Cramping your style?

Once, after I had presented a creative medical education proposal, I was told by my client that we had been too creative and that the concept would not get approved. When asked how we should change it, she answered, Sometimes being creative is wearing different coloured shoes. This led me to question if regulatory changes are indeed stifling creativity in medical education, or if creativity and innovation are simply window dressing?

The 2006 version of the ABPI Code of Practice provides guidance about the industry's working relationship with key opinion leaders (KOLs), holding meetings, sponsoring educational programmes and developing educational materials.

Although almost all areas of the Code impact in some way on medical education activities, some have a more direct influence.

Clause 19, for instance, defines what is acceptable in medical education and the definitions of what is appropriate content for a meeting. It also provides regulations on travel, accommodation, venues and refreshments. These definitions have forced the face of med ed meetings over the last few years to change.

Trends and challenges
It is not only the regulations and their interpretation that have changed in recent years — the role and status of medical education as part of the overall marketing mix has also had to adapt.

These changes have, in part, been driven by two factors. Firstly, there has been a notable shift in the promoted medicines and pipelines of the industry towards hospital-focused or hospital-led therapies — making KOL relationships more important.

Secondly, changes in the effectiveness, efficiency and reach of some aspects of marketing have increased the role and prominence of med ed. The well documented decline in efficiency and effectiveness of the sales force as a marketing tool, and the increasingly blurred line between the formerly separate activities of public relations, public affairs and medical education are examples of this change.

At the centre of these shifts is a pharma industry's marketing fundamental — advocacy. As the process by which a medicine is selected and prescribed becomes more complex, involving stakeholders beyond the GP or specialist, the role and importance of advocates has increased.

Updated Code of Practice 2008

Different approach
Added focus and reliance on med ed has caused the discipline itself to change. The traditional tiered opinion leader (OL) approach — where leading OLs were engaged, educated and mobilised to cascade their opinions and advocacy — is being replaced by an inclusive and multi-disciplinary approach.

Setting up meeting series that act as a forum for onside KOLs to didactically deliver their opinions is no longer the draw it once was. Meeting fatigue, the need for scientifically credible and independent content, and time constraints on prescribers and influencers are affecting even the simplest meeting programmes.

Medical education is now much more than simply the drive to create brand advocates, it is about being at the forefront of practice and creating a forum for opinions to be formed and changed — about the disease itself, as well as individual treatments.

The result has been significant growth in unbranded medical education (continuing medical education — CME), and a growth in non-meeting-based channels such as med ed materials, virtual meetings and online education. CME has always been a part of a number of med ed programmes, however, the emphasis of these programmes is now more on scientific independence and credibility.

Industry investment in CME has not gone unnoticed; a number of new, independent suppliers are emerging to provide multi-disease forums, each sponsored by one or more companies. Societies such as the Royal College of Nursing are now actively seeking sponsorship for a number of disease education websites. The advantages are clear — access to a wide audience, credibility through an independent third party and an opportunity for the firm to build its profile and reputation in a specific disease area.

Despite the growth of other medical channels, it is my view that all of these programmes will remain grounded or shaped around face-to-face meetings.

Although DVDs, educational materials, virtual meetings and online education are seen as valuable, most of the OLs and clinicians we speak to still value peer-to-peer interaction above all else. This is not to say that add-ons don't extend the reach and impact of meeting-led activities, it is simply that they can't replace the value of human interaction. 

Toeing the line
The challenge for medical education programmes is to delivery advocacy from a range of stakeholders for brands, companies and ideas; support and build synergies with other parts of the marketing mix; overcome meeting fatigue; capitalise on the growth of CME and non-meeting channels, while still remaining within the strictest interpretations of the regulations.

How can medical education rise to these challenges? In the same way that public relations is no longer simply about media relations, medical education programmes must look beyond the quality of the agenda and prominence of speakers, and address the following:

Our approach to measuring RoI in medical education