Monday, May 21, 2012

3 Things To Do Differently

I had the opportunity to participate in the PharmaMarketing Summit 2012 in Chicago a few weeks ago. Unlike most summits where you have to sit through 3 days of dreck, this conference’s program was a veritable goldmine of thought-provoking presentations from a range of healthcare marketing leaders.

My top 3 takeaways about what pharma marketers should be doing differently in the future are:

  1. Heed the needs of the new power players: Payers and patients.
  2. Social media: Engage or be seen as indifferent.
  3. Prepare for the “unexpected inevitable.”

The new power players

Even with all of the changes in the healthcare landscape over the past decade, physician marketing remains the heart and soul of every pharmaceutical company. Payer and patient marketing teams generally play second fiddle to their HCP colleagues in terms of budget, review committee time, perceived value, and company attention. Some of the talks at the summit, however, made me think marketing departments might want to change gears to focus on those who are increasingly calling the shots: Payers and patients.

While talking primarily about emerging markets, Neil Wolfe, Global Alliance Lead of Bristol-Myers Squibb, was adamant about the growing power of payers to make or break a drug. Payers have a different set of criteria for what “good” looks like that revolves more around populations than individuals. So according to Neil, a product that reduces the intensity of a heart attack is not as good as a drug that lowers hospital re-admittance rates.

In the past, a big sales force armed with smart marketing pieces could often overcome payer restrictions at the physician office level. With sales forces shrinking, office access becoming more limited, and changes looming on the US policy front, I couldn’t help but extrapolate that payers will soon have the same grip here.

No extrapolation is needed, however, to see that patient opinion is increasingly a powerful lever in determining a product’s adoption and commercial success. At the summit, Dr. Frank Spinelli, a physician currently in private practice and formerly the Clinical Director of HIV Services at New York’s Cabrini Medical Center, spoke about how he and his partner (also a physician) finally set upon a definitive course of treatment for his partner’s cardiovascular condition only after joining and consulting the relevant Facebook community.

Consulting with 3 different physician specialists left them where they began— scared and unsure about which course to take. So Dr. Spinelli and his partner turned to Facebook and got passionate, personal, and specific information needed to tease out a way forward that made sense for his partner’s particular situation. This example is all the more powerful because it illustrates a growing trend of physicians turning to patient communities to help understand and solve clinical problems.

But as the most recent Neilsen Study about global consumers’ trust in advertising points out, Dr. Spinelli is not alone in acting on information received online. 70% of those polled said they completely/somewhat trust consumer opinions posted online. Even going beyond the issue of presumed bias, why isn’t there more useful information being provided by experts like physicians and pharmaceutical companies?

Sometimes it's the fact that the labeling doesn’t contain all the information a patient needs—for example, how to deal successfully with side effects. If it’s not in the label, despite being medically accurate, helpful information is withheld from patients—end of story. But that represents organizational inertia to me. I’ve seen some organizations develop new ways to adhere to the spirit of the regulations and dispense the needed advice. With every patient now having a trusted voice, doesn’t it make sense to be helpful wherever you can?

Which brings me to my second major conclusion:

Engage or be seen as indifferent

While patients and doctors are fully engaging in social media to solve their health issues, what about pharma? John “PharmaGuy” Mack answered this question with a very comprehensive chronology of pharma’s activities in the social media sphere. In reviewing John’s presentation post-conference, it struck me how few examples there were of truly helpful engagement with patients. One standout was AstraZeneca’s live chat about its prescription savings program, AZ&Me.™

In other industries, customer care similar to what AstraZeneca offers is a major focus of companies’ social media efforts. There are even conferences dedicated solely to the use of social media for customer service. Financial services manage to create meaningful, customer service offerings through social media, despite regulatory and public opinion pressures similar to those in the pharma world.

