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 1/20^th 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

Dodge Ball A La extrovertic [Part 1 of 2]

Everything we do, we do the extrovertic way—insightful strategy and nimble execution. But our approach isn’t limited to our clients: it extends to our dodge ball team (uniform pictured above).

Like every account we have, we take dodge ball seriously. After debilitating losses in the first 2 weeks, we made changes. We asked ourselves what was and wasn’t working. 

Then we hired a coach, who brought a change in attitude.

To prepare for our weekly matches, we Sextroverts take part in strategy sessions that recap the previous week’s matches as well as develop our ongoing strategies. We’re even using specific plays and tactics derived from Sun Tzu.

The result? We have moved from last to fourth place (out of 9 teams).

Encouraging. But the question remains—will our strategic insights about dodge ball garner the same success as our strategic insights about healthcare marketing?

As we approach the league playoffs, we’re keeping our strategy and tactics under wraps. However, as we progress deeper into the season, we’ll share some more methods to our madness (in part 2). Until then, feel free to check out our spiritual leader.

-Captain Thomas 

2 concerts and a plate of bones.

Whether it was poor timing or some inner party animal instinct, I managed to lock myself into two consecutive nights of concerts.

Both bands would feature loud guitars, a healthy dose of ‘80s-style synthesizers, pulsing bass lines, and did I mention loud guitars? Yet, they’re different.

One band is relatively new - the mean age of their members was about 26. The other, a band that’s been around for about 30 years, whose members are geezers and could technically be the fathers of the kids in the first band. These bands are quite unalike, yet each has qualified as ‘kickass’ in my opinion.

Without prejudice.

We had spare tickets to these shows and offered them to friends. No takers.

“I don’t know these bands, but I don’t think I’m gonna like ‘em,” was the typical response. This, was without hearing a single note from either band.

Much prejudice, it seems.

When I asked a colleague if he wanted to see one of these bands, he promptly googled them and told me, “I see that they’re classified in Wikipedia as a shoegaze band. What on Earth is shoegaze?!” Then he didn’t think he was going to like them. His reasoning made my head explode. “I think they’re before my time, before I was born.” I’m pretty sure people shouldn’t be benchmarking new music on the basis of their birth date.

You see, I have a voracious appetite for new experiences – not just music – and I believe that every one should be constantly on the look out for new and different things.

For example, lately I’ve taken to the idea of nose-to-tail eating, which means I’ve been going out of my way to try every type of offal I can find. Heck, before last night’s concert, I pigged out on roasted bone marrow with ramps.

I knew I liked bone marrow, but I had no idea what a ramp was, so I ordered it. (It’s a wild spring onion and you can see the little bulbs embedded right into the marrow).

(My mouth is watering just looking at that picture)

We all need to go out and try everything weird. If not weird, something that makes you a tad uneasy, and takes you out of your comfort zone.

So what’s the point of all this, then?

Run towards ideas that are unfamiliar or different from what you currently believe or understand. Have a voracious hunger for new ideas.

Despite its original context in the film Wall Street, Gordon Gekko’s seminal speech has a universal truth to it:

“Greed, for lack of a better word, is good. Greed is right. Greed works. Greed clarifies, cuts through, and captures, the essence of the evolutionary spirit. Greed, in all of its forms; greed for life, for money, for love, knowledge, has marked the upward surge of mankind.”

Greed is very good for marketing, in the sense of the pursuit of ideas and creativity. Eat up everything around you – in pop culture, in automotive design, in furniture aesthetics, in product packaging, in films, I gastronomy–all of it.

I believe that so many solutions for pharma marketing lie outside pharma marketing. And the only way we’re ever going to find them is when we start paying attention to things about which we have no idea.

-Des

Please Welcome Our Latest extrovert to the NY Office.

As part of extrovertic’s recent rebranding brainstorming, each of us was asked to “bring in something that you feel represents extrovertic.”

I brought in a bulb.

But not just any bulb—an amaryllis bulb.

You’re probably wondering, “What does an amaryllis bulb have to do with extrovertic?"

A bunch of reasons come to mind:

        ·      It blooms big, with multiple flowers

        ·      It’s determined. An amaryllis is one of the easiest flowers to grow. The bulb of this one couldn’t even wait to get to work. It’d already started to sprout before we put it in soil and watered it

        ·      It’s unstoppable. An amaryllis can keep on growing and blooming for years with minimal care. This is the second time this one’s bloomed. I just trimmed off the wilting stalk and it grew another stalk that then flowered

        ·      It’s popular. Because it’s so easygoing and cooperative, there’s a worldwide demand for them

        ·      It’s diverse. They flower in different colors (red, white, pink, salmon, and orange) as well as with different stripes

The way I see it, we at extrovertic operate the same way. It’s who we are. What we do. And how we work. Is it genetic? The environment? I don’t know. I’ll leave that to the Watson and Cricks of the world to unearth.

