The Art and Science of List Buying

Okay, so we’re talking about list buying. List buying is one of those things that seems simple, but is super hard to do. There’s a lot of reasons for it, not the least of which is you really don’t know what you’re getting until you try it, and by then it is too late. Many people don’t know this or even think about it (because they’re not Content Engineers) but there are a lot of factors to list buying.

Now, for clarity what I’m talking is about the art of buying a list for use in CRM. There are many other reasons to buy a list, and I mention some later, but let’s start there so we can go deep on one thing.

Why are you buying a list?

How are you going to use your list? Lists work in a lot of different ways and, of course, there is kind of a curve to it. So if you, for instance, want to send print or snail-mail (this is still digital because I can pull that right out of my CMS or right out of my marketing automation) that’d be one way. But for e-mail addresses, that’s a slightly different thing.  With that in mind, here are a couple of ways you can uses lists to accomplish your goals:

There are three ways to purchase a list. We just considered one way where you don’t actually get a list. It’s more of a media buy. Go pay Med Page Today, WebMD, an AMA licensed provider, and they’ll send the e-mail for you. But they won’t necessarily give you the list. You only get whoever responds and opts-in to add their information.  This option has a medium to low upfront cost, but a higher variable cost than the other options because you typically pay per tactic.

Then, there’s a second way which is called a rented list.  Rented lists can take many forms.  In some cases, there is a service you can use, like a Doximity authentication.  Another form could be actually borrowing the data for a year, putting it in your database, and returning the list at the end of the year.  There are some advantages to this over option #1, but similarly you only get whoever responds and opts-in to add their information.  Cost wise this is middle of the road – medium upfront cost, and low variable cost, but that upfront cost is actually ongoing so it can add up over time.

Lastly, you can buy a list.  This method had the most flexibility, but it also has a few disadvantages with list maintenance being the most difficult.  If, however, you have the right systems and your campaigns are active enough to keep your data fresh, this may be a good option for you because of the versatility, high upfront cost, and low variable cost.

#1 They send it for you

List blasts are good when you want to hit a wide audience once or very few times, so they should be treated more like a media buy.

The AMA list is quite good and well kept up so it will be the example we’ll use for this section even though there are many organizations that work like this.  Typically, the organizations that offer this provide content or services to the target audiences as their primary business and the list sales are in service to that.  These lists have a lot of information, but traditionally they are not bought and sold. Actually, the AMA list is pretty well protected.  You need to be an AMA DBL (Database Licensee) to get access and there are all sorts of fees that go with doing so.  Once you are there are restrictions on what you can do.

The first thing to note is that the AMA does not give out email addresses.  This means that some of the information that they do give out can be used for targeting on and off-line channels.  But, once you are ready to send an email, then you have a few choices to make.

The first option is that the AMA DBL can send it for you.  You provide all the segment information (note that strategy is important to technology is a reoccurring theme) to the DBL.  Depending on the agreement they can either give you counts (i.e., x number of y specialty at z hospital), or the actual names, or a number of other data points.  That’s all up for negotiation, but the point here is that they will send the email once you agree on the segment.  Should the HCP who receives your email click through, you will have the opportunity to capture their information with a registration form or some other kind of tracking, like DMD (but that’s for another post).

The other option is done is with an AMA extension list.  Some DBLs maintain their own database of email addresses.  It’s not as kept up as the AMA list, but there are some good ones out there.  When you’re ready to buy, what they’ll do is use the AMA list to help create the segment, but what you are actually buying in the end is from their own database.  (Note: this will still have an AMA fee associated).  The nice thing here is that you can actually get the email addresses.  The DBL may still want to send it themselves, but in the end this could be a very good and targeted way to extend an existing database.

Having the AMA or a DBL send for you is not an uncommon model.  It may be uncomfortable at first, but remember that many organizations are very protective of their data, and that’s a good thing.  Usually they are based in some kind of service that relies on the trust of the end user.  To achieve trust this model allows data providers to vet messaging to make sure it’s relevant, and to ensure lists are not abused.

In short, this protection is what gives you the opportunity, but to get in the gated community you don’t have to trust without verification (although I highly recommend you verify – more on that in the analytics post).  In return for the blindfold many organizations will offer a guarantee.  For example, they’ll promise X HCPs of Y specialty will see it, and Z will click through during T time.

