Many of Kanga’s employees have health conditions themselves or are carers for those in their immediate families, and this helps us stay connected to what we do. Our Account Manager Ed Snook, who has Type I diabetes, has recently facilitated a number of patient co-creation workshops on the subject of diabetes. In honour of World Diabetes Day this 14th November, I had a chat with him to find out how it went.
What’s it like working for Kanga, as someone with diabetes?
It’s the 10th year since I was diagnosed with Type 1, and working for Kanga has opened up my eyes to the sheer amount of research going on in diabetes care, as well as the possibilities for new kinds of treatments that are potentially just years away! It’s been exciting to work with a number of pharma companies who are leading the way in this research, but also beginning to involve patients at the heart of their digital strategy.
How have you been working with diabetes patients recently and what did you learn?
I was lucky enough to meet several patients on Insulin Pump Therapy (IPT) this year, to film their stories of diagnosis, living with diabetes, and their tips and tricks to successfully managing the disease through IPT. Those videos along with nutrition animations developed by our team will eventually sit on an IPT patient information app. I self-inject my insulin, but the patient and carer stories and the information they provided really made me consider whether IPT could be an alternative for me.
It was also terrific to work on a Twitter campaign covering a congress last year, where one company were informing HCPs about their new flash glucose monitoring device, a device that I use myself. We ran a Twitter ‘clinic’ for HCPs to help them join Twitter, follow the company’s handle, and therefore receive updates about the device.
I’m looking forward to what the next few years hold as we continue to partner with pharma companies working in diabetes.
Where would you point people who’d like to find out more about the future of diabetes treatment?
Eyeforpharma Barcelona took place last month and was the biggest yet. Here are some of my thoughts and observations, a few weeks later but that is because I’ve been busy with efp follow-up opportunities!
The exhibition hall was more vibrant than last year. Roundtable meetings taking place within the hall, together with ‘guided tours’ of the exhibition and a stage with presentations at one end made it a more lively and interesting place to be. Good job, eyeforpharma!
Here are my takeaways:
1. The next big healthcare leader may not be a pharma company
Ordering drugs by Prime? Paul Simms boldly predicted in his opening address that ‘the fastest growing health company isn’t a health company’. He tapped into a big question on everyone’s mind: will pharma become irrelevant as an industry in the future? As you’d expect, this was a major topic of conversation running through the days.
Amazon’s business model is famously about customer service. In the early days, each new customer was not profitable for the company because they invested more in service than the initial customer purchase – but of course over time this investment has been a winning one. This is a mindset that applies equally to healthcare, and either pharma needs to get the ‘Amazon’ mindset, or Amazon Health might be the future.
2. Patients are experts in their long-term conditions
Patients live with their conditions every day. Involving them adds value from the earliest point of drug discovery to the ongoing support of therapy. It was great to see that this year patients were delegates alongside everyone else, integrated into the conference.
It was particularly refreshing to see a panel of young patient representatives, who spoke with vision and clarity – the voice of future patient advocacy.
Matt Eagles, who chaired the Patient Track, has young onset Parkinson’s. He read out his medical notes from the last 30 years or so, hilariously pointing out that, no matter why he’d gone to the doctor, the comment appeared each time like a diagnosis – ‘Parkinson’s’, as if this were new… ‘So apparently I still had Parkinson’s in 1998’ etc. He used this to make the point that he has Parkinson’s every single day, hour and minute – that is his experience, whereas the healthcare professionals only experience Matt’s Parkinson’s two or three times a year.
3. Big companies are making a strategic effort to transform
It’s a fun three days, but eyeforpharma is far from an industry ‘jolly’ nowadays. Some companies sent large cohorts this year and organised session attendance and ‘congress reporting’ back to colleagues.
They came to the ‘roundtables’ with notepads and devices at the ready, keen to learn from each other. Presentations, too, were focused on the practicalities of transformation, with top tips and to-do lists in abundance.
Companies know transformation is imperative for future survival and teams are eager to make this happen. But there is work to do – in one poll (IQVIA) only 7% of the pharma professionals said their customer experience is integrated across channels.
The presentation from Google highlighted that we still have much do. 86% of patients search for information after receiving a diagnosis. Both they and HCPs often look for ‘side effects’ relating to their medication, but companies do not always highlight this information in a useful and visible format. Ryan from Google also pointed out that social listening is helpful, but keyword analysis can give a different perspective on what users are really interested in:
4. Twitter conversation enriched the event (about time!)
Happily, more delegates were ‘walking the talk’ and engaging on Twitter this year. This fostered useful sharing at the conference – I chatted with a few industry colleagues in person and discovered new opportunities as a result of enlightening Twitter exchanges – our customers are, of course, doing the same.
5. The role of Big Data and AI
Artificial Intelligence in healthcare is growing up. Otsuka showed the impact of data collection through DigiMeds, wearables and patient apps, leading both to better patient management and accelerated drug discovery.
Watson Health has plenty of examples of what they refer to as ‘Narrow AI’ where a specific question is answered through use of big data. They also introduced ‘Broad AI’ – in which multiple types of data are used – for example in diabetes using glucose levels, insulin dose, lifestyle factors, food consumed – different data types together can predict an outcome – such as a hypo – 4 hours in advance.
This is the shape of things to come as innovation becomes less about ‘what new shiny thing do I want to make?’ but more ‘how can I harness data to learn more about my customers and patients?’
Develop your own website or connect via trusted 3rd party platforms?
This was a central theme at the recent eyeforpharma Marketing Customer Innovation Europe conference in London.
The round table I was chairing saw strong views for each ‘side’. Those representing platforms that offer third-party visibility for pharma were keen to point out the value in ‘fishing where the fish are’. On the other hand, some pharma folk felt clear that establishing leadership via owned assets was the way to go.
Really, the debate needs reframing. In most cases we should be doing both of these tactics. The balance we choose depends on our strategy: What are we trying to achieve? What does the customer need at different points in their journey, and what are the business objectives?
Why a combination? Because every strategy needs to combine reaching new customers with building sustained relationships over time.
Partnering with a third party is a great way reach new HCPs and build awareness –
A respected 3rd party platform may have a large membership and user base – check their statistics on your target audience. Partnerships enable you to offer up your content to as wide an audience as possible, demonstrating to relevant HCP groups that you are considered a trustworthy stakeholder in this area.
EPG Online offers opportunities for companies to sponsor and syndicate content
– but a 3rd party partnership doesn’t cultivate lasting relationships
Every time you want to communicate with each customer, it costs the same as last time. There is a lack of economy of scale: as soon as you stop paying, your audience goes away.
Your own platforms are where you and your audience can commit to each other
If you want to be a therapy area leader, an owned platform is a likely necessity. First of all, this is how you will get those all-important search rankings and ensure that customers are coming to you, instead of your competitors, to get their questions answered.
Once on your website, customers will sign up to receive high-value content – if it’s compelling enough and meets their needs. This is how longer-term relationships are forged. Some companies are embracing this approach and building sustainable relationships, for example Sanofi with diabetes.sanofi.de, Lilly with LillyOncology.co.uk and Shire with the ADHD-Institute.
ADHD Institute – Shire’s international platform for specialists – was a finalist in this year’s eyeforpharma awards in the category Most Valuable HCP Initiative
Think you can’t form long-term relationships with customers in a digital-only setting? How about our relationships with Amazon, Google, or Apple – do we ever have a face-to-face meeting with them? Amazon has inspired loyalty in millions through its personalisation, effective search engine, breadth of product offering, and customer service.
Most industries take for granted that a combination is needed
If we see an emotive video about a new Apple product on one of our favourite news websites, we expect to be able to click through to the manufacturer’s website to find out the product specifications. We wouldn’t have made it to the site in the first place without the third-party video, but it is only once there that we will sign up for newsletters or register for an account, forming a relationship with Apple.
We use different types of websites for different reasons and our experience with a company in each type impacts our engagement in the others.
Proof that it works in pharma?
When developing LivingWithNets.com (Ipsen’s award-winning resource for people living with NETs, presented at the co-located eyeforpharma Patient Summit in London), we initially wondered whether a new web-based NETs resource would add any value for patients, and indeed whether patients would even visit a company-owned website. There was already the Carcinoid Cancer Foundation, a thriving US-based resource that meets patient needs on a global scale.
Ipsen’s approach? Partner with the Foundation itself as well as patient associations in other countries to gather insights. They helped us to connect with patients so we could better understand their needs. It turned out that many patients were keen on the idea of an additional NETs resource to support patients from symptoms through diagnosis and living with the condition.
Co-created with patients, LivingwithNETs.com has gone on to meet considerable unmet needs and to win an award at eyeforpharma Barcelona 2018 for Most Valuable Patient Initiative. One of the first to congratulate the team was our 3rd-party partner, the Carcinoid Cancer Foundation:
This is an approach that applies for healthcare professionals too. If you want them to get to know you, customers first need to know you are there – so you must ‘fish where the fish are’. But once they have discovered you, the connection requires a space where you can deliver lasting value to the customer and get to know each other better.
This is a sound approach to all relationships, traditional, digital or multi-channel.
It would be an exaggeration to say we are already surrounded by brilliant examples of pharma using social media to meet patients’ needs. But at the international Pharma Social Media Conference last week in London, I could see that on the horizon.
This year’s conference had a hungry buzz about it, with our colleagues in pharma really wanting to grapple with the question of ‘how’ to engage with patients, rather than just, ‘Should we?’. Much like at eyeforpharma, the mix was filled with crucial ‘newer’ partners such as biotech and medical device firms. Collaboration, the key to pharma’s future, is now a given.
Co-creation with patients is the norm at Kanga. When I shared some examples in my talk (such as the MyFeelPlus app for prostate cancer patients), it sparked some great discussions – rather than merely the fear of regulatory constraints.
Leo Innovation Lab was created to put patients first and deliver digital solutions for patients, independent of Leo pharma and their products. Morten Remmer described how they built a community for Psoriasis patients to allow them to have a private discussion, as they often don’t want to share problems in front of loved ones in social media. Later, Maria de Freitas from the same organisation showcased an app that helps psoriasis patients track their condition:
Pharma delegates told us that they want to meet patients and doctors on their own terms. They are ready to get down to the ‘nitty gritty’ of governance issues. As Serli Çubukçu of Sanofi pointed out, we are all ‘prosumers’ now. We understand from our own experience the irrelevance of firms absent from social media. ‘No-one has 30 seconds for interruption, but we all have 30 minutes for stuff we like!’
Real, Relevant, Respect, Respond: the four Rs of social media that I outlined in my talk. Speakers gave solid presentations that touched on all of these. In a helpful case study, Sarah Holiday of Pfizer shared their strategy for congress tweeting for HCPs. Each team runs their own congress through the central @pfizercongress account. This makes the account a hub for SM-active doctors, while the posting is still done by teams with the most relevant knowledge.
Alex Saunders provided insight into GSK’s social media approach, noting that ‘the content has to be brilliant or we’re wasting our time’. He explained their aim of combining journalistic editorial leadership with a culture of creativity and an ‘outside-in’ mentality.
His presentation recognised that the most crucial information must be gleaned from those we are trying to engage with. It’s refreshing to hear a presentation like this. It signals the sea-change in big pharma that can help patients the most – and, in turn, ensure the industry’s successful evolution.
There was discussion of the potential of LinkedIn, with an insightful talk from Cyril Mandry from MSD. He outlined the business opportunities of the channel for pharma:
Of course, LinkedIn does not allow drug promotion, including to HCPs. Engagement must take a different form and signpost to other assets. LinkedIn is an increasingly versatile channel. Its scope for connecting pharma with HCPs is considerable.
Facebook is a vital tool for engaging patients. Maria outlined her top tips for getting the most out of it, in particular using FB’s Business Manager to run projects, which offers insights and functionality not available to an ordinary FB user.
I noted in my presentation that when Ipsen’s LivingwithNETs (developed by Kanga, co-created with patients) won the eyeforpharma award this year, Ipsen’s share price saw a notable increase. Delegates told me afterwards that this fact had helped to confirm what they already knew: that the winners in our industry are winning because of their close attention to patients’ needs.
I also learned the hard way how many times you can tweet in a day before Twitter thinks you are a bot and blocks you! – It’s around 100. My tweet behaviour probably also pushed the ‘regularity’ button – I was tweeting at a consistent rate as I do at all conferences. I had to ask for an ‘unlock’:
The conference chair commented I was ‘tweeting like a millennial’ (must tell my millennial children 🙂 ) But on a more serious note, we were surprised that only a few delegates were tweeting or using any SM to share conference content. Cyril pointed out that companies with socially-engaged employees perform better in SM, and Jannick Larsen of Teva encouraged everyone to ‘become a thought leader’ on SM and share great content.
We must all become participants in order to learn how to implement the key theme that emerged from the conference: Being human, treating people right in social media, is where patient, healthcare professional and business value are delivered.
I sensed an atmosphere of determined optimism mixed with uncertainty. I heard diverse speakers from industry and beyond. This year’s eyeforpharma heralded some deep shifts, bringing together those working to remodel the industry with patients at the centre. Here are my key takeaways:
1. Companies are now actively involving patients in decision-making
‘eyeforpharma has taught us that pharma is actually listening.’ Carole Sian and Sonia Hawkins, Patient Experts at eyeforpharma
Patient centricity has been on everyone’s lips for a while, but many companies are now putting it into action.
2. True multichannel approaches are replacing the assumption that digital means ‘digitalising the rep’
A glance around the conference revealed a wide variety of vendors, from Trustrack (a scientific copyright tracking platform) to 60 seconds (an app for coaching in mobile sales). At one time, ‘digital’ in pharma meant ‘digitalising the rep’. Now, I’m glad to see, it’s an infinitely broad term signalling the central means for direct-to-customer engagement.
Roche have updated all job descriptions to include ‘insight-gathering’, demonstrating a commitment to providing the right kind of information to the right people at the right time. A platform at the conference was given to Share4Rare, an innovative project that uses social media to connect the stakeholders of rare diseases across Europe. True multichannel approaches are now valued and commonly known to be effective, driving value for patients.
Takeda’s MOOVCARE program that improved survival of
lung cancer patients through symptom reporting
3. The industry is starting to explore the exponential power of embedded analytics
Companies are starting to realise that measuring digital activities is essential, as it provides the data they need to propel them into greater customer engagement and personalisation. Analytics and KPIs are a subject of concerted focus for most. Elena Bonfiglioli from Microsoft highlighted that, of all industries, pharma suffers the most from ‘pilotitis’. The accessibility of data is what can enable pharma to embark with real confidence on a broader range of projects to support patients and doctors.
4. Doctors are almost all digitally ‘naturalised’ and industry is catching up
With the concept of a ‘digital native’ almost a moot point now, all doctors are digitally ‘naturalised’. This means they use digital devices and applications as their main professional and personal tools for communication, research, and other activities.
We know that 99% of doctors are using Google for work. It was clear at the conference that the achievement of ‘owning Page 1’ with our brand – a basic brand hygiene factor in any other industry – was still not common, but the imperative to achieve this was stronger than in previous years – at last!
5. Digital is finally seen as a major imperative for strategic transformation rather than just a ‘tactic’
Voices at the conference reminded delegates that today’s customer needs operate in a different plane from the make-up of the industry. One was that of rheumatologist Dr Deepak Jadon (Cambridge University Hospitals), who highlighted that patients very often use ‘Dr Google’ for information on their condition, and HCPs want them to be able to find credible information this way.
The good news is that the transformation required to meet these needs is in progress. Pfizer, for example, have identified their 25 most time-consuming processes and made them more efficient, in order to make room for upskilling. Digital is finally being seen as a long-term reordering requiring strategic business transformation, not just a tactic.
6. AI and virtual reality are starting to be used as real business tools
Innovations that make use of AI and Virtual Reality are finally getting traction as real business tools that can support patients and doctors. Janssen won the Most Valuable HCP Initiative award with virtual reality training for cancer nurses in Multiple Myeloma.
The sheer amount of health data being collected – 90% of the world’s health data has been collected over the last 3 years – is too much for humans to make sense of. Enter AI and machine learning. Google has been rolling out voice-based symptom checkers. Merck is using holograms to help with surgery – the surgeon can call up any image or patient information as needed.
Merck’s use of holograms in surgery
7. Pharma’s future role lies in collaboration with tech and other partners in new collaborations
Google has developed scans of eyeballs to let you know if you might develop heart problems, and wearables predicting IBD flares and diabetes. With Google & co. stepping up to fill gaps in patient need, the question of pharma’s role hung in the air. Clearly, continued investment in research into Alzheimer’s, cancer, heart disease and the 7500 rare diseases for which there is still no treatment, is critical. But how can pharma match what tech has to offer?
Most of us believe that partnership is the way forward
What delegates thought about pharma’s response to tech companies disrupting healthcare
Dr Wolfgang Lippert (Salesforce) spoke about ‘the rise of multi-stakeholder omni-channel engagement’ and ‘PRM (Partner Relationship Management) rather than CRM’. One outstanding example of this was Takeda’s sponsorship of the Cancer Alliance in sub-Saharan Africa, which led to a 70% increase in oncologists, 200% increase in oncology nurses, and more than 120 GPs being trained to spot early signs.
8. Segment-of-one communications will soon allow for better message sequencing and personalisation
Already, machine learning and big data analytics allow for automated segment-of-one communications. This means far better message sequencing and personalisation, and a view, said IQVIA’s John Procter, of patients as valuable ‘assets’ who need careful attention on an individual basis. Pharma will need to get much, much closer to patients. Though pharma is now doing plenty of patient engagement, these activities are too often a ‘point in time activity’ at times that are convenient for pharma, he said. Pharma should have activity with patients throughout the life cycle through a continuum of interactions.
9. Cutting time-to-market through end-to-end digitalisation is demonstrably achievable
An in-session poll of delegates revealed low confidence that technology could reduce time-to-market. Some companies are making headway here, though. Lilly, for example, reported having cut out five years of clinical trials through end-to-end digitalisation of the whole process.
There are many different ways that digitalisation can improve the efficiency of clinical trials. One example is harnessing real-time patient feedback to shape the way a trial progresses. The Christie is doing exactly that in their work supported by Kanga on the Digital Experimental Clinical Trials Team.
10. The future of pharma is as a lifestyle and wellness sector well beyond the pill
Attention is turning to behavioural medicine and lifestyle factors for illness prevention. The challenge before pharma to fulfil its potential as a partner in healthcare is stronger than ever before. Opportunities presented by cloud-based data management, AI, advanced diagnostics, and wearables are real. They mean that pharma’s continued ability to invest in R&D to develop lifesaving medications will require a concerted effort to broaden its role and become a key partner in lifestyle and wellness. It will no longer be simply providing support ‘beyond the pill’ but looking at health from the perspective of the whole person and recognising pharma’s role as a stakeholder in our overall wellbeing and ability to live in a way that prevents disease.
