E-Pharma Summit Day 1: All Roads Lead to the Internet

What’s the definition of insanity? Isn’t it doing the same thing over and over and expecting a different result?

That was Day 1, e-Pharma Summit. There was talk of innovation, blogs to watch, how to engage with Web 2.0…all seemingly okay, and quite reasonable-sounding … unless you had heard it for the last two years.

Pharma as an industry "gets" the Internet. The room was stocked with really smart, forward-looking folks. Research, metrics, couponing, CPA, ROI, ROMO (Return on Marketing Objective), quant, qual…all plain to the eye. Paul Ivans (www.evolutionroad.com) ran a good event. But it often had more of a Shriner’s feeling than a typical pharma event — which was to his credit. Yes, it lacked case studies, but it was full of ideas and given the dramatic increase in size from last year to this, perhaps more converts exist now about the simple fact: for health, the end of all roads does not lead to the doctor, it leads to the Internet.

But it was still a little disheartening. For all the talk of innovation, attending the conference was like watching people try to sprint in a potato sack race — it looks like a race, seems like a race, but everyone is hobbled and going way too slow.

Nevertheless, there were good moments and insightful observations. To name a few:

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The Internet is about connecting, and we still do a poor job of connecing to patients. Pharma needs some practical advice, and only one person, a gentleman from Digitas Health, actually had a SOP for how pharma could engage and connect and innovate with blogs despite the fears of Adverse Event Reporting.

Another excellent use of the Internet was the Novartis YouTube influenza Fluflix videos  campaign. As you’re no doubt aware, in this campaign, users create and upload videos dealing with their feelings about the flu. The response was impressive, and Novartis showcased some really creative, innovative videos. That was the most innovative idea yet.

Maybe the smartest observation was from Katheleen O’Neal, of Merck. She said the industry was at the same stage as IBM was 10 years ago with Small Business Solutions. Boy, was she right, and I know so because I worked on the CRM campaigns that supported what was a total re-positioning of IBM from its top 300 clients to embrace mid and small-size businesses.

What did I learn from that work?

That when serving a customer through the "e" channel, nothing is linear, and everything is circular.

Okay, let me explain. Pharma, for the most part, still takes a "push-pill-to-person" approach.  Even if the dressing is creative and evocative, the fact is, the path is linear. (Only Rozerem, http://www.rozerem.com/consumer/home.aspx broke that model by using dream imagery in their "Your Dreams Miss You" campaign starring Abraham Lincoln and a talking beaver.)  In the same way, most Pharma/Biotech e-CRM speaks to patient stage

This is important yes, but it’s also a one-dimensional approach and too linear: it assumes that the immediate need is the only need. IBM figured out — and not overnight nor easily — how to integrate channels, call center included, around two key communications objectives: (1)relevance and (2) action. The relevance objective took a bullseye/circular approach to content, by being both direct and indirect. For action, the cardinal rule was: NEVER let the visitor go without surrounding the content with some next step, deeper engagement, all sorts of actions which led to more time with the brand.

An example: if you were a small to midsize business customer, and spoke to IBM  at the call center, they’d send a follow-up email with a link to a custom micro-site with content directly relevant to your discussion — if you had a server, here’s FAQ’s, and a PDF on maintaining them. They’d always surrounded that directly relevant content with potential cross-sell and upselll content, which was delivered with attendant actions. As a whole, then, the customer is presented with an environment consisting of the relevance bullseye and the surrounding action circles. For Pharma/Biotech, perhaps the bullseye is using treatment stage as a way to sort people, but then to move beyond that immediate need and surround it with content and interactvie rich experience circles that set clear patient expectations of what to do next.

The ultimate theory was that you always serve what the customer asks for (bullseye), but  you also service what might also open them up to something more (surrounding targets). IBM’s customers responded to this approach quite well. More cross-selling, more contract renewals…yes, it was B2B, but there was always only one individual seeing that Web experience at a time. We were still selling to people. 

The IBM approach requires integrating channels, treating them like a dance where a consumer moves back and forth between media at will. The IBM story was using both mass media and CRM to repositioning lines of products and services. For Pharma/Biotech, the path to Righteousness and increased profits: Adherence. CRM and DTC could do that for us,too.

Vy-ctim Mentality

Christine Truelove had a good roundup of opinions on the Vytorin issue. But what I saw? Media Gods and Drug Industry — monoliths each. This week, with the Vytorin Enhance Study being revealed, another feeding frenzy began. Yes, the study raises many disturbing issues, but today I saw the answer, yes, THE answer for the industry and how first and foremost, we (agencies, clients alike) need to start speaking to patients, not at them.

The answer? Read Gary Taubes NYT Op-Ed on Vytorin http://www.nytimes.com/2008/01/27/opinion/27taubes.html?ref=opinion

But before I tell you why, let’s take a slight detour…

A journalist called me for a quote on the controversy — but then he surprised me by trying to couple it to the does-Dr. Jarvik-take-Lipitor news story. I was all ready to share my thoughts on what I thought Vyrtorin/Merck/SP should do — but I started to laugh. Dr Jarvik and Vytorin? Now we HAVE lost our minds. But then I realized that for this journalist, these were all the same example that further demonstrated the sleaziness of Big Pharma. It all smacks of a culture of consirpacy to bamboozle the American Public.

I told him that Dr Jarvik and Vytorin were two different issues entirely. I would not comment on them jointly; I suggested that he weigh which was worse — Dr Jarvik possibly not taking Lipitor himself, or Dr Phil betraying Brittany Spears. Can we move on, please?  Have you ever seen such a blatant level of distrust — no, it’s worse: it is NEED to distrust.