#2 Renting a list

List renting is the next way to get contact data.  Usually this is a little easier and cheaper than buying a list outright, with the added bonus of actually having the list data in your database. The benefit is that you’re going to be getting data fast and cheap. But in the end you’re not actually building up your internal system, kinda — I’ll explain that in a minute. So there’s a value curve. On one side of it you have those who want to own the information and build on it, and the others who still need the information so they can’t use #1, “send it for me”, but may have speed and budget restriction.

The first model gives you little to no direct access to the list, and in the third model we’ll look at buying a list that you’ll own and can do whatever you want with.  List renting is in the middle.  When you rent a list you literally rent a list for a year and return it at the end.  At this point most people start asking, “how’s that work?”, and they’re right to do so. List renting can get very complex technically and there’s not really a standard way to go about this.

What is a rented list?

A rented list is a list that you buy give you and you use in your system for one year or some other set period of time.  You actually get the list and can put it into your MDM (Master Data Management) or master record platform for CRM use. At the end of that year you return the list.

Wait.  What?  How do you return data?  That makes no sense at all.

Good question.  But before going there I should note you don’t have to return 100% of the list.  You only have to return that data that you were not able to get elsewhere over the period of rental.  So, for instance, you rent a list of 100 physicians for use in a CRM platform.  Over the course of a year 12 of them click through the CTA (call to action) on your email and register on your website.  An additional five register at a convention presence, and eight more register for speaker programs.  That means you’ve used the rented list to collect, complete, and extend 25 records out of the 100.  So, at the end of the year you only have to return 75.  Make sense?

Here’s the rub.  In most cases the list data does not live on its own.  It will be combined with data that you bought or own from another source, ex: collected by the field force.  Combining a rented list with other data is where a rented list gets tricky. You’re going to need to track the information and where it came from in your MDM platform. At the end of one year when you actually have to return the list and delete records from your database this is how you make sure you keep what you’ve earned.

Seems difficult, why use a rented list?

Rended list are especially good for pre-market & pre-approval brands where budgets are tight, time is short, and you are not starting with a lot of information.

I see this in the pre-marked/pre-approval brands a lot.  This is the period when you don’t have a revenue stream yet and budgets are still low. What you want to do in this case is to understand exactly who your audience is, exactly who in your audience is responding, and exactly what they are doing.  You don’t have a huge base to draw from unless you have other products in market already and you can make good use of established systems, but even then, you’ll have to be pretty lucky for the target audiences to match up.  If they do, great, you’re done.  If not, read on.

If you listen to or read some of the other Rx Digital Marketing podcasts we talk about anonymous and known channels.  Known means that you can identify people who are in the channel, verse anonymous, where you cannot identify people in the channel. For example, email is a known channel, I can identify who it is through email address. Certain login websites are known, but regular web is typically an unknown/anonymous channel (with some tracking service exceptions). Twitter is sometimes a known channel-ish, because it can be hard to get back to exactly who that person is on the other end of the twitter handle. Convention is a known channel because you can collect a business card or scan a badge. Medical Education is a known channel; rep visits are typically known if you are collecting good data from the field. Actually, rep delivery is a mix of known and unknown. You know who they are going to see, you can actually track what content is being shown, if you are using digital media like Veeva’s iRep.

So there’s lots of known channels and there are lots unknown channels.  How do you decide what’s important to technology?   Your strategy of course. To go with a rented list, your strategy may be focused on known channels because you want to get detailed information (as opposed to aggregate information) in the system.

There’s a lot of reasons to do this.  One example is needing to know who is seeing the content.  It could be a legal issue, or it could be that you’re looking for insights.  Either way, there are services out there that will help you, for instance, authenticate. So, say you want to identify someone when they are registering for your website or newsletter, or coming to your booth and signing up to use your digital media, or auto-complete a reg form, show HCP only data, etc. Doximity, for instance, will service out their social media platform which has physicians that they have checked and made sure are real physicians. That is an offering from them. They will license out their system to use just the validation.  It’s like a list, but it’s just for authentication, which is one way that you may want to use a list.  To ensure whomever you are serving is who you want (and who should be receiving this material).