In summary, there’s a way to go – but the industry is changing. Historically slow to meet the needs of a digitally immersed world, pharma is now leading some pioneering collaborations, serving patients and, at last, beginning to disrupt itself from within. The sense of determination in the conference room was palpable, with glimpses of a twenty-first century driver of improved worldwide health.
Last month’s annual eyeforpharma Barcelona saw marketing and medical affairs leaders gather to discuss how they are engaging their customers. For me, the 4 themes of collaboration, patient centricity, ‘succeeding in failing’ and gender equality emerged. Here’s what I came away with:
1. United we triumph #unitepharma
The theme of the conference this year, and the hashtag, was #unitepharma (although I find these special hashtags a challenge as everyone also uses #e4pbarca, so there’s 21 characters of your Tweet gone already).
Why? Because eyeforpharma recognises that solving healthcare problems is complex, requiring the skills and capabilities of many types of players in this interconnected network.
Some of the best examples shown in the three days involved collaboration and working together.
Leo Pharma won an eyeforpharma award for their Innovation Lab which partners with technology organisations world-wide to develop digital solutions to support patients with skin conditions.
Another award winner was also a collaborative project – Boehringer Ingelheim’s Angels initiative is working with the European Stroke Association to certify 1500 hospitals across Europe as specialist stroke treatment centres, in order to save more lives.
It is a bit of a myth that health professionals do not want to collaborate with pharma. We sometimes over-interpret surveys that say ‘doctors don’t trust pharma digital stuff’ or ‘doctors prefer 3rd party sources’. Sometimes this is because pharma hasn’t (yet) delivered what they want in these spaces. Alistair Grendell of QuintilesIMS pointed out that ‘85% of HCPs want more digital services from pharma’ and used clinical trial recruitment as an important opportunity area.
Ryan Olohan (@RyanGOOGHealth) of Google supported this with a case study – in one example a trial had recruited just 10 patients in 4 months with traditional methods, then got the other 90 in 10 days with a search-led campaign.
Collaborating with patients is also vital. A helpful patient panel (Marc Worthmann of Alzheimer’s International, Kawaldip Sehmi of IAPO, Ananda Plate of Myeloma Patients Europe and Natacha Bolandos of European Cancer Patient Coalition) had some advice for the delegates – they do want to work with industry, but expect to be involved from the start… ‘Don’t come to us and say “look what we built”’ was their message, also ‘a patient support programme is not a marketing campaign’. Which brings me to…
2. Patient-Centricity – mindset or a marketing tactic?
All companies have patient-centric straplines but only a handful are demonstrably putting them into practice. On a show of hands, only about 15% of delegates thought their own company was truly patient-centric today.
Google pointed out that of the estimated 165,000 health apps (mostly created by pharma), just 36 of them make up half the health app downloads.
Ian Talmage (Bayer), a pharma leader of many years and a cancer survivor, had a unique perspective. He talked movingly about his brain cancer, the depression and fear that accompanied it and the long-term disability it has left him with. He was very clear that there is lots of opportunity for the pharma industry to help patients. “I didn’t want shiny leaflets, I wanted trust and involvement, my way”.
Takeda won an award for delivering a service to patients, designed as a result of a direct patient need. A colleague with IBD had a long-haul flight in which the food served caused a flare-up, so Takeda created ‘FlyWithIBD’ a campaign to encourage airlines to support IBD patients by labelling food more clearly and making WC access easier.
Launched with a Thunderclap, this simple but effective campaign was worthy enough to win the eyeforpharma award for Most Valuable Patient Initiative.
Wendy Keyhoe of GSK described an enterprise-wide initiative to talk to patients with COPD and bring videos and images into the business for all colleagues to learn from, with a patient journey map aligned across the organisation and a ‘workshop in a box’ to help countries develop their own insights.
Hats off to Nestlé Nutrition who interviewed no less than 15,000 patients worldwide in building their new commercial model based on real insights.
3. How to Succeed in Failing
Bruno Villetelle (@BrVill), Chief Digital Officer (very good to see one of those), described the vision at Takeda as ‘how to transform a 237-year-old company into a 33,000 people startup’. They have implemented an internal ‘Dragon’s Den’ for entrepreneur colleagues to come and ‘pitch’ their ideas and win funding.
Bruno pointed out that the ‘early adopters’ can’t do it alone (I agree, see my post on Crossing the Chasm) and was challenging, saying “Pioneers do not let go. Failure does not deter them”. How many of us in pharma have succeeded in failing?
Here are Bruno’s 5 top tips:
GSK’s AJ Ploszay showed that to transform effectively for multichannel a pharma company needs to really change the business model. GSK does not pay doctors to speak for them and no longer rewards sales reps based on prescriptions but on customer satisfaction.
Their approach to digital assets is iterative: “get a minimum viable product to marketplace, see what customers think and build from there”.
Felix Jackson (@FelixJackson) also described an agile project approach in his talk about Dynamic Digital Content Development. His 4 principles were:
Just do it
Minimise production effort
Get real-time insights
He pointed out that so many of our approvals processes were designed for print. Don’t try to fit into it, change the process, he said. I agree, an agile test-and-learn approach has been done in pharma and it works.
Fabian Mettes of Amgen showed the importance of consistent measurement in delivering transformational change. They are implementing a common KPI framework (‘Brand 360’) across the organisation and this is allowing the sharing of best practice and learning, and the linking of ‘multichannel performance’ with sales results.
4. #BeBoldForChange: Glass Ceiling or Sticky Floor?
A disappointing observation at Barcelona was the very unbalanced nature of the speaker faculty. 80% were men and all opening and closing keynotes were male, as were all the ‘Lifetime Achievement Award’ finalists. It is a shame to learn from eyeforpharma that they tried really hard to get a more representative speaker list but companies overwhelmingly put forward men for the task. Why is this?
Even the session on gender parity, ably led by Magdalene Pederson of the Healthcare Businesswomen’s Association, was not as well attended as it might have been.
This is a productivity issue and men as well as women need to stand up and campaign for better diversity and equality in our organisations, particularly at a senior level. In an industry dominated by women (especially in commercial roles), whose customer-base is dominated by women (80% of healthcare decisions are made by women according to the HBA), women should have a fair share of leadership and decision-making. There is no lack of ambitious or able women in our industry. The problem goes deeper than that.
Magdalene pointed out that there is a glass ceiling for sure – the built-in unconscious bias on the part of male senior hiring managers that “she won’t want that more senior role because she has children and will not want to travel…” or “if I promote her she’ll just get pregnant and leave me in the lurch” – without actually asking the woman about her own ambitions and preferences. These doubts and questions do not apply to men! Companies must go beyond the letter of the law in having equality policies that address this very real bias.
In addition to this Magdalene told us, there is a ‘sticky floor’ – the women who get promoted, it seems, often get paid less than their male counterparts for the same job. With little pay transparency in industry this is often a hidden problem – but also needs addressing. Once again, unconscious bias rather than policy is the biggest problem in terms of the gender pay gap.
Paul Simms, CEO of eyeforpharma, has issued two newsletters on this topic and called for improved equality across our industry – “if we’re to fully deliver on patient outcomes, we must be representative of our patient population.” Interestingly the only negative feedback Paul’s had so far has been from a handful of men, illustrating, I think, that it is very difficult from a position of privilege to see the impact of prejudice.
I call on all women and men in our industry to call this out, challenge their organisation and show leadership in driving for better equality in the interests of our future and that of the patients we serve. Let us all #BeBoldForChange!
We tried a website with brand <x>, and it didn’t work, so we’re not going to build another’.
‘We have got too many websites; we need to reduce the number’.
‘We created this website and it only had 10 visitors in the first 6 months – websites don’t work!’
‘Why would we build our own website – customers prefer 3rd party ones don’t they?’
Have you ever heard comments like these? Why is it, in pharma, we blame the channel for our shortcomings?
Think about it. What if you substitute another, more traditional channel for these in the sentences above:
‘We tried a sales rep with brand <x> and it didn’t work, so we’re not going to hire another’.
‘We have got too many telephones, we need to reduce the number’.
‘We had a stand-alone meeting and only 10 people turned up – meetings don’t work!’
‘Why would we have our own congress symposium – customers prefer 3rd party seminars don’t they?’
Clearly in these last examples it is silly to blame the ‘channel’ for our own poor execution in it (and questioning the ‘number’ of assets alone is meaningless) – so why do we do this for websites?
My team and I do a lot of digital landscaping to find what customers are finding in certain therapy or disease areas, and we also do a good deal of insight research into the digital habits of patients, healthcare professionals, providers and consumers. Generally-speaking, we observe this
Customers’ behaviour is universally search-led, with Google (a website) ubiquitous in most of the world. Google penetration amongst HCPs is 100%, most of them using it several times daily.
The most common things customers do on their smartphones is check email, text and yes – search the web and browse websites.
The most common needs are content driven – information, education, guidelines, FAQs, expert advice.
In almost all therapy areas the landscape is fairly barren. Customers are simply not finding the content and services about therapies and medicines that they are looking for, in formats they prefer. In other words, there is a lack of good quality websites.
If we are going to meet customer needs with compelling content in formats convenient for them, this means the cornerstone of our digital investment should be – you guessed it – good quality websites.
This will likely be a combination of a presence on 3rd-party sites (where we will reach users interested in the topic and hopefully engage them with our content – this is like going to a congress and getting them to come to our symposium) and our own websites (this is like having a stand-alone meeting and inviting customers interested specifically in our TA or brand) – there is a place for both of these.
The key phrase here is ‘good quality’. The difference online is that ‘your competitor is just a click away’ so we have to execute with excellence and deliver an outstanding user experience in order to provide what our digital-savvy customers need and expect. There is a lot to get right, and this requires work. Get it right, and you’ll be delivering what your customers want at the most crucial moment for them (when they are actively looking) and on their terms.
What could be better than that?
So our focus as pharma marketers, before we build that innovative adherence app or enjoy the excitement of crowdsourcing an awareness campaign or wow HCPs with our latest virtual-reality game – should be occupying that first page of Google with our content on our websites, serve their needs and make the most of the relationship that ensues.
That is how your own the digital landscape for your brand. Bring back the website!
There are a few themes we have been discussing in the pharmaceutical industry for a long time. The transformation of our businesses for a digital world. The need to put the patient at the centre of everything we do. The fact that our customers, health care professionals, are no longer interested in the same old ‘push’ messaging and need a completely different relationship with us.
At this year’s eyefopharma Barcelona, after 15 years of ‘talk’ I felt we had reached a ‘tipping point’ – things are really happening, we have measurable results, we have stopped talking and started taking ACTION. There is a good deal of work still to do, but at last it has finally begun in earnest.
With the much-cited 2014 ‘tipping point’ of over 50% of HCPs now ‘digital natives’ (PMLive/LBi) perhaps it was bound to happen. But it was very encouraging to hear people who are making change happen across our industry, for the benefit of those taking medicine and living with health conditions.
Indicative of this was the fact that eyeforpharma (@eyeforpharma) invited both healthcare professionals and patients to the conference, and they were invited to ask the first questions in each session – a nice touch.
Three themes stood out for me that I’ll use delegate quotes to illustrate:
“From product-based marketing to developing customer loyalty through great experiences”
This was by Tim Sherwell of AstraZeneca, who has been rolling out a multichannel customer engagement approach using different channel mixes in different situations. The AZ formula is resonant of the new model implemented by corporate software providers in the 1980s and 1990s, finally making its way to pharma:
Product + Service + Experience = Customer Loyalty
GP Julian Spinks (@JulianSpinks) and Consultant Endocrinologist Partha Kar (@parthaskar) made it clear that in a doctor’s busy day, information and education need to be concise and available on their terms as and when needed.
Ashfield Health worked with them to understand ‘a day in the life of a GP’ and ‘a week in the life of a specialist’ and it became clear that traditional educational formats no longer serve physicians. They blog, tweet, Google and game for professional development.
Julian described a 45 minute compulsory ‘safeguarding’ elearning module he had had to complete on a Sunday as he could never fit it into his working day (50 patients, 7am to 7pm). Julian described himself ‘as a bit of a dinosaur’ but on Day 3 of the event I had an audience show of hands ‘Who Tweets?’ – less than 15% of eyeforpharma delegates. Julian tweets regularly. Our customers are leading the way.
If we are going to engage our customers, we have to ‘stop standing on the edge of the Grand Canyon and yelling’ said Craig Fiebig from IMS. The importance of delivering great content and letting customers utilise it on their own terms was a recurring theme.
Lundbeck have developed an elearning platform to help embed good content marketing skills across the organisation. Lanre Ibitoye gave a number of practical ways they have achieved this focused on McKinsey’s three ‘c’s of customer satisfaction: Consistency, Consistency, Consistency.
Lundbeck develop content that is easy to share across many channels and they work with customers to predict future content needs, rather than just asking customers ‘what do you want?’ – then they learn and iterate over time. They also have both a ‘localisation’ and a ‘globalisation’ process so that ideas working well in one market can easily be rolled out. Lundbeck’s focus on measurement was impressive – spend 30% on content, 20% on promotion and 50% on measurement – this is how you learn and improve.
Peter de Jong of Elsevier presented some interesting customer research on content usage. Google is now ubiquitous at 100% usage, and interestingly, ‘manufacturer’s websites’ are used by 90% of physicians. He also observed that 61% of content consumption is on personal, not work devices, echoing our busy doctors who told us most of their CME has to be in their own time.
“It is important to figure out where the sales rep fits in the multichannel business model”
This was said by Pablo Ouro Villaravitz from UCB and it was music to my ears. For too long we have been asking ‘how can these other channels support the rep’ where in fact the field force is just one of many channels. As I showed in my introduction to Day 3, customers now spend less than 5% of their information seeking time in ‘face to face’ interactions but an audience poll in the room showed the majority are still spending 90% of their budget on F2F. Why is this?
Cegedim’s study showed a 55% increase in eMeetings and 23% decrease in F2F meetings with customers, but still only 3.3% of overall sales and marketing budget being spent on digital.
Len Starnes (@LenStarnes) discussed the future of congresses for the now ‘digital native’ HCPs. The recent ESC event had 300,000 unique visits to its website – more than 4 times the ‘real-life’ membership of the ESC. ‘Virtual’ has already exceeded ‘physical’ in spite of the congresses own reticence to engage – many will not yet make content available online for fear of impacting attendance, although some are looking at ‘virtual booths’ to complement physical exhibits.
This reminds me of the reluctance of major media owners in the 1990s, as the newspapers struggled with ‘free news available everywhere’. Only the astute players who recognised the importance of high-value content and the conversation and engagement it can generate, survived the digital revolution. It is inevitable for medical congresses too, and ASCO has embraced this for years and leads the way with Twitter feeds, blogs and online content.
There are immediate opportunities for pharma here, with ‘overnight congress reporting’ and ‘symposia summary videos’ being delivered or sponsored by some companies. As rules on sponsoring doctors to attend events tighten, companies are bringing the content to their customers.
UCB described three business models: ‘Multichannel’ (by which I think they meant ‘digital’), ‘Hybrid’ and ‘Empowered F2F’. Clearly the cost for the last is the highest so they save this for the most high-value customers but believe they are having a significant impact on market share with all models.
AstraZeneca created brand archetypes (e.g. ‘Launch’, ‘Star’, ‘Fortress’) and built the channel mix around these based on customer needs and potential profitability. Like Lundbeck, AZ ruthlessly measured and learned along the way, with one pilot in Russia demonstrating a 17% increase in sales with their multichannel approach and in Italy generating 18,000 customer interactions in just 6 weeks at modest cost.
An interesting comment from Rosa Maria Lopez of Boehringer Ingelheim, who is new to the pharma industry and said ‘before I came to BI I had never heard the phrase ‘multichannel marketing’ – I just called it ‘marketing’’. Quite.
“It used to be a marketing tool to say ‘we care about patients’, but now it is becoming a reality”
This was one of the patient guests at eyeforpharma. All the patients expressed how important it is to have dialogue with industry and that we need to collaborate more. This was very refreshing and many speakers reflected this new optimism for a better partnership.
Anne Beal (@acbeal), Sanofi’s new Patient Engagement Head gave an inspirational overview of their strategy, admitting that that ‘We don’t know all we need to know but we are determined to learn’.
In Sanofi there is a drive from simple Patient focus to patient engagement and ultimately patient empowerment, said Anne, and her Centre of Excellence is a catalyst but everyone in the organisation needs to be doing this.
The Sanofi core values are about Transparency, Partnership (not ‘to’ patients, ‘with’ them), Continuous Learning and Development and Focus on Outcomes & Impact.
Anne’s goal, similar to that expressed by Tim White head of Customer Engagement at Lundbeck, is to be ‘redundant’ because this way of working is embedded across the organisation.
The Patient Vision for Sanofi is ‘People take control and improve their healthcare outcomes to positively impact their health and lives’. Note that they refer to ‘people’ and not ‘patients’ – this was also a theme, and reminded me of my eyeforpharma presentation 2011 looking forward to 2016 and saying by then the thinking will be ‘the Patient is dead, long live the Person’. A reality already?
Bayer’s Jesus del Valle heads up Bayers Grants4Apps program that sponsors start-ups with innovative healthcare ideas. His panel discussion led to @thomas_thinks reflecting on the fact that ‘Pharma says ‘patient’, start-ups say ‘people’. That’s why person-centred innovation won’t come from pharma’.
Sanofi’s action plan consists of embedding people centricity in the Culture and Community, offering real Outcome-based Solutions, and learning in order to get real Input and Understanding.
A blueprint for the industry, maybe? This and a panel debate about ‘disruptive innovation’ stimulated a hot Twitter debate about how patient solutions should be funded when companies are focused on the lifecycle of individual brands. Should there be a collaborative approach organised by health providers/patient organisations with companies working together or co-sponsoring?
There was a Patient Engagement track at the conference as well as the Multichannel, Sales and Value tracks but the observations here are from the Multichannel track and it was refreshing that even here the patient/person was at the centre.
Gilles Pluntz from Ferring summed up why: ‘In countries where we have high patient engagement, sales grow, and where we don’t, they don’t’.
I attended eConsultancy’s Future of Digital Marketing Conference this month, feeling like I was playing truant from my usual pharma industry to learn what’s happening ‘out there’ in the less-regulated ‘real world’. However, some of the challenges discussed were very familiar. Here are my takeaways:
You are what you wear
Sarah Bentley (@saraheb) kicked the conference off wearing a Tweetskirt, which all the girls immediately coveted. Its LED patterns changed, responding to tweets. Not sure of the application, but it was cool.
At the end of the day Marcus Mustafa (@dacrumb) showed a tableaux of wearables, from glasses used by Virgin check-in agents to welcome passengers by name, to self-protecting underwear that detects ‘rough’ handling and electrocutes the attacker.
