Does Biopharma “get” the role of caregiver? Do any of us really market to their needs? Ask 65 million people. (Part 1 of 2).

Summary: 65 million caregivers. Their role is often undefined, undeserved and undersupported. Are we as marketers, and as human beings, missing out on a key audience and the opportunity to engage with a key Influencer? Caregivers challenges are formidable — there must be ways to help. While this is an ever-growing part of the population, we as brand marketers in healthcare need them on our side — or rather, we need to be at their side!

Remember, when your branded treatment needs to be part of the conversation, a caregiver may be your best sales force! 

So, best advice: don’t reinvent the wheel. Check out the numerous existing resources (some examples in this post) before developing any strategy; look to partner for credibility and to tap into an already existing expertise. People are already doing it right: learn before you spend.

Let’s look at a recent study by AARP . In a recent study by AARP* titled “Valuing the Invaluable 2015 Update: Undeniable Progress but Big Gaps Remain”.

Here are some startling facts (with an infographic to add depth):

  • Family caregivers in the U.S. provided 37 billion hours of care
  • This is worth an estimated $470 billion—to their parents, spouses, partners, and other adult loved ones in 2013.
  • The total estimated economic value of this uncompensated care provided by the nation’s family caregivers surpassed total Medicaid spending ($449 billion), and nearly equaled the annual sales ($469 billion) of the four largest U.S. tech companies combined (Apple, Hewlett Packard, IBM, and Microsoft) in 2013.
  • 74% of workers at some point during their career provide care to a loved one.
  • Approximately 18% of caregivers say they are “highly strained” financially because of their care giving responsibilities.
  • 1 in 3 have no help at all, paid or unpaid, the report found.
  • In the U.S. alone, 65.7 million people provide care to an older adult.

Let’s not lose sight that these aren’t numbers, they’re humans. Armies of human beings, individuals, each with their own needs and story. This is what lies behind the numbers. Let’s use these infographic from 101 Mobility to show the burden of tasks and time:

What does this mean to marketers? First, if you are going to address and engage with the caregiver as a branded treatment, study all the current digital and offline resources available —,, even the BMS

More on what are good resources to research to help define your marketing strategy in Part 2 on Caregivers. (Part 2 later this week!)


Thank you to: Thank you to AARP for doing the good work we as a society need.

*AARP “Valuing the Invaluable” 2015 Report.

Does Biopharma “get” the role of caregiver? Do any of us really market to their needs? Ask 65 million people. (Part 1 of 2). was originally published on Harbinger Associates

Surprise! EHR’s are hurting not helping the doctor /patient relationship.

Summary: A healthy Patient-Doctor relationship is the core of all healthcare.  This reports on a JAMA* study as well as one brilliant doctors’ personal view on the impact of EHR’s on that hallowed relationship.

When JAMA publishes a study, everyone pays attention. But this was not a clinical study; this was research into the impact of EHR’s (Electronic Health Records) on the patient-doctor relationship. They videotaped numerous consults and them interviewed the patient afterward.

Guess what, the news is not good. (Especially for those Biopharma marketers looking at EHR’s as a new promotion channel: do you really want to annoy the doctor more by interrupting their work with a savings card?)

With the healthcare system was heading towards the abyss of being too costly, the Affordable Care Act was supposed to be the game-changer for nearly every aspect of the entire trillion dollar industry.  One mandate was for all patient records to become digital (and accessible). Incentives and punishments were created requiring doctors and hospitals to have Electronic Health Records as a means to more efficiently serve patient care, lower costs  and create Connected Health with inter-operable systems…a glorious vision of a healthcare system that is efficient and patient-centric.

Well, maybe not so patient-centric as the architects of the ACA believed. The collapse of the independent practice, the turnover of EHR’s, the bad User Experience, are all well known shortcomings.

JAMA looked at the reality of what “efficiency” really means to patient-centricity:

  • The researchers used data from encounters between 47 patients and 39 doctors at a public hospital between 2011 and 2013.
  • Doctors who entered data into computerized health records during patients’ appointments did less positive communicating, and patients rated their care excellent less often, in a recent study.
  • Doctors who used the computer more also spent more time correcting or disagreeing with patients.
  • Private practices, due to ACA, EHR and other burdens, have collapsed and been acquired in droves by large hospital networks (estimated under 30% remain private); in doing so, doctor’s are in the thrall of hospital guidelines and procedures…and no real influence on choice of EHR’s!