Now, remember you are going to get drop off.  Twice in my career I’ve sent emails for free giveaways having to do with popular alcoholic drinks.  In both cases there was no drop-off.  But you’re not giving away beer, so plan for drop-off.  This is, again, why technology always comes back strategy.  If strategy says fewer people and you really wanted to know who they are, you know you are willing to sacrifice getting more people, so this may be the right tech for you. That’s an important trade-off because your strategy may be to ensure the content gets delivered, not ensure authentication.

Now, back to rented lists.  The next big consideration with rented list is how you store the list.  Here’s why: Let’s assume you are going to send e-mails, for instance, and you want to use your own e-mail system, your marketing automation systems, master record system, etc. In this case a rented list is going to be combined with other data.  This becomes a problem because, don’t forget that rented lists are only rented.  They need to be returned at the end of the year.  And even if this is your only data set, when you “return” the data you do still get to keep the opt-ins and additional data that you’ve collected on your own, through your programs.

So, how do you ensure that you’re deleting the right records? *This* is the trick to a rented list. If you’re going to be combining it with other data, you need to set up your database in a way that you can actually carve out this data that was rented. The details of actually doing this is both too granular and slightly variable depending on your situation so my recommendation is to keep calm and call your CTO.  Hopefully you have an MDM system and a good DBA (Database Administrator).

So let’s assume you can do that, with a properly architected MDM platform and a good DBA so we can get back to WHY you would want to do this, because it seems like a lot of trouble (but it’s not).  In my experience, rented lists are good for teams that want to seed a database at the beginning of something. For example, you are just getting started, you may be two years pre-market, or maybe you’re entering a new therapeutic area, have a new indication, or just have a new data-driven strategy that targets new specialties. Given this, your goal is to seed your CRM/MDM/Marketing Automation system with a rented list because you probably don’t have enough data in this space.  As an organizational strategy the plan is to go into ownership of the data, but building a list from literally nothing (or very little) is difficult, expensive, and takes a long time with no guarantee of success.

Enter the rented list.  A less expensive way to prime the marketing machine.

So that’s rented lists. They are a perfectly legitimate strategy, but remember to be careful how you setup your database. As I’ve seen, a lot of people end up renewing rented list. They renew, and they renew, and they renew because it’s very difficult to separate out the data. Then large data initiatives that are undertaken just to separate out that rented data that counter some of the rented list savings.

Of course there are other factors, like market size, how many people are in your market (is it 2000 or 2,000,000), and is it a select group of people, specialties, or general practitioners, even consumers? Just to note again, we’ll talk about specialty in a minute.

#3 Buying a list

The next type of list is a bought list. A bought list is bit harder to come by, they are a little more expensive, and once you get it, you get it. Of course this is not always the case as there are good hybrid plans that allow for updates, but I’ll continue without that assumption.

Again, not always the case, but the quality of bought list tends to go down because the thing they want to show you is the number.  This is not a bad thing, it’s just a thing to consider – like having to return a rented list at the end of the contract.  Account for it and it’s not an issue.

When you start talking lists what they’re going to try to sell you on is the number.  “We’ve got four million people in the database”, “we’ve got one million of your specialty in the database,” etc. That’s great at a macro level to get narrow down list vendors, but now how you’ll make your choice.

Back to the quality issue, just be prepared for that in your first couple of campaigns, especially if it’s email, you’re going to see a ton of opt-outs and unsubscribes. If you are the technical person responsible for your marketing automation you should be aware that this first blast is when you’ll most likely get blacklisted. That can be serious and is something you’ll have to watch with bought lists.

Blacklisted, for those who don’t know, is when you send an e-mail there is a ratio that spam filters keep. This is the number of emails that are successfully delivered to the number of emails that are not successfully delivered (note: it’s a bit more complicated than that).  This ratio also analyzes the content and structure of your email to ensure CAN SPAN compliance with the CAN SPAM Act of 2003. Besides that, it considers “report spam”, “not interested in”, and “unsubscribe” actions taken by the person who receives the email.  There’s a few more considerations like DKIM and SPF that we won’t get into now. Suffice to say, all this is taken into account for the ratio that is used by companies who maintain the blacklist.  We’ll call them blacklisting authorities.