Of course there are many applications in our own area of health and Marcus showed several – the ubiquitous FitBit, contact lenses that detect blood sugar levels and send signals to an insulin pump, and beyond wearables to ingestables like electroceuticals, drugs with chips that detect body chemistry.
This was the hot topic of the day, introduced by Sarah who pointed out the digital native generation will not tolerate poor experience – they expect seamless usability and immediate gratification. Sarah’s 5-year-old daughter single-handedly bought a Hello Kitty Umbrella online, only letting her mother know of the purchase because she was cross it had not arrived immediately.
Anthony Mayfield (@amayfield) pointed out that we used to organise around the message, but now we must organise around the consumer and their needs. Newer businesses are doing this, he said, because they don’t have legacy systems or legacy thinking.
Jason Mesut (@jasonmesut) focused on user interfaces and pointed out that they are not just ‘web-based’ – but include, ‘knobs, knockers and switches’ too. Think about your user as a human, not a customer, he said, and used the beautiful video from Corning ‘A Day Made of Glass’ to illustrate the opportunity to create immersive experience.
He asked us to ‘prototype out loud’ and make mistakes in order to learn what works. There is no one ‘customer journey’, Jason said, we must find ‘moments of truth’ throughout the ecosystem.
Minter Dial (@mdial) showed a number of examples of retail immersive experience, with mixed success. Vanquish store in Tokyo lets you take a funky picture of yourself using a mirror and uploads it to their Facebook page – you Like the page to share it.
But execution is everything, Minter said, citing an example of another retail app, to ‘build your dream bra’ in a lingerie store, failing to work correctly. The problem is that management doesn’t test the user experience, he said, they think it is someone else’s job.
The importance of data to drive experience was clear. Rapid test-and-learn is critical to create the right product for customers, said Wendy Tan White (@wendytanwhite). This point was picked up by Ottokar Rosenberger (@OttokarR) in a session on agile marketing – we should have KPIs around the speed of iteration as well as customer outcomes.
In our effort to drive agile marketing with data we must focus on consumers – ‘we have to start respecting people and their attention’ said Anthony, we are all turning into ‘cryptoconsumers’ protecting our data carefully. We are increasingly being analysed, from black boxes in cars for insurance companies (@agwp) to the Watson computer searching 29 million PubMed articles for potential cancer cures (@ibminteractive).
As Otto said ‘We should be data driven to optimise the curve but passion driven to shift the curve completely’.
In Content, in Context
Doug Kessler (@dougkessler) gave a thought-provoking talk about the future of content marketing, pointing out the blurring of content and advertising, but the counter-trend of the ‘return of the editor’ as providers try to build trust. He also pointed out that when the head and heart combine – strong rational argument with huge emotional hook – you have a ‘home run’ of impact, using the Shark Attack stats as a great example. We can use this more in our health campaigns. We are data-rich but often forget that health issues can invoke a strong emotional response, for patients, caregivers and sometimes healthcare professionals.
Neil Perkin (@NeilPerkin) agreed that editing and curation is key – ‘it’s not about information overload, it is filter failure’ and identified 3 pillars of content curation – Professional, Algorthimic and Social.
Talking of algorthimic filters, the Hummingbird release of Google has brought this to a new level, with an algorithm that provides answers to questions (‘What time is the match on?’) and the algorithm learns as it goes – even the Google engineers don’t know how it works anymore, pointed out Will Critchlow. (@WillCritchlow).
Malcolm Coles (@malcolmcoles) illustrated Trinity Mirror Group’s approach to contextual marketing in their Us Vs Them Campaign – instead of pushing content the campaign builds irreverent engagement around topical issues. For example, they asked people to find Damascus on a map just before the US bombed it. Another tactic was their ‘how much does the Daily Mail hate me’ game.
Barney Leohnis gave us ‘a glimpse inside the incredible, wild and exciting world of Digital China’. Every aspect of Chinese life is being transformed and digital is the enabler of this change. The internet is seen as the route to the outside world and China has 3 of the top 7 internet companies by value. Taobao the ecommerce site, delivers more packages per year than UPS worldwide, and ‘it’s everyone’s dream to make a mint on Taobao’.
In a country of state-controlled newspapers the internet is the most trusted channel for product information and phone start up Xiaomi sold 100,000 phones in 83 seconds through social flash marketing. The technology isn’t cheap but its desirability is clear – people will eat rice for 4 months to be able to afford an iPhone. The empowerment is so valuable that, in Barney’s words, ‘the Chinese don’t give a crap about user experience’.
The digital empowerment has many facets – for example the ‘Diaosi’ movement – a social media-fuelled rebellion against the overwhelming pressure to succeed in China’s emerging middle-class with hot-housed education and huge expectations of the single child in the family.
In healthcare, the huge challenge of cost outstripping income has created a massive online counterfeit medicine scandal.
Transformation was a theme throughout the event with Anthony pointing out that the CEO must lead the transformation, and several speakers agreed with him that digital transformation is not a campaign, it is a whole new thinking – about ‘inbound marketing instead of ‘outbound’.
Sarah insisted the CMO must take ownership – only 1% of companies going through a digital transformation have the CMO in charge of it – and predicted that in a few years digital should be 75% of marketing spend.
In the pharmaceutical industry, where risk-aversion is often rewarded, promotion is highly regulated and a large portion of spend is still invested in a highly-qualified sales force, transformation of mindset and model remains a challenge.
We have the tools but are we organised to use them? This was the question coming through. This point was summed up by the quote Jason borrowed from William Gibson:
“The future is already here — it’s just not very evenly distributed.”
Here are my takeaways from the recent eyeforpharma Multichannel Marketing Summit in London. It was an interesting and stimulating discussion, yet a lot of the points made came down to Marketing 101:
Start with the Customer
Develop a Marketing Strategy
Ensure you have the right Skills and Tools
Lead from the front
1. Start with the Customer
If you are a non-pharma marketer you will probably be shouting – ‘where else do you start?’ but in fact in the pharma industry the tradition has been to start with the science, then move to the ‘data’, then develop the ‘brand’, followed by the ‘key messages’ and somewhere down the line we start thinking about the doctor and the government/insurance company and then eventually, if we are lucky or especially perceptive, we finally get to the person putting the drug in their body, who we refer to as ‘the patient’.
The Customer is, for most companies, the health professional as the person who has most influence over what drug is used, and we (grudgingly) recognise the importance of the patient as ‘the Customer’ too, but we struggle with this as in most countries ‘we can’t communicate with patients’ (we believe).
Forums offered engagement and customer loyalty long before Facebook
On a positive note, putting the customer first really works. There were a couple of shining examples of this at eyeforpharma. The stand-out for me was the final non-pharma presentation of the conference from the inspiring Robbie Hearn (@Robsticks). He described the online forum provided by Telco company GiffGaff. Not new technology, not ‘social media’ as we think of it today, but as social as it gets, with a vibrant forum of over 10,000 posts a month (compared with 100 on their Facebook page), 99% of which are from customers. Customers supporting customers, waxing detailed about their service, their hot tips, their experiences. Solving each others’ problems.
This is the sort of community we should be able to create in health care – such a peer-driven environment. Why don’t we? GiffGaff has a Net Promoter Score of around +60, similar to Google and Apple. Other Telcos are at around -20. It works, this customer-centricity stuff.
Univadis – customer service from MSD
The pharma example was the ever-impressive Univadis, presented by Shona Davies. With 2.1 million HCPs registered and 70% of them willing to accept promotional messages from MSD, this is a long-term customer relationship strategy that other companies can only look on with envy. How do they do it? By continually asking customers what they want and delivering it. Simple, really.
The sentiment was echoed by some other speakers. Seleen Ong of Pfizer (@DigitalMedical) said we should learn from Amazon – be totally customer focused, be frugal, innovate. If you ONLY do what customers want, you’ll spend less and succeed.
Seleen, together with John Gordon (@DigiHealthGems) presented a HCP meetings app to help doctors find their way around a cardiology congress. There was no Pfizer promotion in the app – it was provided purely as a service and beat all its targets in terms of customer engagement. A nice step towards customer-centric business.
‘Push marketing makes push-back customers’ said John Gerow of AstraZeneca. I agree.
Jenny Cowdery, Head of Healthcare at Google said their rule was ‘start with the customer/user, then everything else will fall into place’. (Then immediately after her talk on the morning of day one Jenny left the conference – obviously not that interested in her customers then!)
2. Develop a Marketing Strategy
Henry Anderson from Novartis made the point that the pharma marketer’s objective is so often still about ‘doing stuff’ rather than having a real strategy to engage the customer. He shared with us the Burberry video showing how they have changed their business completely by having a great customer marketing strategy.
One problem is evidence. We have 50 years of evidence that the traditional F2F-selling led model works, where is the evidence for a multichannel approach?
As Liz Murray pointed out, we must challenge the paradigm. To find the ROI we must experiment and deliver it. She quoted Einstein ‘the intuitive mind is a sacred gift and the rational mind is a faithful servant’. Her point – that we must adopt a learning mentality, be ready and willing to learn constantly, not stick with what ‘we know’. What we know is already obsolete.
Tim White of Lundbeck pointed out we must break down silos, walk the talk, get everyone to step into customers’ shoes. Ask customers what they want – at the moment we are not really delivering it:
@DavePinnington gave an interesting presentation about the behavioural psychology of marketing and influence models, with particular reference to gamification – which as he pointed out, does not mean making a game. Digital channels give us opportunities to do things very differently and our customers will engage with us if we do – what would you rather do, said Dave, work or play? He referred us to the TED Talk from Jane McGonigal – how Gaming can Make a Better World, where she describes harnessing the commitment and creativity of millions of gamers to solve real-world problems:
Silja Chouquet (@whydotpharma) focused on the patient and urged us to ‘legalise’ non-adherence as a normal part of human behaviour. We need to work hard to ensure there is supportive information online – the majority is negative simply because we are not delivering the information and motivation that patients need.
AZ’s Flumist product launch was cited by @JohnPugh as a strategic customer-led approach – a launch without a sales team – yes, really.
Flumist – launched without a sales force
3. Ensure you have the right skills and tools
Cap Gemini said recently in a their Accerating Digital Transformation report that pharma are still ‘digital beginners’. This lack of multichannel marketing skill was a theme throughout the event.
We have a tendency to also ‘put unqualified people in digital roles and then have to rely on agencies to tell us what to do’ said John Gerow of AstraZeneca. There were nods of agreement around the room.
Another problem is we spot a good sales rep and make them a brand manager. Then if they deliver ‘what the sales force wants’ we promote them through the marketing ranks. But this isn’t good enough any more.
Don’t rotate people into digital roles to give them experience, or put your graduate trainee into the role because they are a ‘digital native’ or assume sales reps can become marketers without training. Multichannel marketing and digital channels require a high level of skill and expertise.
Would you have unqualified chemists developing your drugs? Then why is it OK to have novices trying to drive the most important customer engagement transformation the industry has seen?
Our customers are digital natives but we are not. Example: we were 4 speakers into eyeforpharma before we had one with a Twitter handle – at a digital conference! That speaker was @KaiGait who pointed out that we think we’ve ‘gone digital’ because we gave our reps iPads. Choose the right channels and interactions.
The Happy Fork – tells you when to stop eating
Kai showed some great examples of digital as part of the fabric of healthcare, from the Misfit Shine he had on his wrist to the ‘happy fork’ that tells you how many calories you’ve eaten to smart asthma inhalers that use GPS to track asthma triggers.
What is your company doing to deliver real value through participatory healthcare?
4. Lead from the front
Cap Gemini also said in their report that in other industries, where a Chief Digital Officer has been appointed, the business has transformed more quickly and those that transform the quickest, win in their industry.
When will we have a Chief Digital Officer in the pharmaceutical industry?
Can we make the ‘pharmasaurus’ evolve? asked Dina Rey from Roche. Dina suggested treating your senior management like a venture capitalist and ‘provide a rock solid business case’. I wondered when will the leaders themselves be driving the business case? Why do we have to ‘sell’ it to them?
Google spoke of ‘big crazy, audacious goals – moonshot thinking’ not ‘1% more on digital’. Change accelerates – mobile searches are set to outstrip desktop in 2014 – we look at our phones 150 times a day. Kai pointed out that more people have smartphones in the world than clean drinking water, yet many pharma companies still do not have a mobile strategy. Why?
What’s the ROI? The way to find out is to DO it and deliver the ROI, said Liz Murray of Quintiles. Get it 80% right and iterate, she advised, the pursuit of perfection is futile and stifling. It reminded me of a Marketing Leadership Council study showing that those brands that change the channel mix most often, learn the quickest and are the winners in their respective markets.
Our opportunity is summed up by the Life Healthcare video:
This year’s DigiPharm in London had a different vibe to previous meetings. People have stopped talking about digital as ‘the future’ (finally!) and are getting down to business, looking at the detail of how we should be executing in these channels, using these tools and the practical organisational changes we need to make. Consequently it was an odd cocktail of change management, customer service and content optimisation.
The ‘Sex’ is about breeding. Brian Smith @DrBrianDSmith (of the Open University) opened the first day by holding up a mirror to the industry and pointing out that we need out-of-industry ideas in order to change. ‘As an industry we are very good at having sex with our cousins’ he said, but to evolve, species need to acquire new genes and they do this ‘by promiscuity, not incest’. (Some tweets suggested immediate action on this, since from the regular loud and raucous laughter there was apparently a Comedy Convention going on in the room next door)
Brian was echoed later by Yannik di Mondo (Mylan) who told us to ‘quit your job – or at least, your office ‘ – and meet our customers. He decried the ‘we need an app’ mentality and insisted the channel is last – ‘only when you have a customer, a strategy and a plan should you choose channels’.
Ragnar Gaseby (Merck) provided the news that the pharma industry declined by 1% in 2012 – the first time ever, due to the pressures that have been with us for 10 years – declining access, price pressure, shifting decision-making power.
Tim Ringose’s diagnosis on the industry was loss of moral virtue, obesity and lack of fitness. He reminded us that next year is the ‘digital tipping point’ when more than 50% of doctors will be digital natives, i.e have all their careers in the post-digital age. Sady, as someone pointed out on Twitter, this is not the case for pharma executives.
Michel Baes (Janssen) can always be relied upon to bring a strategic vision with practical steps to achieve it, and he described his 7-step change management program, starting with a sense of urgency, then creating a vision and ambition, through customer insights to creating a coalition for change.
Michel also pointed out we have to get the basics right first before we will be ready for the mhealth revolution. I agree.
The most fascinating presentations for me were those that made it clear that our industry is no longer just about ‘Drugs’.
The first was from Peter Villadsen of Leo Pharma who gave an inspiring account of that organisation’s QualityCare program. ‘At Leo we have one customer – the patient’ he declared, and pointed out that only 1% of patients succeed on medicine alone – we need to provide healthcare solutions. Hence QualityCare – an online service to help patients process information and take control of their lifestyle.
The service is ‘above brand’ and provides services to all patients with the skin conditions that Leo provides for. They are very clear about the KPIs:-
…in that order. Here we have a pharma company recognising what the software industry has known for years – that great service really drives sales, and that keeping existing customers is much more profitable than acquiring new ones.
Further, the QualityCare program provides superior insight with around 100 data points being collected in an ongoing manner, and enhances relationships because they co-create the solutions with the patients themselves. Hats off to Leo for living their mission:
In a more traditional example of customer service Gizem Bickakci (BI) described the doctors ‘In-Club’ in Turkey, offering a range of services to HCPs to access information, professional development and connections with colleagues. A nice initiative but KPIs were not clear.
Shona Davies @ShonaLDavies (MSD) blew us away again with Univadis, a successful service for doctors because ‘it is part of our corporate culture, the drive comes from the top’. (Back to Michel’s ‘Vision’). As usual the awe in the room was palpable as Shona described the 2.1 million signed-up HCPs, 70% of whom have agreed to receive promotional messages – a 1.5 million email permission list. Using this list costs about half that of 3rd party lists. Shona was clear about the KPIs. They measure user retention, engagement level (light, deep, extensive), customer satisfaction and NPS (net promoter score).
It is not just about Drugs any more, folks.
The final big theme of the conference was optimising a ‘traditional’ channel – the sales rep – by providing outstanding content and services. @MartynGlanville recommended letting reps play with their iPads for 6 months before giving them the content so that they know their way around and love the tool first. Stefan Wieman (Merz) reminded us that ‘digital’ selling is a different skill set and needs training.
Philippe Kirby pointed out that sales force automation is not the same thing as CRM and we should look at the customer’s preferred channels – citing a doctor who asked to receive emails but it wasn’t in the brand plan. Deni Baschiera of BMS gave a great example of providing email clinical reports and recognising the HCP drivers of trust, value and time – getting the content in the right format and place is key: ‘Content is King but Content Curation is Queen’.
Rene Neubach @newstream advocated making your reps ‘amazing storytellers’ – this is where the personal relationship really adds value. He also pointed out that ‘interactivity’ is not the same thing as ‘animation’.
Sebastien Koelsch @SebKoelsch gave us a startling statistic – of 100 rep visits initiated, only 20 see the doctor and only 8 are remembered. (My first reaction to this was – what’s the ROI of THAT channel?) Seb’s point was that you need an outstanding, individualised interaction with the doctor. This is where technology can really add value. I liked his ‘shoe analogy’ (see picture) showing that technology allows us to cost-effectively deliver an individual product or experience.
In our rep-doctor interaction we can ask a question and show how the customer’s answers compare to the population – and bring that same answer back into the conversation later. If we do this well ‘the sales rep can be the best pull channel we will ever have’.
Several presenters used the transport analogy: Traditional detailing is like the bus – get on it and get taken where the driver wishes – whereas interactive detailing should be like a chauffeur-driven Rolls Royce – the ultimate travelling experience to a destination of your choice.
So there you have it, Sex, (not just)Drugs, and Rolls Royces.
With Facebook topping a billion members and every news story having a hashtag, social media is embedded in everyday life. Pharmaceutical companies are already using these channels but enthusiasm for them, the quality of execution and success rates are varied.
Assuming you’ve done your insight work and you know that social networks and other social media channels are a good way to engage your customers, how do you go about executing well in this space?
Why do HCPs and patients join a conversation? What motivates or deters them?
What is the behaviour pharma needs to adopt? Are you a service organisation, marketer, content-provider, colleague?
Are there parallels we can draw from other channels we operate in or other industries?
Follow The 5 ‘C’s of Social Engagement and you will not go far wrong. They are:
Content is still King
In a user-generated content environment you might think that companies do not need, or perhaps should not, be providing content. The first editor of FT.com, the Financial Times online, is famously quoted as saying “We publishers are just throwing the party. We have to hope people will turn up and chat”.