As Peter Pitts from the Center for Medicine in the Public Interest pointed out in an excellent presentation on social media, the offline rules apply to the online environment. Despite the lack of definitive FDA social media guidance, we do know what to do. I’d argue that ignoring consumers’ online complaints and questions is akin to refusing to answer phone calls to medical information lines.
It is easy to focus on the costs of answering patient questions (additional FTEs, infrastructure costs, and review time); however, angry patients have their costs, too! Frustrated patients now have a public outlet—the online community—where one woman blogged about how she did not receive a satisfactory response to her questions about why her hair did not grow back after her chemotherapy ended. No one likes to feel ignored.
Healthcare providers increasingly see that indifference has a tangible negative impact. As Dr. Richard G. Roberts (past president of the American Academy of Family Physicians) has written, doctors who are compassionate and communicative with patients, “can avert not only malpractice claims but also patient injury.” In this vein, 7 Massachusetts hospitals recently launched a "Disclosure, Apology, Offer" initiative to fully disclose mistakes to patients and apologize. Why wouldn’t we expect the same to carry over to the pharmaceutical arena?

While there are regulatory complications, companies like UCB with their PatientsLikeMe® partnership effort are taking a proactive approach to figuring out the challenges of using social media and fostering interactive dialog with patients. Other companies need to do the same so they can actively engage in answering patient questions or risk being seen as indifferent.

This brings me to my last takeaway:

Prepare for the “unexpected inevitable”

The summit opened my eyes to a number of healthcare issues that I either thought were somewhere way off in the future or of which I had been totally unaware. Our annual planning processes largely ignore these looming changes since the specifics are so uncertain. I’d argue, however, one thing is certain; we spend too much on healthcare in the US and therefore, resources are going to become more limited and/or expensive. Most companies ignore this inevitability.

This “blinders on” approach reminds me of an interview I read a few years ago with a Toyota executive talking about Toyota’s decision to invest in the Prius despite operating in the midst of explosive consumer demand for big, gasoline-guzzling SUVs. Toyota thought that no matter what, energy was inevitably going to get more—not less—expensive. So while you can argue about the timing for a hybrid car, you can’t really argue about the inevitable need for one in the future.

It seems to me the same is true with healthcare. What products and practices can pharmaceutical companies develop in anticipation of shrinking dollars being invested in healthcare? The conference presentations provided some interesting “what-if” scenarios to think about.

So what if:
  • Mumbai-style hospital cities made their appearance in or near the US? According to Neil Wolfe, patients can get a coronary bypass at one of these hospital cities for about $2,500—about 1/20th of what it costs in the US with overall outcomes the same or better than the major US centers of excellence
  • The goal of US health policy went from offering the most “advanced” healthcare regardless of cost, to one based on getting the largest number of people covered with the least expensive option?
  • Physicians get compensated on the quality of care they deliver versus the quantity (as is supposed to happen in 2014)?
  • Direct-to-patient pharmaceutical shipping went from a Loss Of Exclusivity strategy to a commonplace way of conducting business? 
Obviously, a company can’t prepare for all the unexpected inevitabilities.  However, Ellen Brett, a former colleague of mine who headed up Global Strategy and Innovation at Pfizer, suggests a company can:
  • Come to a consensus about the most likely and important changes
  • Engage in scenario planning

With some dramatic changes looming in 2014, shouldn’t 2013 planning incorporate at least a nod to the future?

While none of my 3 takeaways from the PharmaMarketing Summit were out-of-the-blue surprises to me, each of them underscored the urgency to start acting NOW. Healthcare marketers can leverage lessons learned from counterparts in other industries that have come to understand and adopt new approaches before us. I still remember a Wyeth colleague telling me in the mid-1990’s that he didn’t have to invest promotional dollars in his Managed Care Organization customers, since fee-for-service practices still accounted for half of his business.

Wonder what he is doing now? Is he thinking, “What if I had invested more in preparing for the future, shifting customer segments, the new ways to engage, and the inevitable realities of the future?” If not, then he should be.


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