But I leave you, kind reader, with a perennial question: Why not grow your brand with extrovertic?

-PVB

This Skittles Commercial Is the Spinal Tap of DTC

The 2008 documentary It Might Get Loud showcased 3 highly influential guitar players of the modern-rock era: Jimmy Page, Jack White, and The Edge. It’s a brilliant film. You really should watch it if you haven’t yet.

One glaring moment was when The Edge recounted the time he watched This Is Spinal Tap. He said, “Spinal Tap….That's a movie that I watched. I didn't laugh, I wept.”

Those weren’t “I laughed so hard I cried” tears. Those were tears of shame. Not because The Edge had himself been guilty of the same big-haired, cheese-rock, melodramatic antics that Nigel Tufnel, David St. Hubbins, and Derek Smalls got up to. It was because the parody was so spot on that it was hard not to take personally.

And that’s how I felt when I watched this brand‑new Skittles^® commercial from Canada.

DTC TV spots are certainly not new fodder for parody. Saturday Night Live has been taking jabs at the category for ages. But having the likes of SNL poke fun at DTC was a little like an outsider looking in and laughing at us. It’s a whole different ball of wax to have our marketing brethren do so. That’s an inside job, a more personal jab. (And it seems to be a common trend—here’s another pharma spoof for Stoogesta, courtesy of the upcoming Three Stooges movie.)

Just as The Edge was chagrined by the over-the-top parody of rock‘n’roll in Spinal Tap, I was gutted when I saw that Skittles commercial. It cut a bit too close to home. Look at every cut in that spot—you’ve seen them all before. Every smile, promise, motion, on-screen effect—all of it. You’ve been seeing them for close to 20 years now.

So how did we get here? Have we squandered the last 15 years creating a monolithic category of pharmaceutical advertising that can be summarily goofed on in 60 seconds by a candy company? You know the answer to that question: yes.

I have worked in DTC marketing for almost 10 years now. And I want to continue to do so for the foreseeable future (at least as long as the FDA allows us to communicate directly to consumers to keep them better informed). But I also want to stay in DTC because I never want to make a “typical DTC commercial.”

Take another look at that Skittles ad. Soak in the horror of such creative mediocrity. Do our consumers really want to see creative like that? As marketers, are we truly satisfied that that sort of work is what we’re churning out day after day, month after month, year after year? Watch that spot again and let it drive you to create something better, more meaningful, that matters. We CAN do better. We CAN create fascinating imagery and tell stories that smash the norms of DTC advertising. We CAN create meaningful messages that do more than serve as fair balance wallpaper in a commercial pod.

We continually struggle to get standout creative to market. We don’t always succeed but that doesn’t mean we or anyone else should stop trying.

Let’s never give anyone reason to rip on our creative again. Do it first and foremost for the consumer. They deserve better. Then let’s do it for ourselves. Because we’re better than that.

-Des

Be the Patient

Every time I’ve started a patient-centric initiative, I’ve given the direction to my teams: Be the patient. I’ve found this helps provide my creatives with a deeper understanding of what an average patient is going through. Recently, I took my own advice a bit too literally—I broke my left humerus bone and spent a day in an ER, followed by a day spent with a highly regarded orthopedist. Having never broken a major bone before, the experience was both very painful and very instructive.

Upon arrival at the hospital, I sensed an information disconnect—I kept asking questions but only got selective information in return. It seemed the hospital staff wanted me to feel comforted by giving me some answers while flat out ignoring others. They weren’t really listening to what I was asking for. This experience got me thinking about how we listen (or don’t listen) to patients in focus groups.

I’ve spent as much time as anyone in dark focus-group rooms, chain-chomping M&M’s^® and taking notes on patient stories. But my accident made me wonder if my previous objectives had been to hear what I wanted to hear rather than to try to understand what patients were truly saying. Since patients are usually quite expressive in focus groups, if we really listen when they speak about how they are feeling, we can end up with keener, truer insights that might change the type of strategies and concepts we come up with in the future. It could also affect the patient’s long-term health.

For instance, at extrovertic we were recently able to discover a valuable truth about a patient group. This truth completely changed how we viewed the group and our approach, which ultimately resulted in very successful pre-launch and launch campaigns. We came to this truth by listening differently, not just to what the patients were saying about their condition, but to other significant experiences they’d been through in their lives. We established a greater understanding of our target demographic through this process.

To that end, listening beyond what patients are saying to truly get at what they are expressing or feeling can continue to help us find patient truths. With those truths, we can offer patients what they really need and not what we think they need. As a patient, I know I certainly would have appreciated being more closely listened to.

Are you really listening to what people are trying to tell you?

-Tom