Maybe so, but you have to give people a reason to turn up. A pharmaceutical company’s scientific meeting without any presentations would not be very successful. The FT itself is still renowned as a provider of quality content by expert journalists. But they do it differently online. Every article or news story is the start of a conversation or debate. Readers can rate, comment, add their own blog posts, and join in. The FT reports the conversation too, as word-clouds and sentiment analyses. It uses the conversational aspects of social media to enrich its own content.
Many industries have recognised that to engage customers you have to have great content. Red Bull, who you might think is a drinks company, spends more money on producing content than on the beverage. The company produces award-winning movies; it has its own sports magazine and radio station, and a whole content business all supporting the brand values of adventure and extreme sport.
In healthcare, content is even more important. As medicines become more commoditised and companies under more pressure to add value, content is a key deliverable from your company to your customers.
It is important to recognise the opportunities for using content socially and to remember content is video, sound, games, animations, interactive tools, as well as text. Sanofi TV on YouTube is a great resource for patients and their healthcare professionals with some fine educational videos.
Some global organisations develop their higher-cost content elements like video and gaming once and re-use them many times in different markets.
Pfizer’s Back in Play
Pfizer, in seeking to engage young men with symptoms of ankylosing spondolitis, produced the award-winning Back-In-Play social football game that was deployed across 12 countries and showed significant impact on diagnosis of the condition.
Content is certainly vital to engage your stakeholders. But how can we convince them to come to our industry for content? This brings us on to the second ‘C’.
Trust is a major issue and the fact that our industry, for very good reasons, carefully controls every communication that it delivers to the general public is not necessarily a strategy for appearing transparent and building trust. Yet social channels give us an opportunity to really engage with people in a new way and break down some of the barriers between the industry and the public.
In social media, you gain credibility in two ways: by borrowing someone else’s or building your own. Using an expert editorial board or steering committee as in the Academy for Complement Inhibition from Alexion, partnering with a professional association or patient advocacy group, or working with an international congress, can all help build credibility.
How not to build credibility
Good behaviour is important to build credibility. It is vital that you are not promotional in tone. This is a hyperlinked world and other content is only a click away. Your users won’t stick around to be ‘sold to’. You should be ‘listening’ at least as much as you ‘talk’. More on this later.
It is self-evident that a party is no fun with only one person in it.
Physicians want colleagues and patients and consumers want ‘comrades’ – people they recognise as peers and can relate to. Thought leaders are important for credibility, but ‘people like me’ is crucial for ongoing success. Often we think social media is a low-cost option – provided our content is interesting,customers will just flock to it and it will ‘go viral’.
This is generally not true. Even if your content is great and you are highly credible, you still must work to get people to engage with you. Your customer will leave quickly if there is no-one else in a community.
Assuming you have your own platform, you need to have a promotional strategy to drive traffic and advertising still plays an important role, even in social media.
St John’s Ambulance in the UK offered a variety of multichannel services (apps, elearning, workshops) to help people learn how to perform simple First Aid. They promoted these with a moving video depicting a man surviving cancer only to die from choking. The quality of the content and the story it told meant that it did indeed go viral, but they kick-started it with commercial slots on TV and in cinemas.
The Spinal Foundation Facebook ad
The Spinal Foundation ran a small ad campaign to drive patients with chronic back pain to a Facebook group to share their experiences. As expected, click through was very low (they targeted ‘all adults’) at 0.03%, but they found click-to-conversion – those who joined the group after clicking the ad – was extremely high, at 25%, and the Foundation quickly recovered the cost of the campaign.
As expected, people are quite ‘banner-blind’ in Facebook, but if they do notice and click on your ad, they are highly engaged with its message. Since Facebook offers pay-per-click advertising, this can be a cost effective way to build awareness and drive people to your community.
Can pharma companies engage in open online debate with customers? Yes. There are risks, as with all communications, but they are not insurmountable. The clue is in the name – ‘social’ networking. If you are serious about it, then be sociable, and network.
Here we return to the need for good behaviour. Think about the ‘4 Rs’. You should be:
Real – a person, not a brand or corporation. Even on your brand or company page, ensure you give the name of ‘who’s on duty today’ to give it a human face.
Respectful – treat customers as you would like to be treated. Respect their time, intelligence, opinions.
Relevant – don’t add irrelevant content into a conversation, especially about your brand. This is spam and will harm your reputation.
Responsive. If I ask you a question, answer me. You need to plan how to do this –have a set of responses prepared if need be, but people expect a response in almost real time.
Companies are starting to have conversations. AstraZeneca does a good job of responding to comments on Twitter in the US via @AZHelps, mainly helping with questions on side effects or access to medicines. Lilly has managed Diabete a colori, a Facebook page encouraging people to discuss diabetes, since 2007.
Companies are concerned about inappropriate content in a user-generated content environment, and they should be. Teva Canada experienced this problem with their MSWatch community. Patients were using it to discuss off-label and even illegal drug use to manage their MS. The company regretfully chose to remove this popular discussion forum rather than edit or delete these posts.
As the Teva example shows, it is important to think about all the ‘what-ifs’ – how are you going to handle inappropriate posts? – and have a plan in place to mitigate risk.
Some controversial subjects have been addressed successfully by companies. MSD in Denmark gathered some insights showing that among young people unwanted pregnancies was rising because of a lack of education about contraception.
The page features polls and quizzes, amusing videos and surprisingly frank and open discussions about sex and pregnancy. MSD monitors the page and it has to be fair balanced, but apart from that anything goes. The Danish health authorities have approved of the initiative and it is helping to build the company’s credibility and reputation.
More than 70% of physicians use social networks and an estimated 2 million in Europe are members of physician online communities. There are 8000 groups of healthcare professionals on LinkedIn and thousands of doctors are using Twitter to become ‘self-made’ thought leaders.
ASCO on Twitter
Some congresses are capitalising on this, for example ASCO has a very active social media presence and encourages companies and individuals to tweet and share news from the event. Pharma companies are also joining the conversation.
Social media buzz around your own meeting might be achieved by training delegates to tweet and having a meeting Twitter handle and hashtag, with a set of pre-prepared ‘response tweets’ to deal with any potential issues.
This is the most difficult of our ‘C’s for pharmaceutical companies. The problem stems from our commercial model. Although drug development is a very long-term business, drug marketing is very short-term. Medicines have a few years of patent life and after that the drug’s revenues will go off a cliff – and so does its marketing budget.
You cannot start these conversations with valued customers, deliver great content, build credibility and establish a thriving community, then abandon it all when your circumstances change. You have to be in this for the long term.
This is one area that is quite unique to our industry – the fact that our products have such a short life cycle – and it presents particular problems that other industries don’t face.
AstraZeneca launched the Academy for Infection Management in 2002 and it became a thriving online and offline community with face-to-face meetings, workshops, and advisory boards and an online community where content, opinions and meeting details were shared. In 2009 with Merrem going off patent, AZ stopped AIM and took down the website.
AstraZeneca now has a significant infection pipeline but its claim to be at “the forefront of research into new ways to treat infectious diseases” is not backed up by its online behaviour.
Think hard before engaging in a social space if you think your company will not be interested in that space in 5 or 10 years’ time. If you have a significant commitment to a therapy area but no drugs coming to market soon, how will you support the community going forward?
Pfizer Man MOT
If you know you will not fund it in the long term make sure you have an exit strategy. Pfizer did this with the popular Man MOT service – an online clinic in the UK for men to discuss their health issues, including ED. When Viagra went off patent Pfizer handed the service over to the Men’s Health Forum.
In summary, to be successful in social media you should provide valuable content, build credibility, bring colleagues, engage customers in conversation and show commitment. Social media relationships, therefore, are just like any long-term mutually-profitable customer relationship.
And remember that in social media, as in life, good behaviour is vital.
I originally presented this at the GLC Pharma Social Media Conference on 7th June 2013.
Last week (6-7 June) was GLC’s Social Media and eMarketing in Pharma Forum in Frankfurt. It brought together 60 pharma industry professionals for an engaging and interactive session. Here are my own personal take-aways:
Medicine is a majority digital-native community
Emma D’Arcy (@darcyemma) chairing, pointed out early in the proceedings that 2013 is the first year when the majority of doctors are digital natives – i.e. they grew up and qualified in medicine in a post-digital world.
5 million HCPs are now on LinkedIn, taking part in more than 8000 groups on that platform. 95% of US Medical Schools have their own Facebook account. Emma asserted that SM is driving the ‘creative destruction of medicine’ as we know it…
Yves Lavail from BMS pointed out that SM is the new ‘water cooler’ around which doctors chat. 89% of EU doctors use physician portals for professional information and 53% use social media. A good percentage – 41% – accept that portals influence prescribing – more than the number that admit the same about sales reps (32%) (Manhattan TTP EU 2012).
We discussed the 90-9-1 rule: that 90% of HCP SM community members are ‘lurkers’ – reading not participating, 9% are joining in and 1% are initiating discussions. As in life, perhaps?
“We can smell the cooking but we are not yet eating the meal”
Yet in spite of our customers’ behaviour, our industry is still talking about digital and SM as ‘new’. Rahul Agrawal of Bayer coined this sub-heading in his session entitled – Pharma and SM – Friends or Foes? He pointed out that SM channels can be useful for reporting adverse events and getting insight into sentiment about our products. But our industry is still dragging its feet and asking too many questions about compliance, data privacy and promotion issues, rather than looking at ways to provide services.
Rahul drew comparisions to IBM – 15 years ago the company sold computers, now it is a full service company. We must do this too. For example patients over 60 with diabetes are taking 25 pills a day – what are we doing using digital channels to support them?
Alex Simidchiev of GSK challenged us to see SM as a way to help build the industry’s reputation – it provides the possibility for open, transparent engagement with stakeholders. It could also be dangerous and the audience enjoyed the metaphor – “social media is the tell-tale blue dye for the pharma industry”.
Burak Ergenoglu of Sanofi Aventis highlighted the fact that new models are needed in the fastest growing markets – for example Turkey is second only to China in growth rate and has a young highly digital-savvy population. Perhaps markets like this can leapfrog the 20th century business models and create a digital healthcare economy from the start?
Alexandra Fulford (@pharmaguapa) observed that many companies now have a presence but are not always engaging in interaction with the public – for example you can add a post on Boehringer‘s Facebook page, but not on Novartis’s. There are shining examples of best practice such as GE’s global #GetFit campaign, but they are few and far between. Alex‘s advice was simple – get leaders on board, have processes, work collaboratively across geographies. This can’t be isolated tactical projects – have a strategy!
“The only thing interactive about your program is its name”
I can’t remember who made this comment but it certainly reflects a lot of projects that we call ‘interactive’ when what we mean is ‘online’. We had quite a discussion about what is ‘social media’ versus ‘digital’.
The problem is that ‘digital’ has become a bit of a ‘last year’ label in pharma – astonishing since we are certainly not expert in it yet! – and leaders are often saying ‘digital is just a channel’ (I don’t agree and will write on this soon). Therefore we are now calling our innovative programs ‘social media’ even if they have no ‘social’ (conversational) aspect at all. But many programs that are essentially static can still have ‘social web’ elements like comments, ratings and so forth.
As Jacopo Murzi of Janssen pointed out, it is important to understand the entire digital landscape, which might include websites, apps, emails as well as social media. This should be a precursor to every brand’s multichannel planning session.
Indeed as Luis Arimany (@evolufarma) made very clear, email is the single most important channel in terms of return on investment (see picture).
Content is still king – and it is our responsibility
Every speaker emphasised that it is still all about the content – medicines and content are pharma’s offering to healthcare after all. I showed some examples in my own session (The 5 Cs of successful social engagement). The HCP communities discussed attract their membership primarily for the valuable content they offer.
I suggested thinking about content differently, not as a promotional tool but a core service. If you want to be seen as a leader you should be providing excellent content in that therapy area.
And why not produce something that can be viral and social, such as Pfizer’s Back In Play social game to drive awareness of ankylosing spondylitis?
Bought versus owned?
There was a good deal of discussion of the ‘buy versus build’ debate with respect to engaging HCPs in communities. In my own session I warned of the dangers of launching a social media platform then abandoning it (the ‘commitment’ C) and a Tom Renneberg of Esanum gave a good indication of the impressive HCP membership of that highly credible community. Yves Lavail showed the preference of HCPs for private physician-only portals versus open social networks or pharma websites.
Aleksander Stojanovic of Razorfish paid us a flying visit to ask whether we should be investing in ‘bought’ or ‘owned’ media. In other words should we promote on 3rd party sties – bought media, a ‘cost’ item, or should we invest in our own properties – owned media, an ‘asset’.
This is a good point but I believe in healthcare the terminology should be different – the debate is, do we want to ‘hire’ relationships – temporarily engage a community of HCPs that is owned by a 3rd party provider – or ‘own’ them – build our own community and permission list so we can interact in an ongoing way. I wrote a recent article on this and concluded that we should do either or both, dependent on strategy, but it is vital to ensure that if we do establish a relationship, we are committed over the long term.
All in all a good event with lots of challenge and debate (in spite of a couple of no-show speakers – shame on you!). I’ll post my own session – the 5 Cs of social media engagement – shortly.
This is my fourth and final resolution. Full list is in my first post.
When I first became digital leader in a pharma company many years ago, I wanted to appoint a global agency to work with all our brands and affiliates. My vision was to have a partner that could help formulate strategy and digital platforms, capabilities and assets, and roll them out across the world, customising for brands and markets.
I soon discovered that I had a choice: I could find a good pharma agency and train them in digital or find a good digital agency and train them in pharma. At that time, the combination did not exist, certainly not at an international level. Clients hadn’t been demanding digital, and many agencies therefore hadn’t seen the need to develop capability in the space.
Happily things have evolved since then, led by some brave agencies that invested in digital and took it upon themselves to help lead the industry into the 21st century. There is now a growing cohort of excellent digital healthcare agencies.
Unfortunately there is still a much bigger group of agencies that hired a web designer and now ‘do digital’ but have not transformed their platforms, people and processes (see Resolutions 1-3) to truly embed digital excellence, so you need to know what to look out for.
Here are some watch outs:
Tactics without understanding the customer and landscape
If any agency listens to your brand plan and says ‘we can provide an app for that’ I suggest you show them the door. As with all marketing, insight is key. The environment is complex and in some therapy areas, crowded (in others, sparse). It is vital to conduct an analysis of the digital landscape, the needs, habits and preferences of your customers and the activities of competitors and other players in the space. Only then can you decide where the leadership opportunities are and make good channel and engagement choices.
If you’re in a global or regional role you almost certainly want to develop programs, platforms and assets and reuse them. Has the agency provided ready-built programs including content and templates for international use and the support to localise them? Ask how they achieved this. Is all e-learning and e-detailing content built in a way that separates objects like text from graphics, for ease of adaptation? (Is it SCORM-compliant?)
I recently saw a ‘regional e-learning’ that had been built by an agency and I asked them why they had chosen to have video of a person talking to camera as part of the creative – very difficult to localise (dubbing looks silly, subtitles are ugly, etc…). They commented that the client hadn’t asked for it to be easy to localise (!). I later learned that this agency had done very well at this company, building the same content over and over again for multiple affiliates. I can imagine.
The primary use of smartphones by physicians is to check email and number 2 is web browsing. So it is shocking that so many services targeting HCPs are still not responsive and render badly or not at all on mobile platforms. Check out some of the online assets your agency has provided; ask to be sent one of their emails and open it on your phone. Is the edetail built only in Flash so it won’t work on iPhone and iPad? Is it built only in HTML5 so it won’t work on older versions of Internet Explorer? Does the website automatically respond and render differently on your phone?
Other warning signs:
Talk about the ‘number of hits’ (digital experts don’t call them ‘hits’)
Talk of ‘delivering messages’, ‘bought versus earned media’ and any attempt to put promotional messages into a social media conversation – these are indicative of an old-model ‘push’ mentality, whereas we should be thinking in terms of ‘engagement’
A website without plan to drive customers to it including a Google strategy (unless for a specific reason e.g. a small ad board site)
Any case study evaluated only on ‘metrics’ (views, clicks etc.) and not customer measures
Anyone that thinks ‘iPad/tablet detailing’ is a ‘digital strategy’
Any agency not active on LinkedIn, Twitter, YouTube, Facebook as a minimum. If they don’t understand the value of it for their business, how can they use it to deliver value for yours?
So that’s it. Happy agency-hunting and I hope you’ve enjoyed my New Year Resolutions.
This is the third of my New Year Resolutions. Full list is in my first post.
One thing we do pretty well in the pharma industry is define processes. We have Standard Operating Procedures for everything, from good laboratory practice to approval of marketing materials. Why then, is it that those who use today’s ways to engage with customers, embracing digital and other channels and placing the needs of the customer at the heart of the strategy, report that they seem to be constantly fighting with the processes? Are our SOPs fit for purpose in a multichannel world?
Many of our processes reflect the realities of pre-digital life. Like the behavioural patterns I mentioned in the previous resolution: Get the People Right, the processes are based on minimising risk in the development and communication of static content to be transmitted in a one-way channel to customers, maintaining control of both channel and content at all times. It is not surprising that this was the case, when traditionally content was printed in large volumes (and at considerable expense) then handed to sales reps to take to the far reaches of the planet to give to doctors. This was very long-lived content and had to be right – mistakes could not be easily rectified.
At the same time, we can see how the same processes struggle with both channels and content that we cannot control and that can and do change frequently. Guidance from official bodies such as the FDA or ABPI will never cover every eventuality; we must have processes that can adapt to a changing environment.
Our processes must be nimble and recognise that content, channels, and customers are constantly evolving. How can we achieve this? Some suggestions:
Ensure all stakeholders – IT, legal, medical, compliance – have a good understanding of how digital channels work. I remember one legal team-member asking ‘how can we stop consumers coming to the Twitter meeting?’ missing the point somewhat that the consumers were already there, of course. Training and elearning can be a good start. Why not produce a simple introductory elearning program and make it mandatory for all those involved in digital projects?
Get those responsible for processes using digital channels themselves, living in this space. This is the only way we really understand both risks and benefits. Have a social network intranet. Run a competition on Twitter. Provide RSS feeds or social bookmark sets as internal news or content services. Use an online collaboration tool for approval meetings.
Set targets for approval – recognising that content can be more easily changed and is often transient. Target a one-week turnaround for approval or a (small) maximum number of approvers. Companies that are leading in the digital space have set targets like this, with impressive results.
Get rid of job bags and serial approval. Approve content in parallel and in situ e.g. on a website, by running a web meeting and getting all approvers to step through it together.
Approve the source, not the content. This especially applies to non-product-specific content such as a therapy area news feed or congress round-up. Find a credible partner and agree the criteria for the content (e.g. scientific, fair balanced, and rules about product mentions) then let your approvers do ‘spot checks’ on the content post-publication rather than having to read and approve it all pre-publication. Remember, online you can take content down immediately if there is a problem.
