19-474 Nebido
We are looking for people who have used Nebido to treat their Hypogonadism and would be willing to share their story.

As a First Phase, we would like you to take part in a filming exercise using a secure smartphone app (called ‘Field Notes’) to capture your journey – the symptoms, how long it took to be diagnosed, treatment duration and benefits). This will require you to record a short self-filmed video of you talking about your journey. This footage will never be shared in an external setting; rather it will be used as a resource to identify those respondents who we can bring onto the next phase of this initiative – Phase 2 – which will be to participate in the creation of ‘your story’ a documentary-style short video which would be filmed

Ultimately, we would like to share these (Phase 2: filmed video and images) with other patients and also health care professionals for a campaign that will manifest in both on- and off-line formats:

- Web page: videos will be hosted on the Nebido website, but will be accessible to health care professionals (HCPs) only
- Images and quotes will be used in a patient perspective booklet
- HCP Emails
- HCP to patient videos
- HCP digital sales aids

For the First Phase – of self-filming via the Field Notes app – it will take a total of 30 minutes of your time across a day. This footage will only be used for internal review via a secure, password-protected space. The incentive for this part is 50£

Should your video be selected to be developed further, we would embark on Phase 2 – at which point we would visit your home with camera crew to film you for a day to capture your story and journey in more depth. The incentive that we will be happy to pay is £500.

We strongly believe that this therapy makes a difference as these patients are severely underdiagnosed. The video content will aim to proactively screen patients for HG – predominantly those with obesity or type 2 diabetes.

The company who is commissioning this research will not contact you outside of this project. You also have the right to withdraw from the research project at any point.

We would like to offer you £50 in recognition of your willingness to share your story with us. Should you go on to the filming in home, you will be paid £500


The sponsoring client will ask you to sign a contract to use your image, video and story for their awareness campaign.

ADVERSE EVENT DISCLAIMERWe are now required to pass on to our client details of unexpected product experiences and product complaints that are mentioned during the course of Market Research projects, including any reports of patients becoming pregnant while taking one of our client’s drugs.Although what you say will, of course, be treated in confidence, should you raise a side effect and/or product complaint during the discussion, we will need to report this even if it has already been reported by your physician directly to the company or the regulatory authorities. In such a situation you will be asked whether or not you are willing to waive the confidentiality given to you under the Market Research Codes of conduct specifically in relation to that adverse event. Everything else you say during the course of the interview will continue to remain confidential, and you will still have the option to remain anonymous if you so wish.

We will comply with all national laws protecting your personal data and with relevant guidelines including GDPR, ESOMAR, EphMRA and all other relevant national codes of practice.
Your video may be
• listened to/viewed by Market Researchers/Pharmaceutical Company Staff to gain greater insight; (this maybe via video streaming.) Market Researchers/Pharmaceutical Company Staff may be based outside the European Economic Area ("EEA"), or the country where the interview takes place. All staff have confirmed their agreement to follow Observer Guidelines.
• audio/video/DVD recorded for analysis at a later stage. The recording may be analysed by sponsor who are operating outside the European Economic Area ("EEA"). Adequate data protection measures will be put in place to comply with the Data Protection Laws of the country in which the interview took place.

You may withdraw at any stage of the project or withhold information if you so wish.
If you happy to participate with this project on this basis please answer the questions below.
thanks
a


What is your age? *
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Are you? *
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Have you used or are you using Nevido? *
Required
How long have you been on the Nebido treatment? *
Required
have you had any of these conditions/symptoms? check all that apply *
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