No wonder patients are unhappy! So are doctors! Doctors are trained to observe a patient, literally watch them closely as they speak and use their experience and observations to help in every part of their patient care. But EHR’s force them to break their training habits– type in their laptop, look up-and-down, asking the usual questions and perhaps miss the visual cues they were trained to catch.

The famous ZDoggMD  created a YouTube video just asking: “Let doctors be doctors!”  This is a witty and worthy  commentary from a doctor who is trying to bring a doctor-centric view of fixing medicine. PLEASE watch his video.

Clearly, the ACA/EHR boulder is rolling downhill at it’s own speed and regulatory-demands. Perhaps once all EHR’s are voice-activated (my ENT has one but I wonder if it catches his off-color jokes), and UX is more point-of-care centric, this mess will turn a more positive corner.

*SOURCE: JAMA Internal Medicine, online November 30, 2015

Surprise! EHR’s are hurting not helping the doctor /patient relationship. was originally published on Harbinger Associates

The “Periodic Table of Storytelling”, an amazing resource for a strategy we all should embrace

Storytelling by employees, patient advocates and patients themselves who just feel compelled to share…this is a fundamental strategy that Pharma, ACO’s, Hospitals, need to use NOW to break down the barriers between their customers/patients and the inherent regulatory and cultural limitations they have to deal with.

As an example, Pharma which has a terrible reputation (undeserved, complex and not black and white), should be the first category to stop creating non-authentic, non-emotional, advertising and create credibility and connection through storytelling. It is a gravity point for human-2-human communications and connection. Unlike MLR fears of QOL promises gone amok, the fact is, patients just want to hear a “real” voice to relate to. Authenticity would do wonders for Pharma Brands. It is one reason why Pharmacists trust levels are rising.

But there are so many types of stories! Luckily, there is not a condition in existence where there is not someone who has a passion for how they suffer, how they live, how they treat – activate this! The classic hiring of Snow & Associates patient Advocates for on-the-ground events is little more than minor league storytelling, it is playing small.

Below I am sharing the “Periodic Table of Storytelling.”  This is a great tool and guide for inspiring and organizing storytelling content. Play with this tool – you will be amazed and inspired.


Storytelling periodic table  4.22.14



Please use the link to interact with the Table:

Let’s just take Pharma companies…the troika of authenticity and credibility would be stories told by: employees, patients/caregivers and scientists. This covers a range of passions, missions, journeys — all the stories people crave. And for MLR, you can make it branded if you just do not allow open field feedback.

I have asked this before: what would happen if you gave an entire Brand digital experience over to storytelling by the troika I mention above? In oncology this would be ground-breaking. It goes “Beyond the Pill” which is the use of service as a ways to both support the patient and practice — but in a way, while important, it is often functional support, not personal, human or emotional support, which at the heart of loyalty, an issue of evermore crowded therapeutic categories.

Can this be done? Would a Brand be brave enough? Could it be a true differentiated in message that breaks through the clutter of all the data and noise?


You Have To Give Them A Reason

Today in the DTC Marketing Blog, Richard Meyer made one of those observations that is so simple and so obvious that it just has to be true. And insightful. Writing in a post about the concept of including an 800 number for the FDA in drug as, Meyer made this observation:

"When starting any CRM program one of the key questions you have to ask is "What’s in it for my customers to start a relationship with my company?"

That, in a sentence, is what really defines RM.

Istock_000004747235xsmall When someone goes to the mailbox, or goes online, and instead of simply pushing an ad at them, you are asking them to respond somehow, it is simple human nature for them to ask themselves "Why should I do this?"

You are asking for their time, their attention, perhaps for some information.

It isn’t necessarily possible for you to deliver value right then and there, on the spot, although sometimes you can. As a reason for them to respond, you may provide them with information, or insight, or discounts.

More often, however, what you’re providing is the promise of value, what lawyers call an executory contract. "If you give me some information, I will provide you with value." And in any kind of RM, but particularly in pharma, you absolutely must deliver.

Ultimately, your customers are the ones who are calling the shots in this kind of project, because they are the ones defining value. This is a critical distinction. Value here really is in the eye of the beholder, and the more personalized and distinct what you deliver is, the more valuable it is to them.

Interestingly, one of the least valuable things you can provide for customers often is money — in the form of a discount, a rebate, a free sample or whatever. This is by no means a universal or hard-and-fast rule, but value is a subjective, interpersonal concept. What is truly valued may be something emotional, or inexpensive, or surprisingly simple. And further, the customers who do tend to respond to money — who can be bought, basically —  are often fickle, or not inclined to be loyal.