Blacklisting authorities are these companies who span across e-mail providers (like gmail, yahoo mail, and your company’s mail) who license out their service to corporations. They maintain a list of domains, and that’s where you’re at ( So they maintain the lists of, which is where emails come from, to make sure they’re tracking who is spamming and who is not.If you get blacklisted that means you get on the list. If you’re on the list, you cannot send any more email.

If you get blacklisted that means you get on the list. If you’re on the list, you cannot send any more email.

Well, technically you can send it, but it’s not going anywhere because nobody’s email servers will accept it.  It’s like sending a letter that keeps getting market “return to sender” – it will not make it to the inbox. It will not make it past the SPAM filter. And, BTW, if you set it up wrong this could take down *ALL* your company’s email, not just your commercial email. So just be prepared for that.

Blacklisting is just one of several reasons you want to get clean lists and you want to go to a known authority on lists in health care (ex: Definitive, Redi-Data, SK&A, DMD, etc.). There are a lot of places you can go for good lists, so you want to be cautious of getting any kind of deal. You’ll want to be very cautious of bought lists if it seems like a really good deal. There’s a couple of places that may be a strategic gotcha, this is one. So be cautious of cheap lists. You get what you pay for.

But don’t over pay either. Go to somebody who maintains lists actively and this is what they do, not something they do on the side. What some of these companies do is put programs on the Internet that act just like a search engine. They go out and scrape the Web. They find all these Web sites. Then what they’re doing is they’re pulling off e-mail address that are written. So whenever you put your email address on a Web site these programs are coming by and saying, “ohh, here’s another e-mail address, let me add it to my database.”

Or offline. There was a time I was going to a farm and horse show. It was in upstate New Jersey where we do that kind of mid-western thing. It’s just like a carnival rides, candy, shops, games and stuff like that. But as I was walking into the farm and horse show somebody had a car raffle by the entrance. I can’t recall the brand, but it was a car that I would typically not buy. So as I walked in they handed me a card and said, “write down your information for a chance to win this car.”

Now, I’m a marketer, so I know there’s two things happening. One, they are simply collecting my information. But just because you would give me a car for free, and I would accept it, does not mean I will go shopping for that car. I am not a valid lead. This is garbage collection to increase the number.

A valid lead or “hand raiser”, that’s something else. That’s something worth more. That’s somebody that actually came to one of your properties, looking at one of your cars, came to the car dealer and said, “I’m not interested in buying a vehicle right now. I still want to look around. Let me leave my information with you in case they are any sales coming up.” That’s a valid lead. That’s someone who may literally buy your car. As opposed to me. I’m going to a farm and horse show and you’re giving me an opportunity to win a free car.

So that’s literally where some of this information comes from. Sources like that, where these data vendors may say four million, one million, one hundred thousand. Those are great numbers, but they are not necessarily people who will ever buy your product so it might as well be zero (we’ll also get into filtering lists in a minute).

The moral is, be careful of bought list vendors and make sure you’re buying somebody who knows what they’re doing.

Aging lists

The second thing that happens with lists is that they age. Because of this you must understand list vendor maintenance practices, soask about the practices of how they age their lists. What percentage of the list do they validate on a monthly basis?

Ask about the practices of how they age their lists. What percentage of the list do they validate on a monthly basis?

Some of the best list maintainers or curators have entire staffs of call centers or have reps that are literally out there having good relationships, calling healthcare professionals office, calling these doctors, and making sure the information they have remains accurate.

But this is a two-way street. The doctors and nurses know that this is a good clean list, that the list curator is not going to be abusing it, that they will vet their customers to understand that they’re only selling it to appropriate people. Their information is not being sold to spammers in Poland or South Africa. They are sending it to people who will just be sending good, relevant information. That if they give their information they will not going to get junk mail that doesn’t apply to them. In return, they provide good quality information on who is currently working in the office, are the phone numbers, addresses, email address, and affiliations still accurate.

I was once working on a CRM campaign managing an MDM where the brand mentality was the number of people in our list never goes down.  In case it’s not obvious, that’s not a good practice. If there are people on your list that have never responded, that you get bounce backs from, that physically read “”, that you know are bad for tons of reasons, kill the record.  Just let it go, it’s gone anyway.

It’s really important to understand WHO you are buying or renting from. How do they collect it?  Did/do they maintain the list, and what are their maintenance practices?

