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En garde

New approaches in technology mean that control is in the hands of the consumer, not pharma and that could be scary

A martial artist with a mask in an offensive poseAt the last count I have three Twitter feeds (one for the company, one for me as a business person, and one that is personal), two blogs (one company, one personal), a Facebook account and a LinkedIn profile. Via Facebook and LinkedIn, I'm a member of more than a dozen online special interest groups, and I follow lots of publications online that I track via Manifesto on my iPhone. 

Using different social media tools, I can distinguish between friends, co-workers, business acquaintances and clients depending on where I encounter them (much like real life actually). I can change the way in which I interact with my different contacts depending on who they are, becoming more or less formal as the situation demands. The whole point of social media (and digital communications as a discipline) is that it is a very personal way to engage, one that addresses individual preferences in a whole host of ways.

Now imagine I'm a new statin, antidepressant or antibiotic. Well, you can find me online (probably, supposing Google is your friend), but the difference is that, unless you're a health professional, I'm not really interested in talking to you. Or so it seems. You can read what I'm prepared to make public, but you can't ask me any questions and you certainly can't engage in any kind of dialogue with me, even if you're the one who's taking the tablets.  

Not being able to talk to me doesn't mean that you can't talk about me, especially to others who have been treated, or are considering being treated, with me. But I will only talk directly to your doctor. And even then, all I am prepared to do is to tell your doctor what I think he or she should know, rather than get involved in a conversation, just in case the company that makes me gets sued.

Funnily enough though, if I were a vitamin supplement or a functional food making health claims, like Benecol for example, we could have a good natter online via the company website, where you can post questions directly.

This lack of pharma engagement with its ultimate consumers via social media could be interpreted as being part of some giant conspiracy, but you and I know that just isn't true. And anyway, things are changing. Maybe not as fast as some would like, but they are changing. J&J, GlaxoSmithKline, Pfizer, Roche, Boehringer, AstraZeneca, ViivHealthcare are all online and accessible via Twitter (and they're not alone). You won't find them answering your detailed questions about why the latest cure-all gives you a terrible headache every time you take it, but they are there and they are trying hard to engage.

Making choices
The current challenge facing pharma marketers and communicators isn't whether or not they should join the party, but how and in what way. For some time now, social media has been the latest craze, as though it is the medium and not the message that is the most important thing. No campaign is complete without its digital components and sometimes it feels as though the social media tail is wagging the dog, as marketers rush headlong in pursuit of the latest whizzy technology or social networking group. From an agency perspective, our job is to help clients put the pieces together, and to be honest with them when an online strategy won't deliver the results they seek. 

There is, of course, a popular misconception that pharma marketing communications is less creative than other disciplines, especially mainstream consumer marketing communications. I'd argue that the opposite is true. It's far easier to claim that 'we're worth it' when it comes to shampoo, than it is to explain why Propecia (finasteride) might be the right choice for some men with male-pattern baldness. The regulatory framework within which we operate is designed to protect the physician and patient from misleading information. In an industry where patient safety is of paramount importance, that's surely a good thing. Working in this environment forces us to become more, rather than less, creative, and that's actually one of our problems.

Regulatory fact & fiction
We have all heard the legal and regulatory teams referred to as the 'sales prevention department,' but it is important to understand what's really driving their behaviour. On the whole, they are used to a set type of marketing communications activity that they have to vet – sales aids, abstracts, posters, adverts and the like. If, as is happening increasingly, we come to them with a way of doing something that is outside the norm, then it is not always easy for them to understand where it fits and, therefore, how to address it.  

Recently, we encountered a situation when a journalist had written an article mentioning a specific product. The regulatory and legal team needed to be educated about the fact that this wasn't an advertorial, we hadn't paid for the placement, or even provided the journalist with the information in question. He had done his own research and come to his own conclusions and therefore it wasn't something that was under their control.

Consumer control
Control is a key word here. Traditional approaches to pharmaceutical marketing allow the company to have a high degree of control over what is said publicly and officially about their products. Newer approaches, including social media and networking, mean that the control is in the hands of the consumer, not the information provider, and that is scary.

Some of the fear lies in the fact that the in-house team approving a particular activity has not been exposed to it before, perhaps, and almost certainly hasn't been involved in the thinking behind it. 