Empower your IT team to support digital standards. Often, for example, cloud-based or web-based services are avoided because they involve storing company data externally. However, many organisations including national banks, governments, health services, use cloud-based services. Why not adapt the SOPs that they use?
Ensure you have the basic guiding principles in place. Develop core policies for social media, websites, email, mobile, search engines and so on – the global ‘rules’ for each major channel. This will help expedite projects.
Implement a simple project charter approach and a review panel drawn from all areas that signs off on the project, its business case, the methodology, measures of success and approval requirements up front. This can help with planning and save time.
Build a catalogue of good examples in digital channels. Your approvers might not all have a lot of experience and it can help to have a list of examples they can refer to. Most things have been done before by someone. It can also help to have examples where complaints have been upheld – to show where the boundaries are.
Prepare for the worst but don’t budget for it. I remember one brand team who launched a YouTube educational channel paying a large sum of money to an agency to monitor it round the clock for the first 3 months, planning for the flood of challenging comments that the worst-case scenario of their risk assessment suggested. In that time, they had a grand total of 4 fairly innocuous comments at quite an impressive cost-per-comment for the agency. Oddly enough, the social media public are not sitting waiting for us to post some content so that they can flood our channel with abuse. Maybe they have better things to do.
Now you might be thinking that the agency in that last example showed either a lack of experience with YouTube or a rather cynical cashing-in on the brand team’s own inexperience. And that brings me neatly to Resolution 4 – Get the Right Partner. Look out for that one shortly.
This is the second of my New Year Resolutions. Full list is in my first post.
This is possibly the most difficult of our resolutions because it involves skills, behaviours and mind set. I remember some years ago in a pharma company I was interviewing for a new Digital Manager. My HR colleague had been doing screening interviews and said to me “You’ll really like Darren (NHRN), he’s very much cut from our <company> mould, he should fit in well”. This remark immediately made me question the value of the unfortunate Darren.
Why? Well, because generally in our industry we have not traditionally promoted the skills, behaviours and mindset to execute well in a customer-centric multichannel environment. If he ‘fitted in well’ to that culture, was he really an agent of change? I wanted the ‘grit in the oyster’ not someone who was going to slide into the organisation without making a ripple. I needed someone to stir things up a bit. Consider the challenge:
Traditional pharma behaviour
Take managed risks
Control the message at all costs
Understand the conversation
Decisions based on solid data
Try, test, iterate
Measure business impact
Deliver the message
Serve the customer
This is a shift in mind set that many companies have been driving for in recent years. But still I observe evidence that ‘the grit in the oyster’ is not always welcome or valued.
Here’s what I think you need to do to ‘Get the People Right’
Skill-up. A good part of the digital challenge is that many of our marketers, medical and other functions have ‘grown up’ in a pre-digital pharma industry. Even ‘digital natives’ might know what they like but that doesn’t make them an expert in how to deliver it. This is a complex and many-faceted area and a concerted, blended training program (online and F2F) is vital to ensure everyone knows ‘what good looks like’ and how to deliver it. Because a lot of folks have done digital stuff in the past, it doesn’t mean they’ve done it well. Poor execution in digital channels is all-too-common in our industry and is often attributable to poor skills and knowledge. (Don’t assume you can always lean on your agency’s skills either – this is the subject of Resolution 4 – Get the right Partner.)
Look outside pharma. Ours is an incestuous industry and people move within it but less so into and out of it. But ‘digital’ is a complex skill-set and a transferable one. Consider hiring from other industries where digital is more embedded. That doesn’t have to be FMCG – B2B industries like financial services, telecoms and others have some excellent people to offer.
Appoint experts. Too often a digital novice – perhaps a brand manager or marketing trainee – is moved into a digital job as part of a skills-development program. But this is not the right time to do this. Your Digital team, eMarketers, Innovation managers, whatever you call them – should be experts in the space. They must be able to challenge colleagues and respond to the many challenges they will get in the job. In addition they should have leadership skills to help drive change in their team and the organisation.
Reward the right behaviours. If we want to encourage people to adopt the behaviours on the right of the table above we need to make it worth their while. Reward re-use of programs, rapid-to-market campaigns, active learning/iteration and demonstration of business impact. Permit people to take managed risks, to launch initiatives that might fail with a plan of remediation/learning built-in and recognise the value of that learning.
The last point is perhaps the most difficult because it goes to the heart of our culture. We must be extremely disciplined, perfectionist, detailed and pedantic in how we deliver and measure programs whilst at the same time being brave, nimble, flexible and willing to quickly change direction as results or experience demands.
The company that Gets the People Right is well on the way to winning in the digital space. But we still have Resolutions 3 and 4 to consider – the Process and the Partner.
Pharmaceutical companies are starting to look beyond recession and investing in innovation again. Many are expanding their international customer excellence teams or even appointing a Global or Regional Head of Digital or Head of Multichannel for the first time in 2013.
Where does this new leader need to focus their efforts? My New Year Resolutions will be the next 4 BytesizePharma posts:
Pharmaceutical companies have still not prioritised information technology as a key driver of the business. Many have strategies about it, but have they really committed enough investment to deliver a seamless experience across channels and a single view of the customer?
Of course the platform should be like the ‘plumbing’, it should just ‘work’ and allow you to get on with the job of implementing your strategy. But if the plumbing isn’t functioning well the impact is massive, and so it is for digital platforms.
You should, at the very least, have:
an integrated CRM system to track customer relationships across channels
an enterprise-wide web platform with efficient content management system
a closed-loop system to connect rep visits to the CRM
an email platform with built-in testing and shared templates and reporting
a strong analytics solution to demonstrate both metrics and customer impact
an asset-sharing system that supports all kinds of media
And the core technologies are not enough. You need standard wireframes, templates, content elements and business rules to ensure the platforms are being used consistently and with quality – maximising business impact and minimising cost.
Having the right tool alone won’t make your organization into a great multichannel marketing engine, but you can ‘design-out’ some of the potential pitfalls by offering a ‘solution-in-a-box’ service with ready-built website, email, banners, social media elements and high-quality content that is re-use ready (more on this in Resolution 4).
Back to the investment, what will this cost? With cloudsource and outsource models, the cost can be scalable as the number of customer relationships grows. Still, it is not a trivial undertaking. It needs to be looked at from a global strategic point of view. If your enterprise-wide platform costs €5 million a year and helps you strengthen long-term relationships with 500,000 physicians, that is only €10 per customer. An investment worth making?
This resolution will help you get to the next level but in order to realise its potential your team needs to know how to utilise the platform properly to build strong, engaging customer relationships – that is the subject of Resolution 2 – Get the People Right.
At eyeforpharma eMarketing and Mobile this year my team and I had a serious message that we conveyed in a not-so-serious way, with a few sprinkles of fairy dust. The question we were trying to answer was:
What makes embracing digital still difficult for pharma?
Our answer: It is the thing that can affect all of us from time to time, in an industry with historically good margins and plenty of cash in the bank, where employees move within the industry, not into and out of it…we can all be prone to – a sudden attack of Inertia.
Inertia can affect all of us, and if it does, here’s what may happen:
A marketing leader may ask one brand team member to do “digital stuff” and add it into the plan, rather than re-working the process to design the communications around the customer.
A legal expert may be managed by the risk and say ‘no’ to ‘new’ channels of communication instead of managing the risk and saying ‘let’s work out how’
A sales rep may ‘do what he/she’s always done’ with additional digital tools, rather than seeing the opportunity to transform the customer interaction.
A sales manager may assume that reps are still the only channel really responsible for driving market growth.
A medical affairs manager may find it difficult to translate promotional regulatory guidance into digital interactions and have misplaced compliance concerns, slowing projects down.
Our message was simple, in order to embed digital in pharma you need to do the following:
Educate and up-skill all marketers though training and strategic planning workshops
Create SOPs and risk mitigation plans for all major channel types
Educate sales reps that ‘digital’ is not a gadget, but a core capability to enhance relationships
Build in good smart measurement – prove ROI as you go
Work closely with and educate medical colleagues
This isn’t magic, it is just common-sense. If we do this methodically, we WILL vanquish Inertia in our organisations.
I had a good two days at iStrategy London this week with Complete Digital colleague @mariaatomaca. The event was at Chelsea Football Club so the mood was up-beat in the venue generally (as you might expect) and it was good to see a few pharma industry colleagues there from Pfizer, Lilly, Novartis and Shire.
1. Marketers are experience architects
‘People forget what you said, people forget what you did, but people never forget how you made them feel’ (Maya Angelou) – so quoted @BrianSolis in an inspiring opening keynote that set the tone for the conference. The main thrust of his talk was: rethink the experience, don’t use social networks to do traditional marketing. A ‘Like’ is not an ‘opt-in’ for push marketing.
This point was re-iterated by Twitter, who’ve implemented ‘sponsored tweets’ instead of banner ads (although how users will accept this remains to be seen) and Facebook who pointed out ‘Ads are not content’ and you should give your page fans real, valuable content.
For pharma?This shift in mindset is the most important challenge facing drug companies. For many, marketing is still very much about ‘how can I push my message to this customer’. Yet in a content and expertise-rich space there are many opportunities to engage customers by providing the services they want, where they want them on their own terms.
2. Why Red Bull is a Media company (aka ‘Content is King’)
Red Bull have taken ‘Content is King’ (And as Rebecca Powell of @EbuzzingUK put it ‘Distribution is Queen’) to a whole new level and become a content company. Known as a carbonated drink, in fact Red Bull also has a complete international media operation with TV, radio and magazine production and distribution services. All of this is in-house and monetised. The content celebrates what Red Bull is known for – Formula 1 motor racing and other extreme sports. They showed the trailer for an amazing feature-length movie, ‘The Art of Flight’ (http://www.youtube.com/watch?v=kh29_SERH0Y). The movie has had 42 sold-out premieres (and made over €1 million so far) and even the trailer has had nearly 10 million YouTube views. Redbull claims to be the third most influential social brand in the world with 28 million FB fans, 600,000 Twitter followers, 280 million YouTube views.
For pharma?Most companies provide content as a service to healthcare. If we are serious about healthcare outcomes it is a duty of the leaders in a therapy area to provide high quality content to support patients and healthcare professionals. It’s important that we think about content formats beyond traditional text and flash – consider video and gaming (see below), and how to make our content ‘social’.
Think of ‘KISS’ – Keep it Simple and Shareable. 🙂
3. The power of video
Following on from @RedBull, iStrategists repeatedly emphasised the importance of video and the social nature of it – Pete Blackshaw (@PBlackshaw) from Nestle said the ‘instructional video’ is a major untapped opportunity for many companies and brands. We spend 16 years of our lives in front of video content by the time we are 60, according to @RIBenjamin. Harry from Google cited the TippEx interactive ‘Birthday Party video that makes him want to buy the product even though he doesn’t need it…a great example of making a ‘boring’ subject engaging.
For pharma? Lots of healthcare video opportunities – there are some good examples with J&J Health channel on YouTube, Pfizer Health and for professionals, webcast KOL videos are now mainstream, and companies are exploring other video services such as Lilly’s Oncochannel.
4. LinkedIn – the profile search engine
Everyone who attended @NealSchaffer’s LinkedIn session went away determined to spend more time regularly updating their company, group and personal profiles. Why? LinkedIn is perfect for getting connected professionally because of the power of its information-rich ‘profile search engine’. If you are looking for an employee, an agency, a discussion group, an answer to a question, you may well find it there.
For pharma? There are 2500 pharma-related discussion groups on LinkedIn and 8500 about healthcare. Neal’s tips: update your status regularly, join big groups to expand your contacts, ensure you have some personal recommendations, join discussions that interest you. You never know when those contacts may be useful.
5. The four stage Facebook model
Alexander Schlaubitz of Facebook shared their 4 stage model for brands on Facebook: Connect, Engage, Influence, Integrate. Connect – they recommend you should aim to get 20% of your market to Like your page. How? They recommend offering specific services (e.g. a discount voucher). Engage – frequent light interactions, the brand should stimulate discussion but not ‘tell’ – the discussion should be between fans. Influence – treat fans exclusively with ongoing special services. For example Nike has launched products to FB fans first ahead of the public. Integrate – Facebook should be part of the relationship ongoing and should build over time, it is not a one-off campaign.
For pharma? With nearly a billion people on Facebook how can we engage those with a particular healthcare condition and what can we learn? There are some strong health related groups and pages on Facebook such as the NHS Organ Donation page, but the industry is under-represented beyond corporate brand presence.
6. We’re all (social) gamers now
Gaming is no longer just the domain of young males. 82% of people play online games regularly – 98% of children (I wonder what the other 2% are doing?). Some categories such as puzzles, city building and bingo games are more popular with females. Studies show that game-playing offers three times the engagement level of watching a video. And gaming is increasingly social. 500 million Facebook users play games, 300 million of them weekly, 60 million daily.
For pharma? We’ve seen patient disease awareness games (check out http://www.back-in-play.com/) and booth games for doctors are always popular – such as ‘Ward Wars’ (infection), ‘Vascular Quest’ (cardiovascular), and the ‘Diabetes Challenge’. How can we make productive use of social gaming specifically – anyone know any good industry examples?
7. Influencing the influencers
Ford has used social media to transform the brand in recent years and make it fun, relevant and popular Doug the Ford Focus puppet (@focusdoug) became a minor YouTube celebrity.
They ran a Facebook competition with the prize of a new Fiesta – the impact in terms of sheer numbers was greater than a SuperBowl ad. In another initiative, Ford turned negative bloggers into advocates by inviting them for a factory visit and immersion day. Their word cloud was transformed overnight.
For pharma? Why not offer company immersion days to proactive healthcare bloggers, especially inviting vocal industry critics?
8. Using expertise to engage customers
Stephane Lee talked about connecting experts in the organisation with customer. For example, Peugeot have an ‘ask the expert’ service for each new car. Customers can ask anything they want and the question is put to the appropriate person in the company – engineer, designer, sales person – who answers online, building up a Q&A resource that other customers benefit from.
For pharma?Medical Information is a perfect service function that should be providing online service. Pfizer in the US and Canada offer Click to Connect to get live chat services. Abbott’s brilliant https://www.crohnsconnect.co.uk/ offers expert patients the chance to share their stories with others.
Those are my 8 take-aways. Were you there? What do you think?
I ought to give a shout-out to the iPitchers that I liked – those given 6 minutes to pitch their idea to the audience. My favourites were @Brandwatch who used low-tec videos of their team (extensive use of cardboard) in the office to promote their SM monitoring service, and Kinetise from @funandmobile- an app-builder that Piotr Pawlak said is better than all the others simply because it is ‘the only one that really works’. Anyone want to challenge?
Last year my New Year post was 5 things I’d like to hear from pharma marketers in 2011, and you may like to know I’ve heard 4 of the 5. (I’ll leave you to guess the one I haven’t heard yet.) This year, 5 things I really don’t want to hear in 2012 or ever again… What do you think?
1. I’m not sure that digital is important to my customers
There are a number of problems with this. First, referring to ‘digital’ as if it is one channel, which it isn’t. Second, just about everyone in the developed world, and a great proportion in the less-developed world, use some sort of digital communication. In many countries of the developed world internet penetration is now around 80% of the population. When you also consider that, worldwide, 34% of people are either under 14 or over 65, you realise that almost all of the student and working population is online, together with a good proportion of older and younger people.
It might be social media, email, SMS messaging or a variety of other types of interaction, but digital is very important to most of us. But as I said it is not one channel, therefore it is important to find out what digital interactions are relevant for each customer and when.
2. We have a dedicated digital team; our marketers/medical people/reps don’t need to know digital
Once again we are making the assumption that digital is somehow a channel when it is not – it is a capability that all communicators should have. Reputations are made (and broken) in digital spaces – therefore your PR team must be savvy and your employees require guidance. Medical education is increasingly provided and sought online – pharma medical teams must be active here. The ‘self-made KOL’ is emerging through blogging, HCPs reach out to each other in online forums and networks – key partnerships can be developed in these places. Brand visibility, services, information and interaction are expected from your customers – all members of your brand team and your sales reps must have digital tools in their kit.
Training all communicators to embrace digital in all its forms must be a top priority for companies that are re-organising for the digital economy. This and developing and embedding best practice is the role of your digital team, who should be very busy in 2012.
3. I tried a website and it didn’t work
Whenever I hear a ‘I tried <interaction-type> and it didn’t work’ I want to shout ‘DON’T BLAME THE CHANNEL’!
It is like saying ‘I watched Big Brother and didn’t like it, so I’m never going to watch TV again’.
There are various forms of this, often from people who were ‘bitten’ in the early 2000s when there was a lot of mediocre execution. Companies and agencies alike had not developed best practice in pharma digital and many mistakes were made. Email was too often spam, websites became out-of-date brochureware, banners were irritating interruptions. Tactics didn’t ‘work’ and brand leaders, perhaps already sceptical or perhaps having fought for the budget and been proved ‘wrong’, became disillusioned.
However, if you are taking a more strategic approach to your customer, intending to interact with them at the right moment with the right content in the right format to delight and engage them, at some point websites, email, banners may indeed be the right interaction. You just need to execute well.
Also beware of blanket advice from cross-industry digital experts. You sometimes hear for example that ‘ email is obsolete’ and this may be the case in some sectors, but it is often not so for physicians – studies show many still use and value email from colleagues and also email news from professional associations and pharmaceutical companies. The important thing, once again, is to understand what your customer wants and will engage with.
4. Prove to me the ROI of that digital tactic
It is self-evident that digital interactions are more scalable than face-to-face (engage 10,000 people digitally for a similar cost to engaging 1000, not so for a F2F meeting) and therefore the cost-per-interaction can be lower than some other types of interaction. But measuring ROI per tactic? Think about it – what is the ROI of a single rep visit? Taking a doctor to an international congress? Can you measure it? No. Why? Because the ROI is delivered (a) in the long-term (may be a year or two down the line) and (b) is a result of the entire relationship with the doctor, not that one tactic. A brilliant congress impact may be completely overturned by poor service subsequently by the rep or a bad website experience.
Digital interactions are so measurable I think we sometimes get carried away with our metrics and blind people with science. Yes, we can measure clicks, readership, time spent, where they came from, where they went, and all this is important to understand how well we executed the tactic and the overall campaign’s success.
But real ROI comes from the overall customer experience or relationship. For example, a physician may be invited to a webinar or online discussion by a rep, they may sign up online, receive a reminder email, attend the event and then receive another email inviting them to comment on the event and request next steps. We must measure the success of each of these steps (e.g. uptake after the rep visit, registrants who actually attend and so forth) but the ‘ROI’ of one tactic alone is meaningless.