Affiliation deep dive

Moving on to maintenance practices, there is one thing I mentioned above, which I’d like to go a bit deeper on because it’s important.  That thing is affiliation. Affiliation is notoriously difficult. Affiliation, to define it, is where a doctor can practice and/or admit patients.  Doctors can be affiliated with more than one practice or hospital.

When affiliations change, so does a doctor’s information. If I am a doctor with multiple affiliations You may have a work email address and it is no longer valid. My work phone number is no longer valid. My address, again, no longer valid. So if you are looking to do business with my organization, not me, and you say, “oh I have a list. Let me call everybody who works there,” my name comes up. But I no longer work there. Now you’re marketing to somebody who is not going to buy your product or is not in the target audience that you’re looking for.

Affiliation is one of those super hard things to get right. So when I talk about list maintenance, one of the main questions is, “how do they maintain affiliation,” and, “what does that look like?” On one side they go to AMA where affiliation is kept up, but you can’t own or rent. Or, they may scrape databases, look at NPIs, etc. There may be good practices for maintaining affiliation. Some of the best practices I’ve seen again are the call centers. People who have a fulltime job at company maintaining these will often call directly ask if people are still working here, do they have additional affiliations, working in new roles at new hospitals, etc. Healthcare professionals may own a private practice, but they may also work at a hospital or, a lot of times, a University Hospital. So you have to understand affiliation and how that changes over time. How old is affiliation how frequently is that updated? An old affiliation is not worth as much as a new affiliation because it changes.

So affiliation is something you’ll have to maintain especially, by the way, if you buy or create the list. It’s great today. Maybe not so much next year. So maintaining your list, especially if you own it, is a chore. Sure, there are ways to maintain. You can use your rep team and put special systems and practices in place that can use the reach of the rep teams. These teams that are out in the field are your helplines that can maintain your knowledge.

Strategy-driven technology

Let’s jump back to the strategy for a minute and talk about “who is our audience.”Did you map the customer care journey? Do you know the specialties that make the decisions? Do you know the decisions they need to make that matter?

Did you map the customer care journey? Do you know the specialties that make the decisions? Do you know the decisions they need to make that matter?

Because there are a lot of decisions to be made, especially if you need to get on formulary. That, for instance, is a multi-disciplinary team called the Pharmacy and Therapeutics (or P&T committee) located at a hospital or an insurance. These decisions may include the head or a specialty pharmacist or your audience may be the doctor themselves, if you’re dealing with a private practice.

Whomever it is, the key is you NEED to understand your strategy. And your strategy, if it’s a good one, most likely has several different people involved. There’s a lot going on here, and strategy is the key to technology. Strategy will help you ask the questions you need to ask when buying a list.  It will help you understand who your audience is, and specifically beyond your group of specialty teams, what organizations are you targeting? What demographic and geographic areas or are you targeting? Northeast? West coast? South?

There are a lot of different end-user data points that you will want to coordinate. On top of that you’ll also want to coordinate your channel-specific information. You may even want to understand the specific business and hospitals that are important to your strategy, because you can actually filter your list by organizations. You may actually need to do that because there are about 5600 hospitals in the United States, 70k in the world. So, for instance, you’ll want to put together a strategy that indicates which of those hospitals or physicians are important given the limited resources of marketing and rep teams. Or, in private practice you can put together a list based on maybe size of practice, what insurance they take, what formulary, what that looks like, etc.

It might seem like I got off topic there, but remember, this is all about list buying.  This is where your strategy will drive your technology. Here’s how it works:

Before you get to the list itself, the list vendor will send you a list count. The list count says they have 350k of this specialty and 170k of that specialty. They have this many case managers, this many nurse practitioners, this many pharmacists, etc. There are a ton of very granular specialties. So it is up to you to understand which of these records applies to you.

See where I’m going with this? Because if you’re buying a list of 1.7 million records, and let’s just say it costs you a $100k, which is not unreasonable depending on how and what you are purchasing, you HAVE to understand WHO in that list you are actually going to talk to. Here’s the math: if there are, let’s say 50 specialties and you target 5 (for ease of math) then 5 out of 50 is really not that much. It’s only 10 percent. So as a technologist, your first strategic cut of specialty leaves only 10 percent of that list in your target audience. That means you’ve now gone from 1.7 million to 170k. Ouch.