For example, our US team has been helping a biopharmaceutical company to develop its first corporate blog. Crucial to the success of the initiative was the fact that we worked from the very beginning with a multi-disciplinary team, including legal and regulatory specialists, so that they were fully aware of the project and engaged in it from the first ideas to the first 'live' post. This included running a 'dark' blog (offline) for several weeks beforehand, so that everybody felt comfortable with their roles and what the blog would deliver. The lesson here is that the easiest and most straightforward way to go when developing these types of initiatives is to work as a cross-functional team.

When it comes to talking about patients and side effects, a major concern for regulatory teams is how to ensure that problems are reported. If a patient is talking to a doctor or other healthcare professional in person, the yellow card system kicks in – but if it's online, there are practical problems to overcome to make sure that unwanted effects don't go unreported.

There is little or no guidance available yet from industry regulatory bodies about how to handle these new communications channels, especially in terms of what is or isn't acceptable. Guidance is developing almost on a case law basis, whereby pharma companies put their heads above the parapet to see what happens. Sometimes they get shot down and sometimes they don't. Such uncertainty is difficult to navigate for many legal and regulatory teams and it's not surprising that they err on the side of caution. Just a few weeks ago, the US Food and Drug Administration listened to testimony from around 60 industry experts about the importance of social media as a pharmaceutical communications technique. Yet, formal guidance isn't expected for another 18 months. By that time, the world will have moved on and it is inevitable that the guidance will be out of date.

Back to basics
But how do you choose what you should be doing? Who should you be talking to and why? And is communicating online really any better than communicating in any other way? The basic principles of communications planning have not changed. From a strategic standpoint, we need to understand what we're trying to achieve, mapping out which people we want to talk to, what we want to say and how we're going to say it, identifying the most effective channels and tactics. The thing that really needs to change is the mindset; we must be aware that new technologies have enabled a whole host of conversations to take place at the same time, some of which we can be part of and some of which, frankly, we can't. This is where advocacy moves centre stage, because the new media model requires others to interpret and to tell our stories where we cannot.

With any kind of engagement strategy, it's important to understand how people's needs and perceptions differ, to know when and where they seek information, and then to design programmes that address those needs. Bear in mind that most of us have multiple personalities as information seekers, wearing a variety of hats – parent, sibling, friend, patient, therapist, purchaser – and it is hard to disentangle them from each other.

Consider too, whether you should go to your audiences or make them come to you. It's often much more effective if you go to websites and social networking sites where particular types of physicians or patients can be found rather than re-inventing the wheel, but of course that brings us back to the question of control.

There are some crucial lessons here in terms of best practice. First, as a pharmaceutical company wanting to engage in social media, it is important to be transparent about your involvement from the start. If you're establishing or sponsoring a page on a social network site such as Facebook or MySpace, or if you're blogging, make sure that it's clear from both the name and the images you use that this is supported by a pharmaceutical company. Bring your legal and regulatory folks into the loop right from the beginning so that they understand what you're trying to achieve and why. 

Ask yourself whether the social media space is the right place to find your target audience(s). As stated previously, in this instance it's important to decide whether you should create your own network or tap into someone else's.  This is where an agency can help you, not just to understand what's out there but, more importantly, to prioritise your activities for the best return on investment. Online certainly isn't the only place you can find your audience and you may find that it's a "nice-to-have" rather than a core programme essential.

Tailored approach
Ultimately, if you decide that the digital route is the right way to go, then make sure you tailor your language and approach to your audience. This sounds basic, but it is often surprisingly overlooked, particularly when working with regulatory teams that want you to stick to the letter of the law (or indication) rather than understanding how to word it in a way that a patient will understand. And if you're opening yourself up to a dialogue, do make sure you keep talking.

Actually, with the advent of Google's Sidewiki you may find yourself in conversation whether you like it or not – although AstraZeneca recently solved that problem on one of its US sites by posting its own Sidewiki setting out what can and cannot be discussed (and taking up all the available space to boot!). For the un-initiated, Google Sidewiki is a (free) browser sidebar that allows anyone to post comment or information alongside any web page.

It is easy to fall for the hype when it comes to new technologies – there's so often a glamour around something you don't wholly understand and it's tempting to think that digital solutions have the answer to all our problems. The truth is that for some challenges, social media and new technologies do offer additional choices, but they aren't a universal marketing panacea. In the right place, at the right time, they offer enormous value, but only when they work alongside other initiatives as part of a whole. Digital communications and social media are here to stay. Use them, but don't let them use you.

The Author
Anna Korving is joint founding partner at Resolute

To comment on this article, email pme@pmlive.com

26th January 2010

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