The question, always, boils down to "Why should I?" The key to the whole enterprise lies in how you answer that question. Here’s a hint: "Because I want you to" is not the right answer.

Disease Management: Is Pharma Missing the Boat?

I have thinking a lot about the challenges of patient adherence these past few weeks. For the uninitiated, adherence is the art and science of helping patients with chronic or long-term conditions stay on their therapies. I always think about it, because I have seen firsthand the confusion patients suffer from lack of support — but anyway, a statistic came to mind from my old mass market days that I felt like posting.

Today, so many pharmaceutical marketers still focus on acquisition to the detriment of the overall long-term health of their patient and brand sales. But the classic stat is this: a 1% increase in customer loyalty is equivalent to a 10% cost reduction. In other words, improved adherence goes straight to the bottom line. It is essentially pure profit.

There is so much to say about adherence. Last summer I spoke on a MedAdNews panel about the challenges surrounding the issue, which are vastly complex and easily overwhelming. But while pharma is starting to look at the problem (and I sure wonder why Wall Street is not!), the real solutions are emerging from the Disease Management companies working through managed care and major employers. One which I know of well and admire is Active Health Management ( Aetna purchased them for good reason.


More to the point, pharma and biotech marketers need to decide whether these companies are a threat to their own adherence efforts, or perhaps their best partner. After all, if the disease management companies really take hold, there will be no compelling reason for pharma to have such programs, and in doing so, we will lose access and influence on our patients.

Think about it. Look around. Adherence IS being dealt with and pharma may be left behind.

Advocates and the Long Tail

We are tremendous fans of the concept of the Advocate. In a recent post, Seth Godin links to an analysis of the Long Tail by fellow blogger Kevin Kelly that brilliantly explains the role of the advocate in pharma marketing.

First, the Long Tail. The Long Tail, as defined by Wikipedia, is a description of the business models of Amazon or Netflix, where, rather than attempting to sell a zillion copies of a hit book or CD, they have the ability to sell smaller quantities of millions of things to niche buyers. The distribution and inventory costs of those business allow them to
realize significant profit out of selling small volumes of hard-to-find
items to many customers, instead of only selling large volumes of a
reduced number of popular items. It was described in a very influential book by Chris Anderson.

A picture helps. The Long Tail looks like this:

Longtail On the far left side of the graph, imagine that you have the sales income from patients who see some kind of DTC ad, and promptly run into their doctors’ office and insist on it. Say, you launch a drug with a big, heavily-funded DTC campaign, and you get an immediate, enormous response. The drug is a blockbuster, and you have the initial, left-side-of-the-curve revenue from a phenomenally successful acquisition campaign. Great.

However, there’s another way to look at it, and that is what Kelly does. In his post, he writes about creators — artists, writers, craftspersons or whatever. And he says this (I’m going to edit it somewhat):

Other than aim for a blockbuster hit, what can an artist do to escape the long tail?

One solution is to find 1,000 True Fans. While some artists have
discovered this path without calling it that, I think it is worth
trying to formalize. The gist of 1,000 True Fans can be stated simply:

A creator, such as an artist, musician, photographer,
craftsperson, performer, animator, designer, videomaker, or author – in
other words, anyone producing works of art – needs to acquire only
1,000 True Fans to make a living.

A True Fan is defined as someone who will purchase anything and
everything you produce. They will drive 200 miles to see you sing. They
will buy the super deluxe re-issued hi-res box set of your stuff even
though they have the low-res version. They have a Google Alert set for
your name. They bookmark the eBay page where your out-of-print editions
show up. They come to your openings. They have you sign their copies.
They buy the t-shirt, and the mug, and the hat. They can’t wait till
you issue your next work. They are true fans.

To raise your sales out of the flatline of the long tail you need to
connect with your True Fans directly.  Another way to state this is,
you need to convert a thousand Lesser Fans into a thousand True Fans.

This is an almost letter-perfect description of an Advocate.  And although you need a LOT more than 1,000 of them to  make a drug profitable, the purpose of relationship marketing in pharmaceuticals is to identify Advocates, and to connect with them. Just as the True Fan will purchase anything an artist puts out, an Advocate will share with others her story of success with your drug. The value of this is beyond measure.

We are not talking here about using DTC to push drugs into the channel. We’re talking instead about using True Fans of your drug to help others achieve the same result. Think of the diabetes patient who’s on a therapy long-term, and who uses a combination of diet, exercise, and medication to get her numbers down and keep them down. By connecting with her, your brand can show her how to help others do the same thing.