Three years ago, a PME article described the pharma industry as being like the ugly kid at the party that no-one wants to talk to. There was, it said, a whole healthcare conversation going on out there, but pharma was like the fat bloke with halitosis left standing alone in a corner. I still remember the line – not only because I wrote the article but because I’ve also been that fat bloke.
Last month, a prominent healthcare commentator told me that pharma marketing execs still suffer from a major inferiority complex. The neurosis, it seems, is driven by a creative envy of consumer sectors whose marketing approaches aren’t bound by a straitjacket of regulation. It’s easy to be awestruck by consumer marketing and marvel that it’s so far ahead of pharma. And it’s easy to believe that the allure of consumer marketing is such that it’s the only destination for top marketing talent. But the gravity of healthcare communications makes both suppositions horribly misplaced. Healthcare communicators combine scientific expertise, insight and creativity to make a real difference to patients’ lives – that’s a catalyst for pride, not inferiority.
The rewards of promoting an HIV treatment are so much greater than marketing mascara. But the challenges and complexities are much greater too. The future of healthcare communications will therefore not depend on making green-eyed glances towards consumer markets for inspiration, but on being bold enough to grow from the introvert at the disco into a confident, trusted voice in a collaborative conversation.
Building confidence
The wider healthcare community has expanded significantly – it now comprises HCPs, payers, patients, carers and the public in general. But has this growth, along with the explosion of communications channels, created a crisis of confidence for the industry? “Unfortunately, pharma has an inherent anxiety about interacting with the fullest healthcare community. We’re still stand-offish, weighed down by the behaviour of previous generations,” says David Hunt, CEO, Havas Lynx. “The industry needs to develop a voice within the community, rather than watching from the sidelines. Pharma can bring a hugely important component in terms of scientific rigour, insight and experience to the conversation. Healthcare communications can do so much more than just market a scientific point of difference, it can place pharma at the heart of the discussion and galvanise communities to drive better outcomes. But to do that pharma needs more confidence and belief, in itself and in the community. The best agencies can help them build both.”
Changing behaviours
Successful communications are all about changing behaviours. Pharma has long focused its energies on persuading HCPs to adjust their prescribing behaviours and, more recently, encouraging payers to adopt new models of care. But, in the emerging era of personalised medicines, the ultimate behaviour change goes all the way to the end-user. And it’s in this patient-centred area where the European pharma industry’s apparent discomfort naturally comes. Communicating with patients is unfamiliar territory.
“The real challenge for healthcare communications is how to understand and enable behaviour change. Behaviour is often the rate-limiting step between effective treatments, good advice and optimum outcomes,” says Rob Horne, founder, Spoonful of Sugar. “A key driver for change is that the current situation is hugely inefficient. Let’s take medicines, for example. The prescription of a medicine is the most common intervention in developed health economies. Yet the WHO tells us that only half of the medicines for long-term conditions are taken as prescribed. What happens to the other 50%? Did those patients mis out or ignore all the healthcare communication efforts? Did their HCPs not make a clear enough case for their medicines?
“It’s easy to ignore the patient when we try to dissect the problem and perhaps this is where healthcare communication can sometimes fall short of the mark. As the target recipient of healthcare communications it’s worth digging deeper into the patient’s perspective to understand whether their choices are based on mistaken beliefs or misplaced concerns and if their choices are truly ‘informed’. In the future, healthcare communications will facilitate informed choices and motivate and enable healthy behaviours because they take account of the individual differences in the beliefs and capabilities that shape our behaviour. We are not there yet. But research into health and illness behaviour points the way.”
Behavioural economics is becoming a key ingredient in developing a sustainable brand strategy
Start at the end
Behavioural economics is therefore becoming a key ingredient in developing a sustainable brand strategy – and it’s all part of an important shift from ‘broadcasting’ messages to developing communications programmes that delivering demonstrable and meaningful outcomes. “There is now a widespread recognition that communications programmes go beyond delivering messages and raising awareness – they need to improve patient outcomes and deliver change,” says Dennis O’Brien, CEO, Lucid Group. “The smartest companies aren’t just thinking about individual channels and tactics, they’re building strategic platforms that start by identifying the required outcomes and then work backwards from there.
