MedAdNews Interview

At the heart of being patient-centric is the notion that you need to cede control of your brand to some degree to the needs/wants/fears/wishes of your customer.

We did this Patient Power Study and asked a whole lot of people across several disease states whom they trusted when making a health care decision, and why.

http://www.pharmalive.com/extra/2008/oct08_patients.cfm

MedAd News decided to publicize the results this week.

I was so sure that the results of the HCL patient, and the high blood pressure patient would be in conflict with that of the RA patient. But boy was i wrong. They had hugely similar answers despite condition– and I learned then: the human condition trumps the disease condition. We also learned that lesson at an Adherence conference we led last fall — but that is another entry some other time.

The Phamalive link leads you to a top line results of the Study. But the point of the interview was the doctor/patient dialog. I hope someone out there finds it inspires them as we enter the brand planning season.

Trust and the Database

A long time ago in marketing years (which are like dog years) my agency built a website for BMW. Their response? "This is a great site to get people to re-lease their cars — now we can start shutting down our call center and save money." But it does not work that way –  people want more 'channels' not fewer. This constant demand  is the nature and challenge of operating a service model as a differentiator as well as a revenue driver.

When I think about these two components of great communciations, and especially the challenges of integrating them both into operations, I see two challenges that need to be conquered with equal focus, competence and budget: trust and the database. These two competencies require totally opposite talents to make them work — and to make them work together…? Well, that takes senior management that is really on the ball.

Number display Let's start with the database, which is the backbone of every marketing company. Cost controls, generics, bioequivalency and other forces, are finally nudging pharma and biotech companies from manufacturers to marketers. For a pharma company, having a database that is actively used is a major change. You must, as the ads say, think different. For example,  having a database means you need to know how you want to use it before you build it. (I've seen enterprise-wide database rebuilding, and it's ugly.)

And then, you bring in trust. The same pitiless rule of execution applies: really know the end you want in your patient communications before you start branding and writing headlines.  In this market, at this time, patients are desperately looking for someone to trust. Translating that to real-world organizations, that means service, and from the patient's point of view, not yours. It has to work for them. That means, for starters, that phones and Web sites and social media and suppport CRM all work together.

And it really gets interesting when you combine the database and trust issues. The data you want to collect requires trust; you need to be able to score, profile, develop models and manage campaigns. To gather that level of information, you'd better have a strong value proposition and value exchange– a real, solid, credible reason for asking for all this stuff.

In a perverse stroke of luck for we marketers, patients have really low expectations — they're used to extraordinarily bad "service" from pharma companies. But nonetheless, building trust is the currency of loyalty and both initial and continued sales — acquisition and adherence. People's needs are real: they want someone to make it plain and simple to understand…and if you can knock a few bucks off, that's even better. They want services that help them with the paperwork and insurance. Or they want to ask a question as it arises; GSK has this at the bottom of every page offering immediate call center service.

As we all have heard a thousand times, trust is earned. That means your operations need to be patient-centric in both the human voice (easy) and database (hard) to make this work and set yourself on the way to be a brand standard.  Even doctors see how well a company treats their patient (think aout MS, the most evolved patient support programs in existence).

So, even the BMW folks had their problem with "adherence." It's always starts with a good product, but it aleays ends on service — and the backbone (or the drivetrain, maybe) of serivce is a working healthy database.

The Uncertainty Opportunity

A post in Friday's DTC Perspective blog caught my eye, and I have been thinking about it for the past couple of days. What I've been thinking about specifically is the relationship between uncertainty and opportunity. The image I've been using to do this is a feral cat I know.

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A friend of mine has befriended a feral cat. She puts out scraps for it, and has created sort of a nest for it — a moving blanket inside a recycling box, that at least keeps the cat out of the wind and the rain. This animal is truly wild, and looks it — there has obviously never been a brush, for example, anywhere near her coat.

This cat, who my friend has given the completely unusual name of "Sweetie Pie" is especially interesting to watch as she eats. When the scraps are put out, she'll approach them, and then, at least three times, scan around for at least thirty seconds or a minute before finally putting her head down, briefly, to eat. She is clearly checking thoroughly to make sure that there isn't anything lurking out there, like a raccoon or a dog, that will surprise her. Because she's feral, she's developed a set of skills that domesticated cats don't have, and these skills are what have kept her alive for a long time in a pretty rough environment.

Sort of the same thing is happening in DTC. As the post points out:

Planning DTC efforts for the next few years has become an exercise in
multiple scenarios. First, we have the massive health care reform we
are promised by President Obama. Next, the expectation of declining
media rates makes the decision to buy upfront or wait for spot prices a
tough one. Third, the FDA is tinkering with risk disclosure
requirements making creative ads more difficult. Finally, promotional
budgets are getting cut as drug companies look to protect the profit
line.out, there is a lot of uncertainty and risk in the air surrounding DTC right now. Nobody's sure exactly what's going to happen.