What we can track is the ROI in terms of customer satisfaction and market share of those who took part in this overall campaign and those who did not. We can also track the relative preference for our brand in terms of brand choice/brand equity studies over time, and evaluate what interactions those who prefer our brands have received. In this way we can start building a picture of the right mix for different customers and how well we are executing.
But seeking out short-term ROI measures from individual tactics is meaningless. We don’t demand this of other channels and should not expect it from the ‘digital’ ones.
5. My brand needs a digital strategy
There is no such thing as a digital strategy for a brand. In fairness, my team and I do run ‘brand digital strategy workshops’ but this is shorthand for taking a strategic approach to embedding digital into a multichannel brand plan. And that is the way to think. How can I put my customer truly at the centre of my planning and consider all the interactions that will be effective and how to combine them into a seamless and delightful customer experience and long-term relationship?
There isn’t a one-size-fits-all answer to this in pharma, there isn’t a piece of software you can plug variables in and out pops the ‘channel mix’. You have to gather all the insight you can and take your best guess at the channel mix for your customer, execute with excellence and be ready to change the mix and iterate, iterate, iterate. Over time you learn what works for your brand and your customers in the market in which you operate. That’s where great measurement, analytics and CRM platforms come in – to help you ‘learn as you go’. But your first multichannel plan will have to be your best, most educated guess, drawing on all the knowledge and experience you can access.
Brands, in summary, should have a multichannel customer engagement plan – starting with a ‘channel agnostic’ planning process that evaluates all channels – digital and traditional – equally.
Companies, on the other hand, can – and should – have a digital strategy – by which I mean a strategic approach to embedding digital expertise and processes across the organisation. Only with the right competence in all channels can channel agnostic brand planning take place.
At last week’s excellent eyeforpharma Mobile Strategies event in London (1-2 December) there was an interesting dichotomy between how embedded ‘mobile’ seems to be the lives of the delegates and how far from embedded it is in our professional communication strategies.
In a mini-poll I did as Chair of Day 2, 75% of the delegates had an iPad, 86% a smartphone. Three-quarters of delegates had used their phone as their alarm clock that morning, the same number admitted signs of anxiety if they didn’t have their phone and would not leave home without it.
Yet still we are not necessarily drawing on our personal experiences in order to develop the insight to deliver value for our customers. Here are my five take-aways:
1. Mobile App-athy
Brand teams and marketers in pharma are excited about the potential of mobile apps but our customers are perhaps less enthusiastic. As a result there is a large number of pharma-sponsored apps (one estimate put the total health apps at 34,000) with just a few downloads each. A panel discussion (chaired by Chad Daugherty from Lilly with Len Starnes – @lenstarnes, Duncan Arbour – @rbour and Andreas Claus Kistner) concluded that pharma is too keen to invest in “shiny things” without real insight into customer needs.
Companies want apps but many have not optimized their email and websites for mobile – even though doctors and patients use mobile devices mostly for email and websites. Too many emails will not even display properly on a mobile device, and Sam Walmsley (@sammielw) pointed out that only 12 of the top 2 pharma companies’ websites are mobile-friendly.
To me it feels like the late ‘90s when brand managers everywhere were saying “I want a website” without taking a strategic look about how the web might fit into the overall communications plan. Many useless websites later, companies started taking a more strategic, customer-centric view and websites grew up.
My advice – if your objective is to build an app, don’t. Spend time defining an objective that is about customer value, then see what channels/tools can achieve it.
2. The Mobile Physician – who?
We learned that Doctors download 50 apps on average, but like everyone else, use just 7 regularly.
A panel discussion with Doctors Rob Hicks (@DrRobHicks), Peter Ilves and Henrik Andersson observed that there are “mobile” and “non-mobile” doctors. “Mobile” doctors are doing hospital ward-rounds or travelling from patient to patient and need handy reference services in their pocket – often it is treatment guidelines, symptom checkers, calculators. One example of a this is the Psoriasis PASI calculator from Janssen, a simple tool to help determine the severity of the rash and therefore appropriate treatment.
“Non-mobile” doctors are sitting in their office seeing patients and will mostly use a laptop or desktop computer. We need to provide multichannel services to fit the requirements of each.
One interesting doctor-patient app we saw was the mini-atlas from EC-Europe – anatomical atlases for iPad, designed for doctors to share with patients, the most recent version of which allowing the doc to draw on and annotate the image, then send to the patient. Pharma companies are sponsoring these atlases and the platform is well chosen – 93% of tablets sold to HCPs in the US last year were iPads.
Rob Hicks put it simply: the doctor’s daily workload is already very high and overloaded with multi-channel information – ““Don’t give us lots more to do – give us stuff that will save work and time.”
3. The Mobile Patient and mHealth
MHealth is now an established force in the developing world, where mobile technologies are providing much-needed access to health care and changing lives. In the developed world, however, the picture is more fragmented and, as for physicians, there are a great many under-utilised health apps competing for attention in the app store.
The winners are once again those based on real customer need and insight. For example the Claritin pollen alert for hayfever suffers (I can testify to its usefulness); Medtronic’s Lenny the Lion ‘carb-counting’ game app for children with diabetes, and a sponsored app in Israel for finding the nearest public WC, with links to Pfizer’s advice about bladder control.
The most compelling opportunity to provide mobile health solutions we saw was not for the “walking well” – the traditional pharma targets of asymptomatic patients needing medication reminders – but the moving and inspiring story from the Teenage Cancer Trust. Presented by Simon Davies, CEO, Professor Faith Gibson and former patient-now JimmyTeens.TV developer Tom de Bruin (@deadlyhifi), this told of the problems faced by young people going through chemotherapy.
Isolated by necessity and often very ill, these teens feel even more alone if they turn to Facebook and see their friends having fun without them. They also have a million questions and concerns about their symptoms (as do their parents). The Trust has pioneered web-based solutions allowing patients to ask questions of a cancer nurse and get help, information and support online, as well as connecting with other patients. The mobile potential for this is exciting, and so the Trust and eyeforpharma are running a competition to design such an app.
4. Ready, Fire, Aim! – Reps and iPads
I have stolen the title from Armand Brevig (@BuyingeContent) of Reprints Desk and several of the speakers agreed with the point that companies have taken a “Wild West” approach to iPads for reps, in some cases providing the technology before any application has been identified. Back to those “shiny things” again.
However, there is hope. Roche has integrated iPad solutions for its reps. In the pilot reps said that the ability to update the CRM system right there after the call was saving them 2 hours of data entry each evening. Key learnings: keep it simple and quick, provide offline capabilities, integrate with the rest of the solution (not ‘islands of technology’) and learn to fail fast and learn from mistakes.
My favourite quote of the event is Andreas Claus Kistner’s definition of ‘fail fast’: “Technology is like chocolate, if it is fundamentally bad, you can’t fix it – throw it away and get some new stuff.”
There was also an interesting example from Murat Mendi of Nobel, who rolled out a fully integrated and tracked closed loop marketing system in Turkey with 100% rep adoption based on tablets, not iPads – demonstrating that CLM is about good strategy, strong execution and shifting the culture, regardless of technology.
5. Good Mobile Service/Marketing is Just Good Service/Marketing
Our (@CompleteDigital’s) own Helen Harrison (@harrassedmom) set the tone early on in the event with a story about how the First Directbank – famous for award-winning customer service – developed their mobile app.
As a bank they had some parallels with our industry – they had a mountain of legal, security and personal data concerns and had to very carefully step through the hurdles and ensure high standards of compliance.
Priding itself on being the top bank in terms of customer satisfaction in the UK, First Direct started with its customers. The team developed clear and detailed customer personas and designed the app with the user at the centre. They chose not to do “everything” but to do the few key things that customers really wanted, really well. They tested, tested, tested, including sketching the designs on paper and sitting with customers refining them, then testing further at wireframe and design stage so that by the time the app was built it needed hardly any testing – it was exactly what customers wanted.
In other words, First Direct did the opposite to “I want an app”, they spent a good deal of time investing in finding out what their customers really wanted, then delivered it. With 100,000 downloads in the first month and 85% 4 out of 5 rankings, it seems to have hit the mark.
Medtronic’s Matt Thomas re-iterated this on day 2 when he advised us to start with the strategy, learn from observing customers and continually analyse in order to refine the service.
The best healthcare mobile solutions, like the best banking solutions, do exactly what customers want, really well. In Helen’s words and put very simply, mobile apps or other mobile solutions must adhere to the first rule of great customer service:-
Once upon a time, an HR Director in a large organisation was trying to place me in the pigeonholes of corporate life. Jolly as one is when the focus is “all about me”, I talked through the jobs I’d done. Lab researcher, programmer, analyst, product manager, customer service manager, training manager, marketing director, VP strategic marketing, global e-marketing director, global brand comms director. “What do you like most?” was the question she patiently asked, looking into my eyes, and, she hoped, no doubt, my inner self.
“Change” I replied without thinking.
“Er, I meant, which particular job role were you most comfortable in?”
“Well, it’s best for me when I’m not comfortable…”
Like you, I’ve been on the leadership programmes, the “solution-selling” and “customer-centric-marketing” and “marketing excellence” initiatives. But I’ve long been a student of human folly, and one thing has consistently struck me, through all the changes I’ve seen (test-tube chemistry to computerised micro-samples, punched cards – I kid you not! – to augmented reality, sneaker-net (carrying floppies across the office) to cyberspace, and so on) is the way human beings react to and embrace (or not) change.
Geoffrey Moore had it fairly spot-on in his seminal work Crossing the Chasm (originally published 1991).
Moore’s hypothesis is that adoption of new technologies does indeed follow a normal distribution (as originally described by Joe M. Bohlen, George M. Beal and Everett M. Rogers at Iowa State University.)
In other words, from a small number of ‘innovators’ (the techies who play with the new stuff for its own sake) to a larger number of ‘early adopters’ (who see the possibilities of the new technology and are willing to put up with the fact that it is unfinished because they are visionaries) through to the ‘early majority’ – the mainstream early users – followed by the ‘late majority’ and ultimately the die-hard ‘laggards’.
What was different about Moore’s hypothesis is that he said if the technology is ‘disruptive’ (i.e. completely unprecedented – not “faster horses” but “the motor car” – as per the famous supposed Henry Ford quote), then there is a very large gap between the early adopters and the early majority – the CHASM.
The early adopters have these characteristics: they give credence to the innovators and listen to them; they can translate from tech innovation to business success; they are willing to “finish” the product with their own resources, recognising it is new and may require considerable development to be a commercial product; they understand it is unproven and will take the risk, they will invest and put themselves on the line because they believe in the new innovation.
However, the early majority are totally different. They want a product that is complete, stable and supported; they expect it to have proven return on investment; they expect a good support infrastructure; they want to know the product is reliable and has good references, they will not risk their reputation on the new technology. Why should they?
Therefore, the worst person to sell a new technology to the early majority is, in general…the early adopter.
I have had personal experience of this. In the early 90’s I was working on a market-leading financial software product and we were introducing the brand spanking new ‘Windows’ version of the product, that would replace the much-loved and very successful DOS product. (If you actually know what I’m talking about, by now you should probably be sitting in your armchair in your carpet slippers with a newspaper and a nice dry sherry by your elbow.)
We had recruited client development partners, run focus groups and had an extensive beta test program, and were very confident that the new Windows product would (eventually) have all the capability of the DOS version and would be much easier to use.
At about this time, the great ICI de-merger was happening and Zeneca Pharmaceuticals was being born, leaving ICI as a paints and agrochemicals business. True to expectation, ICI retained the DOS financial product and Zeneca, the new kids on the block, wanted the new-fangled Windows version. I remember working with them for months on the implementation. It was a very happy and productive collaboration.
And most of all I remember our annual user conference, when the very lovely Financial Systems Director of Zeneca (JP, you know who you are) stood on a platform and told 300 Finance Directors, Financial Controllers and Financial Systems Managers (the keyword here being “finance”) that he, and Zeneca, had had “hundreds” of people working on this new platform and spent “millions” on the implementation of the new Windows software. For him, the size of this was impressive and good for his CV. Not so for me. I looked round the room and saw 300 aghast faces and the biggest own-goal of my career looking back at me. Not a single person in that room was going to migrate to the Windows product. (Well, they did eventually of course, but that event didn’t contribute. Not one bit.)
That was the day I fell right into Geoffrey’s Chasm.
Now, almost 20 years later, I consider where we are with Digital Pharma. The innovative brand managers and eMarketers have run pilots and by gum, we’ve shown return on investment. Everyone KNOWS that customer-centric marketing, with digital as a core component, is the future, right?
The problem is, the early adopters in our industry are not turned on by “training” or “embedding” or “standard operating procedures”. So the visionaries who were building websites 10 years ago are now off building apps…and still “websites” are not core to our brand communication plans – although in many cases they probably should be. A brand manager in any other industry would be reprimanded if their product website wasn’t number 1 in Google for the brand name in their country…but for pharma brands it is a rare thing when they are.
Our industry culture doesn’t help. We reward “innovation” not “embedding”. A forward-thinking brand manager who does exciting new stuff that seems to work is quickly promoted to another, often regional or global role, leaving the innovative new practice to wither on the vine.
Meanwhile our core business model is 50 years old and creaking at the seams. What we must have is the leadership will and the management skill to really embed a digital/multichannel customer engagement culture, backed up with everyday stuff like training, best-practice documents, standard operating procedures and day-to-day mentoring and coaching in new ways of doing business.
The pharmaco that cracks this first, will be a winner. Will it be you?
One of the big themes of eyeforpharma eMarketing Europe this year was predicting what the future will look like. Now we’ve got beyond thinking of digital as a “channel” and begun to grasp that it is a ubiquitous part of daily life, we are considering how our lives in general, and healthcare in particular, are changing.
In our Complete Digital presentation we decided not to try to predict, but to travel forward in time and discover the 3 Digital Healthcare Truths of 2016. We jumped up the Digital Maturity Curve (see my last post) and off the top into the future:
TRUTH 1: The Patient is dead, long live the Person
This caused a sharp intake of breath in the audience, perhaps the non-native English speakers who might not know the very “English” phrase that inspired it “The King is dead; long live the King.” But what does it mean?
It is referring to the fact that all patients are people, and all people are patients. We all have health. In the future people will be proactively managing all aspects of their own health, tapping into a variety of services provided by pharmaceutical companies in addition to their medicines.
Healthcare providers and insurance companies will offer lower premiums or co-pays to those of us who join managed health programs and have regular self-checks reported automatically to their healthcare professional.
These self-checks will be using a variety of mobile, personal healthcare devices connected with online information and education resources, integrated with patient records and other services provided for physicians.
The “product” for our industry will become a combination of a drug with a suite of services – most of which will be digital services.
TRUTH 2: Primary Care Physician = Healthcare Broker
The GP will become a “broker” of services for the empowered patient, reaching out to specialists and services all over the country (or world) in response to their patient’s requirements, using digital tools and multiple media including video conferencing to communicate symptoms and find solutions – maybe doing “Skype surgeries” or online chat consultations, and connecting patients with their chosen specialist in real-time.
Healthcare will, of course, be more complex but the physician will have DNA screening and sophisticated diagnostic tools available, as well as a suite of services to support people for whom she prescribes certain drugs. The GP lives in a digital landscape of information, education and peer support, and has everything she needs at her fingertips.
As pharma brand managers it will be our job, not to get “share of voice” with the physician but “share of digital landscape”.
TRUTH 3: Pharma and Health Ambassadors – a partnership
In future we believe that the pharma industry will engage openly with patients, doctors and others about drugs and healthcare issues in the interests of patients.
New KOLs will emerge – patients, doctors, others, who earn credibility through others’ experience of their postings (e.g. like Wikipedia) and lead thinking on health topics – they will become healthcare ambassadors and be recognized as thought-leaders, even though they are not doctors or scientists. What is more, they will partner with us, the pharmaceutical industry, for better patient outcomes.
Can we figure this out do you think? Manage the risk instead of the risk managing us?
Perhaps in 2016 we will look back at 2011 and wonder at the constraints we operated under, that turned out to be perception rather than reality once we figured out how to operate in the world of “participatory healthcare” (thanks for that term, @MeredithRessi):
Let’s start driving the express train that is the digital healthcare revolution, otherwise we might just get hit by it…
There were three themes that emerged for me from this year’s eyeforpharma (#efp) eMarketing Europe in Munich in early March and I’ll write about them in my next 3 posts.
First, there was a sense of “where are we on the digital journey”, what can we learn from where we’ve been and how do we get to the “next level”, whatever that is.
Second, there was looking to the future; the core content of our own Complete Digital presentation, but also featuring heavily in lots of others’.
Third, the angst that surrounds changing company culture. How can we get the behaviour change across our organisation that we need to make that future happen? Not just in marketing, but throughout?
First of all then, let’s look at the digital journey. Several commentators referred to this at eyeforpharma and Peter Hinssen (@Hinssen) in his opening address, The New Normal, asked “are we nearly there yet?” Meredith Ressi (@MeredithRessi) of Manhattan had a nice curve of development over time from “physician-led medicine” to “participatory medicine”.
For the purpose of discussion here I’m going to use my own Digital Maturity Curve. You might like to consider where your brand or business is on the curve:
The first step, that we all went through in the 1990s, is “Visibility” – recognising the potential of digital and sticking up a brochure-ware (in those days) website. In those days we were still in the “push” mindset and these websites did not offer much interaction – the days when the most of the home page of BMJ.com was a picture of the front cover of the BMJ magazine.
The BMJ has moved a long way since then, but Jens Monsees of Google challenged us in the pharma industry on this point – many of those old, out-of-date and frankly poor-quality websites are still out there. We should “eat our own dogfood” he said, spend some time reading your own website and see what kind of experience you have…. Even in 2011 “information seeking” is still the most important online activity for healthcare consumers and physicans alike (@MeredithRessi) and I ask you – if your customers are looking for information, what are you doing to provide it in an easily accessible place and relevant format?
We soon figured out that in this medium we can of course “Interact” – buy, sell, recruit, play, ask questions and get answers. For pharma this means the opportunity to offer higher-quality interactive experiences such as eDetailing , eLearning, video and games, interesting content on demand when customers want it. For example, at #efp Mark Petersen showed how gaming can engage people in serious subjects such as the FAS’s Immune Attack game: http://www.fas.org/immuneattack/
The next big leap on the Maturity Curve is to “Personalise” – if we are interacting we can learn more about our customers and offer a more tailored service, Amazon-style. Gareth Thomas of Doctors.net described how they carefully segment physicians on speciality, sub-speciality, seniority, location, medical school (and year of graduation), clinical interests, and, further, on their behaviours in the community.
Supporting our point about information, the top services for Doctors.net are “Email” and “Education” with the Forums coming in close third, but each member will be offered services tailored to his or her preferences.
