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:
- Heed the needs of the new power players: Payers
and patients.
- Social media: Engage or be seen as indifferent.
- 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.
-Dorothy