170k records for $100k is very different than $100k for 1.7 million records. You’ve gone from about $0.058 per record to $0.588. But we’re not done. Let’s cut that again by targeted practices, or hospitals, or infusion centers, or other organizations. Out of the 170k records, how many people are actually affiliated? Can they tell you who they are? What is their business address? Business name? And what is their confidence in their list? Those questions are going to cut you down even further. Let’s say they cut you down another 40 percent or so. That takes you from 1.7 million down to 170k, and now 110k records. Well that’s interesting – now you’re paying $100k for 140k records, which is $0.714 each.  That’s a pretty different from $0.058.

Keep in mind, this is still just the list. You have not created your campaign yet.  Mailchimp, and online email service, estimates the Pharmaceutical industry has a 16% email open rate with a 1.7% click through rate.  That means from the original 1.7 million records you can expect 17.6k open rate with only 1,870 clicking through on your first campaign – that’s $53.48 per click through.  I’ll stop there before I get into conversions and really freak you out.

But seriously don’t freak out, this is all normal number, it’s just that people don’t talk about it much.  Given these numbers, this may not be the kind of ROI you’re looking for in e-mail. Maybe it is. It depends on how big your audience is. If you have a very specific audience, and this is specifically who you’re looking for, this might not be too bad.  Just remember there is a patient journey, and there are people all along that journey that you may want a contact.  There are also multiple channels, so you can divide by that to decrease your cost per acquisition, and that’s just good marketing practice (for another post). But let’s just say for now these prices are okay — it’s a little high, so be appropriately concerned and decrease your costs by understanding your strategy up front.

The point is, work with the data vendors. Make sure you work with them and they understand exactly who you need. This way you’re only buying the records that you really need.

The point is, work with the data vendors. Make sure you work with them and they understand exactly who you need. This way you’re only buying the records that you really need.

Side Note: if you are buying at an enterprise level, it’s a little different story. You may be using data for validation, for example, or cross-brand / multi-brand promotion. But right now I’m talking about brand CRM where you know your strategy, your customers, and you know your indication very well. In this case you want to be very careful, because you want your ROI to be very good.

If you are buying data you’re probably getting into marketing automation and CRM, so you’re going to want more than one e-mail. You’ll also want to use the list in a responsible way. Again, don’t get blacklisted. Configure your email sending provider (ESP) with an alternate domain just in case. Make sure your unsubscribes are low and make sure click-throughs are high.

Another Side Note: these CTRs and Unsub metrics are for SPAM compliance and technically to prevent blacklisting. I honestly don’t like metrics like opens and clicks. Keep in mind you can drop a paper flyer on the way to a mailbox. Someone can pick it up and that’s a delivery. They can look at it and that’s a view. If they crumble it into a ball and throw it at their friend, that’s a share. So these metrics are good for things for technology considerations, like SPAM compliance, but use behavior change metrics for KPIs. You can link a customer back to an account and the account back to business to see who, that you sent emails to, comes to your booth at a conference. That’s cross-channel analytics. I’ll talk more about that when I cover analytics in depth.

So that pretty much covers list buying, list renting, and even a bit of list strategy and pricing.

  • I didn’t get too far into marketing automation best practices, messaging, cadence and stuff like that – we’ll talk about that in-depth another time.
  • I did not go into the systems that you will use for your master record – it depends on how you want to use the lists.
  • I did mention how and why it’s important, if you’re renting a list like that data up front. Keep it separated from the rest of your data so that at the end of your rental you can return it.
  • Keep in mind your costs your cost per record when you’re evaluating lists, it’s a very important metric.
  • Also keep in mind that you want to go with reputable list maintainer so that when you use this information you’re not getting blacklisted number one. Number two, you you’re putting a lot of time and into campaigns and you want to make sure they’re successful.
  • Trying to cheap out on a list will essentially waste a lot of money in the long term for a small savings up front.
  • Make sure you’re getting a good clean list. And have a plan to maintain your list. Over time your data will degrade.
  • Focus on good behavior change metrics, and real KPIs, not the size of your list.

But that’s for another discussion. So until then, keep calm and call an engineer. thank you.

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