“A key consideration is to establish how patients in your disease area are likely to be treated in the future, work out how your brand aligns with it – and then develop an integrated strategy designed to change behaviours accordingly. The strategy will involve stakeholders – and subsequent tactical implementation – from clinical trial development, market access, communications and commercial operations. But if everything is anchored to the strategic platform, it’s much easier to create coordinated communications programmes that add value and change behaviour. Getting there, however, requires brand directors to think much further ahead.”
From monologue to dialogue
The approach also requires brand teams to make the journey from monologue to dialogue. “Traditional healthcare communications have focused on ‘telling’. There is often an implicit assumption that the recipient comes as a blank sheet that we can write the message on. Of course, this is far from being the truth,” says Rob Horne. “Our reaction to any communicated message is shaped by the beliefs that we bring with us. For example, research shows that non-adherence to medicines is often related to patients’ beliefs about their illness and treatment. These beliefs often differ from the medical view yet have a much stronger influence on behaviour than medical advice or healthcare communications. The real challenge for healthcare communications is to engage with these beliefs, correct any misconceptions and address concerns. We need to listen as well as tell.”
Prepare for the prosumer
Another powerful change that’s driving healthcare communication is the shifting behaviour of customers – not least due to the pervasive nature of digital, social and mobile technologies. The remarkable transformation of communications platforms has become a catalyst for more empowered and informed consumers – and made the battle for meaningful share of voice increasingly difficult. Now is not the time for shrinking violets.
“The future of healthcare communications will be shaped by our ability to respond to the shift from consumer to prosumer,” says David Hunt. “Although the terminology has been widely used in other sectors for many years, it’s not nearly prominent enough in healthcare. Prosumers are more than just ‘professional consumers’ – they’re brand advocates with powerful networks and trusted, influential voices. Historically, HCPs have been starved of diversity, in their sources for information. As a result, the pharma industry had been able to shape the channels, control and deliver the story and ultimately build brands. But the world has changed, and for the better.
“Prosumers now have a proliferation of channels and sources from which they can obtain information. As an industry we must now work harder than ever to build credibility and earn trust, so that we can build relationships and ultimately become part of the stakeholder’s choice. It is these choices which enable informed decisions – that will in turn be shared with the wider community. Prosumers are proactively seeking information from those they trust, forming an opinion and sharing it with their peers. The future of healthcare communications is not about maximising new channels and platforms, it’s about maximising our relationship with prosumers and recognising that they represent the new channels – and leveraging that knowledge to change behaviours.”
To drive progressive and effective healthcare communications, there’s probably an argument for some classic behavioural change on all sides
A collective responsibility
So what do all these shifting sands mean for the pharma/agency relationship? To drive progressive and effective healthcare communications, there’s probably an argument for some classic behavioural change on all sides. “There’s been a tendency in the past for agencies to blame pharma companies for being risk-averse and conservative in their approach to healthcare communications,” says Dennis O’Brien. “This is an easy excuse. In fact, as agencies we could be more ambitious in our thinking and challenge clients to seek greater strategic counsel. Senior executives within pharma do recognise the value of building strategic relationships with agencies. However, although the implementation of that message can sometimes get lost in translation as it cascades down an organisation, it’s actually an agency’s responsibility to push clients harder to develop ambitious programmes that anchor back to their strategy. At times, there isn’t enough challenge in the system for an agency to say: why are we doing this? For every tactic and every programme we need to be asking this question – collectively – and ensuring the answers align with the strategic platform.
“Ultimately, the bigger goal is to improve outcomes and change patients’ lives. It’s therefore a joint responsibility to develop integrated programmes that change behaviours.”