One of the greatest challenges for the entire pharmaceutical/biotech industry is "authenticity." Some would say that the issue is trust, or the lack thereof; and a few years ago when I worked as a strategist on Pfizer for Living, I was of that same mindset; unbranded content could help regain the lost trust. But one line kept going over and ver in my head: trust is earned. So the issue of HOW we earn it is what we should be talking about. and given the Boogeyman role the Media Gods have presecribed for pharma, we will never — yes, that is right — never create a trusted role, at best we may re-gain some grudging respect as the scienctists and pioneers that drive the industry, but the fact is, it is a distraction. (Bob Erhlich had a good post, though he seemed more like a therapist than an editor. http://dtcperspectives.com/blog/ )

Authenticity is a challenge for the industry, because it is not something achieved through quantification nor is there some methodology to get our communications to a place where they actually speak to people, not at them.

It comes down to transparent, personally authored patient education. But not the kind of condition unbranded education we often see, and myself have helped create, but truly broad education that takes into account people’s Learning Styles, lack of knowledge about their own bodies, to name a few ingrediants. I mean education that understands that despite the all-hallowed relationship between the doctor and patient, the reality of lack of time together makes it time we use tools like CRM to augment the knowledge that a patient might get from a longer appointment.

But I digress. Why is that OP-Ed important? He made sense, he gave context, and took the time and language to inform and educate, but not preach. He treated the readers like adults, not pawns in the game of the Media Gods and the Pharma Monolith.

Patient Power Study Tells Us What Patients Want — But Is Anyone Listening?

Ryan TrueHealth, working with our Insights Group, recenlty completed a quantatative study called the Patient Power Study. The point of the study was to figure out what sources people use,and trust and then why they do so, when making healthcare decisions. We kept it broad because we wanted to challenge a basic reality of pharma and biotech patient marketing: a focus on channels as siloes and one-dimensional communciations that focus on features/benefits, but not the real end-result of what a treatment can deliver — a richer life.

Our thesis: it is not about channel, it is about surrounding the patient, it is integrating channels using the right "influencers" to help move people along a decision continuum.

What did we learn from the study? Well, many things, a few surprising, a few not surprising — but the biggest of all, was that asking 10,000 patients across six disease states did not deliver major differences in their decision-making sources. It was as if the human condition trumped any specific medical condition.

So, patients tells they trust "Experts" first. Duh, one could say — but the reality is, that may be their best source, but it is also thier most dwindling source interms of time and effectiveness. Guideline Reports published a study (Summer 2007) that had physicians reporting they spend on average 4-8 minutes with a patient. And we all know that doctors have a sort-of script in their head for what they want to accomplish in that short time, and the patient may only recall half or less of what is said.

Second on the list of sources was "Peer/Spouse/Co-worker." Well, once again, the lack of time spent with doctors, the lack of trust towards medicines and the insecurity people feel towards side effects (i.e. Chantix…http://pharmalive.com/news/index.cfm?articleID=507027&categoryid=9&newsletter=1)and their hatred of feeling sick, all cascade naturally to creating a need for assurance from a someone like them.   

The need is clear; the gap is clear, but is anyone paying attention to the opportunity? From a Relationship Marketing perspective, brands should be focusing more budget and effort on acquisition into e-CRm programs that are tailored by patient stage and patient influencer — we call it e-PRM, Patient Medical Education and see it as using these expert and peer influencers to communicate what patients REALLY need to know (versus pushing what brands think they should know) to create more informed and empowered patients.

More on e-PRM in another posting. It just amazes me all the e-CRM programs we see that are text-heavy, brand-focused instead of patient-need focused and then really alck any Value Proposition for the patient to stay involved.

Here is the link to the press release from Reuters:

http://www.reuters.com/article/pressRelease/idUS145515+07-Jan-2008+PRN20080107

The Upside of Relationship Marketing: Not Rolling The Dice

There’s been a fair amount of controversy throughout the pharma blogosphere in the last few days about the revelation that Dr. Robert Jarvik, star of Pfizer’s Lipitor ads, is not actually a licensed, practicing physician. Blogs weighing in on this issue have included Pharma Blogosphere and John Mack’s Pharma Marketing Blog. At the time the Jarvik ads first appeared, they were a big deal because Jarvik was allegedly the first "real" doctor to be used in a pharma ad.

To us, this incident points up another major difference between relationship marketing and conventional DTC advertising, whether it’s for pharma or, for that matter, anything.

Stackofdice Using Jarvik is, basically, using a celebrity. This tactic, which is as old as adverting itself, can be very effective, but also comes with serious risks. A celebrity is a person, and people have the habit of doing very human things. This was beautifully illustrated in a terrific book on advertising with the somewhat unpolished title Hey, Whipple, Squeeze This!, by Luke Sullivan.

Obviously, Jarvik’s issues, or nonissues, are trivial, if they even exist. But they point out yet another benefit RM has over conventional DTC. RM does not rely on borrowed interest, or celebrities. It’s a direct, patient-centric communication between the pharma company and the customer.  There is never the risk that something may change in the celebrity’s image that will negatively affect your brand.

This happens more often than you’d think outside the pharma world. Think of Michael Jackson’s brief, unhappy, very expensive tenure representing Pepsi. Or O.J. Simpson. As the reach, sophistication and budget of DTC in pharma expands, this kind of thing will happen more and more often.

A lot of DTC is about the product, or the pharma company. RM is about the patient. Which makes all the difference, and often, prevents a lot of risk.