On to our next big leap – “Multichannel Relationships” – recognising that the person on the website is the same person using the app and having the face-to-face interaction. Tesco, the UK supermarket did a great job of this – merging their “in store points/favourites” with “online points/favourites” first, and now have an iPhone app to update your shopping with. In all cases I am the same consumer with the same profile and Tesco “knows” me. In pharma we often refer to this as “closed loop marketing” – connecting the rep interaction, with subsequent digital follow-up. At #efp Fonny Schenck showed how AZ in the US is supporting Nexium with a combination of self-service digital capabilities from eSampling to eDetailing, combined with customer service helpdesk and telephone account managers, providing a seamless multichannel service to physicians.
The next big leap, of course is social media and networking. At #efp we heard about how Citibank has developed an internal social network for employees, a great way to help people learn how to use these channels effectively (and something we’ve employed here at Complete, too). We heard the term “Chief Listening Officer” from Lucien Engelen of Radboud University (first time I’ve heard the term outside FMCG) and saw a couple of great examples of UGC, such as Janssen’s excellent Living with ADHD YouTube channel (http://www.livingwithadhd.co.uk/ ), that allows comments from anyone about this controversial condition, and is moderated but only to remove comments constrained by regulation or the law, not those critical of the condition or company.
Interestingly at eyeforpharma, a digital-savvy audience you might think, a straw poll showed only 15% of the audience were regular Tweeters and a further 15% had “no interest” in Twitter at all.
You might ask where is Mobile on the Digital Maturity Curve? At #efp repeated speakers warned against “app for apps’ sake” projects given that most smartphone users use just 7 apps frequently and the rest hardly at all. Good apps, like good websites, meet a defined user need, are interactive, engaging, informative and fun to use.
Mobile is, of course, throughout the Curve, which is not really about technology but about behaviour – how we use the different platforms that are available to us. Twitter and facebook can be used as visibility tools at one level. So can mobile – creating your website so it has a user-friendly smartphone version is probably the most important thing you can do right now, since as Manhattan told us that most of the growth in internet use is mobile based – and physicians are now spending 14 hours a week online.
So there it is, the Digital Maturity Curve. You can see my #efp description of it here:
What happens next – at the top of the Digital Maturity Curve – what is the next big leap? The picture shows a fairly woolly “Web 3.0” but does not define it clearly. To answer this question, we leapt off the top of the curve and into the year 2016 to see what “Healthcare 3.0” might look like….that is the subject of my next post.
1. Digital is a core skill-set required for all marketers in our organisation.
In FMCG, in banking, in the media, this has been true for years. But in pharma we still seem to think that the eMarketing person “over there” will deal with all the digital elements of our brand plan.
This is a bit like having a brand team member whose job it is to look after “paper”. But “paper” isn’t a channel, and neither is “digital” – they are both types of media with many different manifestations and many channel types, and digital opportunities present themselves in public relations, medical education, brand promotion, KOL discussions, customer relationship management, among many more.
All our communicators, from the medical information team to the board of directors, must be digital-savvy. As the power-house of communications, the marketing team should be leading the charge and ensuring that all marketers are e-marketers.
2. We are evaluating whether or not to use face-to-face selling for this product/customer segment/country
We all talk about customer-centric multi-channel marketing. But do we really challenge our accepted channel mix? How brave are we? Do we evaluate whether these target doctors prefer face-to-face or other types of interaction – the way we (still!) ask if digital interactions are relevant?
Or is our planning still centred on the goal of getting reps in front of doctors? Assuming we feel there is a role for a mix of human AND digital interactions are we optimising the cross-channel opportunities? Are the reps passionate about and selling our digital support services? Are our digital interactions offering face-to-face follow up?
3. It is our duty to try to ensure public sources of information about our products are up-to-date.
Most pharma companies are aware that patients and doctors use public online sources like Wikipedia as much as, or more than, “official” sources of information. Most regulatory authorities do not prevent the industry from sponsoring updates to such sources to ensure their currency and accuracy. But still, most pharma companies are not doing this and most of these sources are out of date. Shall we find a way to fix this in 2011?
4. I am well aware of the online conversations about my drug, and this insight is shaping my strategy
2011 is the year to really start listening. Yes, use an agency and a monitoring service to regularly report on the conversation. But, just as important, go there yourself and listen. To be a “fly on the wall” as your customers discuss your product or the needs they have that it might address is a marketer’s heaven. Let’s make use of it.
5. Is it unproven? Do we think it might work but don’t know the ROI? Let’s do it!
How many times have you been to those meetings where you brainstorm innovative communications, and come up with a number of real “breakthrough” communication ideas that you think, with all the knowledge in the room, will really impact your key target audience, change behaviour somehow, and change healthcare forever.
Then someone asks the million-dollar question “how do we know it will work?” and everyone looks round uncomfortably. If it doesn’t work, you’ve wasted the company’s money and you look like a fool. If it does work, you might create a communications paradigm shift and become a hero.
Generally in the pharmaceutical industry, we don’t reward risk. We don’t risk taking a drug to market until we have all the clinical evidence it needs to support it, and so often we mirror that behaviour in our marketing plans. If we don’t have evidence to support a course of action, we don’t do it. This is impacting our readiness to adapt our mix to exploit emerging channels. We want first mover advantage, but wait a minute, we don’t want to be first.
Happily, we are seeing “innovation funds” and “digital strategy leaders” and increasingly people whose job it is to try things and see if they work. This is a promising trend, but still the risk-averse culture is embedded, and the only people who can change our culture is…..us.
Set aside a portion of your brand budget as the “risk fund”. Reward your team for taking managed risks and learning from them. Adaptability can create competitive advantage. Let’s do it!
At the recent Digipharm meeting (29-30 September) in London, I led a discussion about Wikipedia using live Twitter-voting (thanks to the adrenaline-pumped efforts of my colleague Dave Clarke, who made it work on the day!) to see what the audience of pharma marketers and communicators thought about this phenomenon, the largest collection of knowledge the world has ever seen.
Why is Wikipedia important?
It is highly visible in Google for almost all subjects from blast furnaces to the Rolling Stones. This is because (among other things)
It is content-rich – lots of text about each subject, descriptive headings, images with labels.
Its link popularity. It has lots of links to it and from it and what’s more the links are to and from related content.
It is updated regularly. Google likes websites that get updated frequently.
The reason we all love Google is that it has a pretty good algorithm for putting the most relevant and up-to-date content as the top search results, so we trust Wikipedia because Google does.
What about the pharmaceutical industry?
But for our industry, Wikipedia is “The Elephant in the Room”. It is big, obvious, can’t be ignored, and yet we continue to behave as though it isn’t there. Why?
Perhaps our customers don’t use Wikipedia – can doctors and patients really trust it? Studies suggest they do – according to Manhattan’s latest research (Taking the Pulse and Cybercitizen 2010), 75% of physicians use it regularly and it is the top patient information resource in all countries surveyed.
Are they getting a good service from Wikipedia? Generally, no. A peer-reviewed study (2008) compared Wikipedia to Medscape Drug Reference (MDR), by looking for answers to 80 different questions covering eight categories of drug information, including adverse drug events, dosages, and mechanism of action. The results are shown in the graph – more than 80% success with MDR but only 40% for Wikipedia.
None of the answers from Wikipedia were determined factually inaccurate, while they found four inaccurate answers in MDR. But the researchers found 48 errors of omission in the Wikipedia entries, compared to 14 for MDR.
Why are drug pages on Wikipedia so incomplete?
The answer to this was provided by the Digipharm audience. We found that only 18% of them had updated a Wikipedia drug page, and almost 90% of the pharmaceutical companies present had no policy or strategy to keep Wikipedia up to date:
Why doesn’t the industry do something?
To get to the bottom of this question we asked a few more, and the answers we got were quite encouraging.
First, the perception that Wikipedia is a free-for-all without any control is gradually being countered:
Second, we know (it seems) that neither industry regulation nor Wikipedia’s own rules preclude us from updating Wikipedia pages:
For example, the APBI Code says “reference material for prescription only medicines may be included on the Internet and be accessible by members of the public provided that they are not presented in such a way as to be promotional in nature”. What about Wikipedia itself? Here’s what the audience thought:
Wikipedia’s guidelines simply say you should “Avoid, or exercise great caution when editing articles related to your organisation, or its competitors, as well as projects and products they are involved with” and ensure you adhere to the guiding principles:
So, the industry code and Wikipedia guidance are consistent – content should be referenced, unbiased and non-promotional.
So why don’t we update pages about our drug products?
Maybe because there is still some uncertainty about accountability:
In fact Wikipedia has robust version controls and it can be clearly identified who has updated what. Provided you edit pages whilst logged-in, your edits can be attributed to you, but others are not. Furthermore, if a page is vandalized or inadvertently made inaccurate by another user, it is easy to revert to the accurate version in a couple of clicks, as a full page history is stored.
For an industry that is both information- and expertise-rich and comfortable with manuscripts written from an unbiased point of view with good citation, it seems an anomaly that we have not embraced this platform, a generally-considered-successful experiment in information democratization.
Perhaps, as one physician colleague said, it is because it is not “peer-reviewed”. But that depends who you consider your “peers” to be, doesn’t it?
This is a resource for everyone, so in this case everyone – doctors, patients, caregivers, the general public – are the peers. Wikipedia works as an encyclopaedia because generally people only update topics they are interested in and have some knowledge of. A patient’s contribution about a health condition, provided it is factual, is as valid as a physician’s.
Surely as an industry that values transparency, medical accuracy and high quality information standards we should be dealing with this dominant presence in the information landscape of all our customers?
In other words… can we at least acknowledge “The Elephant in the Room” and start talking about how to address it, in the interests of better patient care?
Last week’s PharmaBrand Summit in Monaco was attended by about 120 senior pharmaceutical industry experts from companies and agencies. This summit is about key trends in the market and how the industry is responding.
Over the 3 days, four themes kept surfacing – emerging markets, the opportunity of digital to engage consumers, the importance of the payer and the need for a different mindset.
Right from the Chair’s (Ashish Pal from Merck) keynote the importance of emerging markets was clear. 90% of the growth in the next 10 years will come from EMs, with infectious diseases and women’s health (contraception) among some key growth areas. A panel discussion concluded that agility, adaptability (recognising that each market is different) and the willingness to appoint and develop local talent rather than parachute in ex-pats are vital.
Digital channels raised their head many times, especially with regard to engaging consumers and patients. I heard the phrase “awakening the European consumer” which, to be honest, I find a bit naive. European consumers (consumers everywhere) don’t need us to “awaken” them – they are very much awake and active with or without us! There was also a tendency to say “there’s not much we can do in social media because we can’t promote to consumers” as if “promotion” were the only possible way to communicate with people. That is a mentality we need to leave behind. More on this shortly.
Payers were the focus of day 2 with Janice Haigh of Astellas Pharma explaining “the Art and Science of Payer Marketing” and my colleagues from ConsultComplete, Ian Pickles and Zoe Gilbe, sharing some interesting Payer insight work, showing that healthcare models are converging, with all markets looking at co-pay models, and the need for product positioning to encompass the needs of all stakeholder in an increasingly complex environment.
The pharmaceutical industry game has changed and we must change too. There was discussion about bringing more people in from outside the industry, and changing our mindset. I enjoyed Gregory Miller’s (UCB Pharma) session. He has “commercial advisory boards” drawn from experts in OTHER industries to bring a fresh perspective. For example for a persistence issue in epilepsy he has invited people from other sectors where customer relationships and loyalty are paramount – like WeightWatchers, Nokia, Hertz, Miles&More – to be his ad board. So far implementing the learning from these ad boards has generated real results in terms of market share.
A wonderful example of a different mindset, using skills from beyond our industry to think differently and using multiple channels to engage consumers for positive results was Pfizer’s ground-breaking “Get real, Get a prescription” campaign, led by Andy Widger (ex-BBC).
This campaign’s goal was to reduce the sale of counterfeit medicines on the internet. It was executed using a number of channels including outdoor (actors dressed as builders mixing “drugs” in a cement mixer), print and the famous shocking “rat-poison” video that was shown in cinemas and late-night TV and has since gone global virally on YouTube and elsewhere. The campaign generated a great deal of press coverage, was supported by the MHRA, the Royal Pharmaceutical Society, Heart UK and the Patients Association.
There is evidence that over 5000 people in the UK are now not buying fake medicines that previously were – a small number but it’s a start. There are now moves to take the campaign global.
As a result of this program, Pfizer’s reputation has improved with the professional bodies involved – they are not sure about impact on the general public’s perception yet. This is a great example of using consumer channels to improve medicine, to support customers and to enhance the industry’s own reputation. Hats off to Andy and his team.
Overall it was an interesting couple of days and I met a good many global pharma leaders who are looking at changing how we do business. Very refreshing. If you were there, what did you think?
Now we’ve got over the whole “do doctors use the internet” thing (see post 1 in this series) we are asking “do doctor’s really use social media?”. Well according to Meredith Ressi from Manhattan Research, 74% of doctors in the EU use social networks, blogs and discussion forums, most of them “lurking” (reading but not contributing). This is higher than in the US.
Facebook, approaching 400 million users, is bigger than the US in terms of population – is it really viable not to have a strategy here? In every field of endeavour we know that “people like me” have the most influence over our decision making. This is the power of social media, but we haven’t fully figured it out yet. Some pharma companies have launched pages, but the company-owned pages do not allow the public to post messages – they are broadcast, not conversation, even though some (e.g. Pfizer) are offering useful information.
The main reason pharma is not engaging fully in the conversation is the regulatory environment. An interesting panel discussion on this topic highlighted the issues – the risks of adverse event reporting, off-label promotion, inappropriate promotion to consumers, etc. The world is waiting for the FDA to proclaim its findings from the social media hearings last September but, as Silja Chouquet pointed out, patients were the least represented there; it was primarily vendors and the pharma industry. The patients are finding the information they want and having the conversations they want to have anyway, without “permission” from the FDA or anyone else.
Silja and Emma D’Arcy were social media experts who challenged our thinking, both in the panel and their own presentations, especially with regard to consumers’ use of social networks. Emma called social media “mighty media” and recommended a pharma strategy (for now) of “listen, listen, listen”. She echoed my own comment that “social media is a mindset, not a toolset”.
Silja described the emergence of new “tribal leaders” in social health media – expert patients such as @sixuntilme, @jangeissler and @ePatientDave who have taken control of their own health choices and become international leaders and gurus for others with similar challenges.
I spoke of one pharma company that has a strategy of spending time with health bloggers, professionals, patients and carers to help shape opinion in a particular disease area. The fact is that many healthcare thought leaders are not yet joining the online debate even if they are reading it. How can we encourage those with knowledge to share it responsibly with those who need it?
Is social media such a dangerous place for pharma? Len Starnes reminded us of my fellow-blogger Jon Richman’s Social Media Wiki – an excellent collection of social media projects from the pharmaceutical industry, with patients, physicians and other stakeholders. Over 300 of them, and according to Jon, not one has received a complaint.
Sometimes we can employ social tools without “conversation” as such. In my own presentation I asked if we could produce content so engaging, funny, shocking or original that it would become viral, and reach a large audience through sharing. I referred to some favourite viral videos of my own. Check out (if you haven’t already) Piano Stairs, the Coke Happiness Machine or Extreme LED Sheep Art. Many of them do not even mention the brand they are promoting in the video itself. Some have reached millions, but will have had the most impact where the key amplifier of “relevance” is present.
Next time I’ll share my own presentation, and hopefully the video, complete with live examples of “bad marketing”….
Delegates from last year’s eyeforpharma eMarketing Europe had indicated that more insight into the thinking of regulators would be very helpful, so Heather Simmonds of the UK’s Prescriptions Code of Practice Authority bravely took the stage to discuss the changing landscape, both in the UK and across Europe.
The very different interpretations of what constitutes “promotion to patients” by different countries does not help companies trying to establish a European strategy. France and Germany consider the mention of a drug name to be “promotion” whereas the UK guidelines allow and even encourage companies to provide “reference information” i.e. factual information about medicines, to consumers, provided it is balanced, accurate and not misleading (check out clause 24 of the ABPI Code of Practice 2008). She observed that in the UK many pharma marketers are currently not doing what they are allowed to do within the code, so why ask for codes to be broadened?
Consequently different countries are reacting differently to the proposed European Directive on information to the public about prescription only medicines – effectively this will relax the rules in some countries and tighten them in others.
The codes in many cases are already in place and just need to be interpreted for online. For example, information you can provide in a closed meeting to doctors can probably be provided in a closed website to doctors.
It only becomes an issue when the translation is not direct – for example, a passing question and answer in conversation, becomes a permanent record when written in a forum or blog – and as soon as that permanence is established it must be treated as a document and comply with the relevant code of practice.
Context is also important: a piece of patient information in one context might be balanced and neutral, but choosing a phrase from that information and displaying it differently might be deemed promotional.
Heather’s plea was to involve the regulators. They want to help us achieve goals of better medical education and healthcare and the discussion can be about not “can we or can’t we?” but “how can we?”
Notwithstanding this debate, the question still stands: in a global channel, if a piece of content is for a “global audience” whose national rules apply? It is not practical to consult every code in the world just in case a citizen of that jurisdiction comes across the content. Further, during a panel discussion, Silja Chouquet of Whydot.com asked “Who has lied about being from the US to gain access to one of their consumer websites?” A handful of hands stayed down – the US delegates, of course.
In my last post I talked about providing good customer service being of paramount importance. The first, most obvious way to serve your customer is to give them what they want when they ask for it. These days we “ask” with Google, and as Jens Monsees of Google Germany pointed out, if you’re not there when they Google you, you’re product is not “on the shelf” so why should they buy you?
Aaron Uydess spoke his usual customer-focused sense and had a nice chart mapping customer needs against business needs, and recognising that we should focus our online services in the sweet spot where customer needs and business needs intersect. It is possible – we have content we want to share and we can organise it in ways that HCPs want to access it. Aaron encouraged us to “do small things and do them really well”. For example, offering a service to doctors so that they can download useful patient content and email it to their patients as a service from themselves. This is just one of the offerings of the NovoMedlink portal, that allows users to rate content and share it with colleagues.
Laurence Sherman (@meducate) of Prova Education pointed out in characteristic pithy style that in digital education as in all online communication, we have to be interactive, entertaining and engaging. It is not sufficient to expect doctors to read text documents online. He asserted that we can offer relevant eCME at the point of care that can stimulate better clinical practice. He also told us that finally the EACCME (the European Accreditation Council for Continuing Medical Education) has indicated it is providing credits for online CME in Europe. (Ironically enough the EACCME’s own website looks like someone has hit “save as HTML” on a Word document…happy to lend a hand if you like, folks).
