects through research, advocacy and education.About Ignite HealthIgnite Health ranks among the top healthcare agencies and was a finalist in 2011 for MedAd News’ Agency of the Year. With offices in Irvine, Calif., and New York City, Ignite Healthoffers clients a broad range of fundamental best practices and digital excellence to createunstoppable momentum for brand success across the continuum of a brand’s lifecycle.Ignite Health is an inVentiv Health company. For more information, visit ignitehealth.com.