The post then goes on to make the point that this uncertainty is an opportunity, in that it will reward pharma marketers who test and research how to reach consumers in different way, and who are forced to figure out how to achieve their results using whatever tools are available. It's sort of the marketers' version of the old Marine Corps slogan "Adapt, Improvise, Overcome".

This is an opportunity in two ways. First, it will just plain make you a better marketer. Business as usual is easy. Business in a dew way requires a lot more thought, work and insight, which you will be able to apply in the future. By creating more options now, you will augment your bag of tricks for later.

Second, and a little more strategically, this kind of adaption is something a lot of marketers can't do. They are too invested in the status qho to change, although they may pay it lip service. If they can't and you can, down the road, guess who wins. You do.

Tylenol gets the generics battle

Generics are always a major threat to a brand sales (DUH!) But unlike a few years back, instead of cutting off all marketing spending and simply giving in to the generic, we are beginning to see see that the potential profit in branded drugs for companies and ongoing quality concerns by patients make this a new area of patient communications. Branded drugs can, and are, defended against generics, and Tylenol is an example.

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J&J's Tylenol has been doing a lot of radio advertising lately, and it's all about how you should only trust Tylenol, not anything but. This is their "blunting" message on their Web site:

Some store-brand pain relievers think if you compare their medicine to TYLENOL® you'll buy the store brand. We think it depends on what you compare.

  • TYLENOL® has patented technology and clinical trials no store brand can match.
  • Doctors recommend TYLENOL® more than all generic pain relievers combined.
  • TYLENOL® works with your body in ways that have been trusted and proven for over 50 years.
  • TYLENOL® does not make any generic or store-brand pain relievers.

I think that is a pretty well-formed argument about why you should pay more. And few brands have a better cache of trust than Tylenol, so it is compelling. And that's just OTC. (A confession: I only buy branded Advil…why? I am not really sure, I just have this "feeling" it's better quality.)

For pharma, the clinical stakes are obviously much higher for Rx drugs than for OTC. Nobody takes Effexor because they have a cold and a headache. In Rx, there is the issue of bioequivalence between branded manufactured drugs and generic manufactured drugs. The example that came to mind this week was for anticonvulsants, like Keppra, having to compete with generics. In this case, it is the doctor who is reluctant to switch to a cheaper formulation due to concerns about quality of the generic as well as the overall disruptive potential involved in changing any anti-epileptic treatment.  Thisi ssue has also arisen in the general, consumer press — a recent article in Self magazine was entitled Bad Bargain: The Dangers of Generic Drugs. The title speaks for itself, and since women are typically the Chief Health Officer of the family household, this piece speaks directly to them.

This also holds true of biologics, anti-depressants, birth control, anti-psychotics, and a host of other serious drugs.

So, the issue is quality, and the marketing approach used by the pharma companies is seeding doubt about generics while enhancing trust in the branded drug. The biggest challenge in all of this is trust, the hardest marketing value there is. Creating trust requires much more than money. Trust is something you build, not something you buy. This is tough ground to cover, both from a credibility as well as from a legal perspective.  

A good strategy in this environment is the "king-of-the-hill" approach that ignoring the "other" creates doubt through confidence: "We're branded and proud of it. Don't doubt the quality. Don't doubt who made your drug and the standards involved in that." Stand proud! Accept no substitutes!" It's sort of a pharma marketing version of a Presidential Rose Garden strategy.

To pull this off, you need to once again surround the argument . You need to have other venues, and use actual people to vouch for your brand. Patients, doctors, nurses, caregivers — for the anticonvulsants all these voices are compelling and create a collective credibility that cannot be easily ignored with the "But I'm saving money" argument.

Since branded drugs can actually spend to make an argument supporting their superiority, they also need to use a level of tansparency. Taking from Tylenol, the first point they make is the rational argument that taps into the emotional doubt:

"TYLENOL® has patented technology and clinical trials no store brand can match."

Why not explain how your drug is made? Why not spend some time working with nurses and patients and some good copywriters to explain in human terms the clinical trial process, results and track record of your branded drug? Why not add a tab to your brand Web site "Brand X and Generics"?

It seems to me that as with so many issues arising for drug companies and their brands, the real challenge is being able to communicate in a human way that is educational, transparent, creative and engaging.Pharma companies need to get away from number- and outcome-driven marketing to awhat you can call "marketing with a human face." Imagine a flash-based MOA video that had a patient actually telling the story of your drug?  What about adding the photos of the team that took it to Phase III successfully? There is nothing dishonest, in fact, it is the opposite — an honest perspective on why you should trust the brand. True, you will never hold your entire share when facing a generic, but you probably can slow the attrition.