Given that 1.5bn people the world over use search (mostly Google), and that health topics still rank highly (Peaks in 2009? “Swine flu” was second only to “Michael Jackson”), regardless of whether you engage in social media or not, you should most certainly (said Jens Monsees) sort out your Google profile. Get your digital assets in order (by which I think he meant build a good site), search engine optimise it and, for the places you can’t compete organically, buy Google keywords. Pretty basic stuff. But still important. As far as doctors and patients are concerned, this is still MUCH more important in terms of sheer visibility than social networks. But watch this space.
Just as other industries have been forced by customer attitudes, commoditised products and squeezing margins to focus on the customer needs instead of product features, so pharma must now. And digital channels mean our customers are butterflies: alternative content, messages, relationships are just a click away. We have to deliver REALLY excellent service if customers are going to want to deal with us. Digital is, in fact, making us better service providers.
So at eyeforpharma we heard a great deal about simply delivering what people want. We are not satisfied with our efforts yet – 68% of the audience said that the pharmaceutical industry does not generally provide good customer service.
Kate Wagstaff of Ferring described providing clinical paper summaries for GPs on a GP portal once the sales force had been withdrawn from the product, Desmomelt. This simple service increased intent to prescribe from 28 to 79%.
Tom Pryzgoda and Tony Bondi of Abbott showed us several great examples of services to patients. One that stuck in my mind was the “cool, edgy” iPhone app for young Chron’s disease patients, helpfully showing the location (and as I recall, the quality) of public toilets in the local area – the app is called, naturally, flushit.
Irina Osovskaya of Janssen- Cilag pointed out that we’ve gone from “information overload” to “interaction overload”. For Concerta they have constructed an award-winning multi-channel campaign in ADHD – from disease awareness website to sales aid. Irina also quoted Ian Maclaurin, Chairman of Tesco (often cited as a best-practice customer retention story): “Customer loyalty is not about how customers demonstrate their loyalty to us, it is about how we demonstrate our loyalty to them.”
More tomorrow on getting the basics right in delivering good digital customer service.
Meanwhile, at eyeforpharma for a bit of light relief we had a little game to steer your brand through digital marketing decision-making. It’s now online so you might like to play Brand Bunny. Enjoy!
With nearly 300 other pharma marketers and communicators I turned up in a chilly Berlin last week to attend eyeforpharma’s 5th Annual eMarketing Europe Summit. There was a cautiously optimistic mood about the place, a sense that we’ve moved from “should we?” to “how shall we?” on a number of fronts. There was a mixture of pharma company and vendor presentations of varying originality and interest, but all in all I learnt some stuff and met some very interesting people.
Here are my top 5 take-aways:
Pharma companies are now (finally) serious about digital.
Customer Service has arrived.
The basics are still important
Regulators don’t always say No
Social media, vital and impossible?
I’ll post my five top take-aways over the next few days, as well as sharing some other bits and pieces from the event. Check out the Twitter hashtag #efp to see all the comments from the two days.
Take-away 1:Pharma companies are now (finally) serious – digital is a global strategic imperative.
Does anyone else feel a sense of déjà vu? In the late nineties/early 2000s many pharmaceutical companies recognised the potential of “eMarketing” and hired eMarketing leaders from “outside” and built central teams to rollout this new sales panacea. These leaders (yours truly included) did some pilots, demonstrated ROI (sometimes) put up some (good and bad) websites, moved to other jobs.
Times became tougher, eMarketing was not yet running through the veins of the organisation and these large central teams were ‘quick wins’ when cutbacks were required. We rationalised this by saying that eMarketing was part of all marketing now, we didn’t need specialised teams. Did we?
Then we watched our customers moving ahead without us, comfortable in their networked, hyperlinked world, with new channels emerging every day. Paralysed and without rules of engagement, we gradually lost control of the message, the channels, the conversation. We looked on in dismay, and then…
At eyeforpharma it was evident that in the last couple of years the forward-thinking companies have decided it is untenable for every brand in every country to work out this plethora of channels and conversations alone.
Two types of global organisation have emerged – the global digital strategy team, working across brands at a European or worldwide level, developing those rules of engagement, this time with the (apparent) support of a leadership that recognises that the game has changed.
The second is the global delivery team, what Garrett Dalton from Roche called his “in-house agency”, finding economies of scale in building best-practice delivery platforms, tools and templates, that can be used across brands and geographies. The way to get affiliates to use the central service? Make it very good: Garrett has 95% satisfaction ratings within the company.
Interestingly those that have a global strategy team, by and large, also have a global delivery team.
Pete West of Pfizer demonstrated how his regional eMarketing platform has created a presence for his brand Tygacil based on the needs of affiliates who did not have the means or expertise to build it themselves. He showed how integrating this with other customer touchpoints such as meetings, emails and rep visits created more interactions with his key messages, increasing intent-to-prescribe from 28 to 41%.
Real, strategic investment in platforms, capabilities and digital best practice – that’s more like it!
Soon, we might even soon stop asking if doctors are using the internet. As I commented in my own talk, can we get over it please? Doctors are people, aren’t they? They use the phone, they drive cars, they use the internet. Is it time for Manhattan to drop that “docs online” statistic from its otherwise-very-useful Taking the Pulse report? I think so. Let’s move on.
Shouldn’t you worry about Web 2.0, when that means all your customers are talking and gossiping and complaining about your brand/company, without anyone listening/checking/correcting them? What’s going on? Aren’t all the experts telling us that reputations are built and destroyed in these places and we should be paying $£€millions for a Social Media Strategy?
Well, my point is this: Web 1.0 is still there and is probably more important right now if your target audience is physicians.
Remember, the read-only Web? The look-for-information-and-if-the-brand-is-doing-its-job-right-you’ll-find-it-Web?
Google your brand/clinical trial/therapy area. Now Google it in each of your major country markets…What do you see?
An out-of-date Wikipedia page?
An ad/page from an alternative therapist telling you you don’t need your brand?
An ad/page from a Law firm offering to help you sue your company?
A competitor’s ad?
What should you see?
Your (local language) home page, giving useful information and services about your medicine for each audience or stakeholder, perhaps?
If doctors, payers, patients, providers, journalists or anyone else wants to know about clinical trials or drug therapies, what do you think they do?
That’s right, 90%+ of them Google it. That’s it. And if they don’t get good service from you at this point – at this “request for information” interaction, what do you think they think of you?
In FMCG terms, if you’re not in the top 10 (some would say the top 3), you’re not “on the shelf”. Why should I buy your product if you can’t be bothered to put it on the shelf?
The healthcare professionals we speak to (mainly specialists) say that they are at the “dabbling” stage in social media but boy, do they want information to be on hand when they need it. Almost every one of them says – “I just want a one-stop shop where I can go and find out all I need to know about the therapy area or drug I’m interested in”. Pharma has that content, and we should provide it. Simple.
Here’s a non-pharma example. I Googled “budget accommodation near Heathrow” and this was the top sponsored link:
Click through and enter “Heathrow” (not sure why I had to do that), and I get:
3 clicks later (no use of the back button or need to use a site menu or map) and I’m at “Complete Booking”. Total elapsed time: 23 seconds.
The Travelodge team have mapped the likely customer journey, and figured out how to get from Google search to satisfied customer as fast as possible.
A near-perfect online service. Do I recommend the Travelodge product? Of course.
Do it. It’s easy – just get your brand/therapy area content online:
Map the customer journey, figure out what your customers want and how to give it to them on a good old-fashioned website.
Deliver high quality, engaging, informative, relevant, interactive content and services.
Optimise the site for search engines.
Promote it to your target audience.
Keep it up-to-date. THIS is your primary “conversation” with your customers. This is the conversation you have when they have come to visit you – be polite, get it right, give them what they want and need right here before you go out to meet them in social networks or anywhere else. If you do a good job of it, they’ll come back and visit again and be your friend.
The media have spent a week or three looking at the ‘noughties’ and marvelling at how far we’ve come, but we ain’t seen nothin’ yet in the digital revolution.
There are massive changes happening in our society, relationships with corporations and governments are shifting in ways never seen before, ordinary people have a voice in their community that they last had in feudal times…the difference is that today, the ‘community’ is global. We have moved from the ‘information age’ to the ‘interaction age’. The human need for a voice is the driving force, but there can be no doubt that digital is the key enabler.
I wonder what Medical Communications and Pharma Marketing will look like in 2020?
Here are a few thoughts. What do you think?
The Pharmaceutical industry will spend 90% of its marketing communications budget on digital channels and 10% on face-to-face channels.
Physicians will have, at their fingertips, on their phone/camera/handheld device, all the clinical evidence for any drug, and diagnostic/prescribing decision-tools for the majority of clinical situations.
Medical education will be delivered in a multi-media format (sound/video/animation/game) and will most often be consumed in healthcare professionals’ living rooms or home offices. The hardware will be televisions (which will be computers, and vice versa).
Each major disease area will have a global online community of stakeholders (HCPs, carers, providers, patients) who will drive decision-making in that therapy area.
It will be the norm for the pharmaceutical industry to deliver “whole products” not just medicines. These will include services and information to add value and deliver better patient outcomes.
Sales stories in pharma will be based on patient benefit (outcomes) rather than product features (efficacy/safety). Clinical evidence to support these stories will be well-developed and readily available in a variety of formats and media.
Thought-leadership in healthcare will be created online, through blogs, microblogs and social networks – and their descendents.
International medical meetings will still happen, but more than 90% of the content consumption from these meetings will happen remotely and digitally.
Pharma companies will have a seamless, integrated relationship with each customer – a single relationship from clinical to commercial, global to local, brand to brand.
The general public will see the pharmaceutical industry in a positive light as an important player in improving human health.
A little aspirational, perhaps, but all (and more) are achievable. Pretty exciting stuff. It gets me out of bed each day, anyway.
One thing that irks me a little is that when I Google my name (go on, admit it, you’ve done it too) the number one result is not me, but another Kay Wesley from London. The “other Kay” is a homeopathic practitioner, whereas much of my working life has been spent in the “traditional” healthcare arena of prescription medicines and the organisations that produce them.
I’ve often observed the apparent freedom with which homeopathic remedies (presumably because not classed as “drugs”) can be promoted to the public in all countries, where drug advertising is outlawed or very limited.
This creates a very skewed picture for the patient who is Googling their condition. If I search for “cancer cure” for example, in addition to a number of sponsored links for cancer charities, the other paid links are all for “alternative” (i.e. not clinically-proven in the generally-accepted sense) treatments. They promise a great deal (NB: None are from my namesake’s responsible website!):
“..start you on a road of recovery to restore your health”
“..defeat this deadly disease”
“an alternative treatment that works”
“drugs and natural agents in low, non-toxic doses”
(This last presumably means so dilute they have no effect on the body chemistry at all…) They all, incidentally, also have very small print of at the bottom saying the equivalent of “I am not a doctor and the FDA has not approved the contents of this website”.
Cancer patients and their carers and friends are among the most proactive in seeking for help and support from any source they can, and we know that Googling “cancer cure” is likely to be one the first things they do after diagnosis.
There were no sponsored links I could see from any reputable pharma companies or their brands. Novartis, Roche, Pfizer, AstraZeneca, all the great oncology franchises are notable by their absence. Why? For all these companies (and their peers), positive outcomes for patients are their top priority:
“Novartis puts patients first”.
AstraZeneca: “We…improve the health and quality of life of patients around the world”
Pfizer “Working together for a healthier world”
Roche: “we make a difference to patients with cancer every single day”
Some of these statements seem a just a bit hollow when we are not providing any front-line support services through patients’ and carers’ chosen information channel (Google) for their chosen search term “cancer cure”. I think we all know why this is. How can you put a sponsored link on Google responding to the search phrase “cancer cure”? The word “cure” is itself generally not usable in the context of clinical evidence.
This is one example of “I can’t” that does not serve patients’ needs. There are others. Most of them seem to be connected to the legal and regulatory constraints on drug advertising and promotion.
This area is a quagmire of problems. In a global channel, what country’s regulations apply? Do you need to get approval from every English-speaking market for global content in English? How do we know if it is a patient, a provider, a healthcare professional (yes they Google too) searching and clicking our link?
Too often brand teams’ (or their medical ethics/regulatory departments’) response to all this is to do nothing – “I can’t”. Agencies, meanwhile, come up with lots of innovative ideas and then, when regulatory questions arise, we bat the ball firmly into the client’s court. Often the final programme is a very watered down version of the original idea, of limited value to patients.
But if we are going to provide the service to patients we promise, we have to work together to find a better way. We can provide disease information and support for patients in all countries. In many countries, when a patient has already been prescribed your drug you can offer them additional services related to managing their condition. The IFPMA indeed encourages this, although not covering “direct to consumer” advertising, “IFPMA and its members are committed to educational and promotional efforts that benefit patients”.
I suggest that provided we take reasonable steps to ensure content is delivered to the right audiences we are practicing legitimately. There is nothing to stop a patient buying a copy of a medical magazine, after all, but it is OK to advertise drugs in there because it targets doctors. Similarly you can have a Google ad link that says “Oncology information for Healthcare Professionals” and target HCP-type-keywords with it.
What about the “cancer cure” keywords? Oncology franchises can offer information and support to patients about cancers and their therapies, I suggest, including responding to this search term, but without offering “cure”.
But, offer nothing? That is not living up to our promise of “putting patients first” or promoting a “healthier world”, is it? At last many across the industry are starting to figure out how we can do a better job of this. There are some wonderful examples of content and services freely available online, such as http://psoriasisthenakedtruth.com(Wyeth), www.cfvoice.com (Novartis) , www.childrenwithdiabetes.com (Johnson & Johnson).
There is much more than can be done in meeting the needs of patients, carers and healthcare professionals with relevant, good quality services and information when and where they need it. Developing and sharing good practice will be important as we move forward. Saying “I can’t” isn’t an option any more.
This week I attended @jeffpulver‘s 140Conf in London. It was a one-day event dedicated to Twitter, as the name implies.
The day consisted of 35 short sharp presentations, with presenters hurried off the stage to loud music at the end of their 10 or 15 minute slot. There were advantages and disadvantages to this format. On the one hand, you got to hear a lot of different examples and didn’t get bored. On the negative side, some of the sessions (such as panel discussions) were not able to go into sufficent depth to tease out some of the issues people had faced and how they had dealt with them.
The whole thing was enriched by guest speaker Stephen Fry (@stephenfry) in his usual witty and engaging style, concluding that this Twitter thing is “not business-shaped or technology-shaped, it is human-shaped”.
In short, my bottom-line takeaways were
1. An incredible number of useful applications of Twitter are out there, from the Police to flower shops to X Factor.
2. Everyone is learning as they go along, there is no established best-practice, just a lot of people who have tried stuff and succeeded or failed.
3. Where is the phenomenen going? We don’t know.
I am grateful to J P Rangaswarmi (@jobsworth) and Jeffrey Hayzlett (@jeffreyhayzlett), because they gave us, respectively, the 3’A’sand the 4 ‘E’s of Twitter. Something to do with the way my mind works, I like these alliterative lists of things. Here they are with some examples from the event and beyond:
What is Twitter for? The 3 ‘A’s – Alerts, Advice and Assistance
Alerts – a great example of this is #iranelection (thanks @mazi) – the world learned what was really happening in Iran’s general election first through Twitter, resulting in a huge freedom movement personified by Neda, the girl shot by police, becoming a global symbol of the voice of freedom.
Advice – a fun example from @jobsworth who asked “how do I rescue the hamster from under the floorboards” and got the answer very quickly from Twitter (broccoli and a knitted tie, apparently). Could he have got that from Google? I don’t think so.
Assistance – BT, the UK telecoms group(@BTCare) tracks the twittersphere for their customers complaining and steps in with “how can I help you”? and yes, actually solves problems (thanks @wiggled)
What should we be doing withTwitter? The 4 ‘E’ s: Engage, Excite, Educate and Evangelise
Engage – for example, Radio 1 in the UK – the presenters themselves (e.g. @Fearnecotton) Tweet, as themselves, not as “Radio 1”. They get very high levels of engagement – more requests come through Twitter than email. (Thanks, @raypaulbbc)
Excite – a great example from @jeffreyhayzlett – Kodak wanted to rename the Zi8 pocket video camera, so they ran a Twitter contest. Thousands of responses were received and a new name (soon to be launched) was chosen. I leave you to imagine the relative cost of this exercise versus traditional brand-naming technques.
Educate – this is nearly always us being educated by our customers, not the other way round. For example – the mental health charity Rethink Tweeted that the Sun Newspaper had published an inappropriate headline “Fury at escape of killer schizo”. Within days of a Twitter-led online protest the Sun revised the headline.
Evangelise – a lovely example of this from the 3 young men of @buyacredit. These moviemakers need to raise £1 million to make their film, so they have launched a website and Twitter account asking people to pay £1 towards the movie in order to get their name in the end credits. It was picked up by @stephenfry (who else?) and thence passed through on to other influencers in the entertainment and movie world. They have recently met Gordon Brown and appeared on UK national TV, and are well on the way to their target.
How does all this apply to healthcare? Well, healthcare is the most networked market of all, with doctors, patients, carers, nurses, policymakers and others in the mix. Further, it is an information-rich environment, with some players (such as pharma companies) in possession of a great deal of information and others wanting and needing information. It is also a field that is continually changing, with new information coming up all the time. This must be a field where Alerts, Assistance and Advice are required all the time.
It’s our job to figure out the best way to do this. Sadly, so far our efforts have not been very inspiring. The few pharma-sponsored healthcare Twitterers (such as @racewithinsulin) out there are providing information, but are they really exciting and engaging us? By and large, they feel like a monologue rather than a conversation.
We all know why this is – we don’t yet know the “rules”, we are in a difficult legal and regulatory debate, but we just have to figure it out. The conversation is happening, whether we are in it or not. “Twitter is like a freight train, you either get on it or you get hit by it” (@lawscomm). The FDA conclusions from the recent public hearings may help, but this is still going to be a moving feast and we can’t wait for it to stop moving while someone writes the rule book – it ain’t going to happen. How difficult can it be to engage customers, listen to them and discuss important healthcare issues – isn’t that what pharma has always done?
To help us think about this I’ve distilled some key learnings from @140Conf into my very own alliterative list.
5 Twitter Tips (Twips):
Tips: Share useful informatin versus your own promotion in a ratio of 10:1.
Tone: if you wouldn’t say it in print/on air/to my face, don’t say it in Twitter.
Talk: Listen to, respond and retweet others, this is a conversation not a broadcast.
True: Be yourself, not your brand. Don’t use those automatic direct messages! Really talk to me.
Topical: Look at trending topics and, where relevant, join in the discussion .
I discovered (through our Tweets of course) that my colleague at CMG Mike White (@Mike2U) was at @140Conf too so we hooked up and had a good day together, and came home with lots of ideas we might apply to client projects.
Were you there? What were your takeaways?
You can find out more about the event at 140Conf .