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Learning from the past and looking to the future

10 Years on in healthcare communications – Sam Barnes, director of PR at AXON, asks what learnings can be taken into the next decade?

September 2011 marked my 10-year anniversary in a communications agency. A lot has changed for the industry over that time. No doubt significantly more will change over the next 10 years. What are the ten most important challenges faced by the industry? How has the role of communications (and the communications agency) changed over that period? How will lessons from the last 10 years inform communications professionals as they face challenges in the coming years?

To try and answer these questions, I spoke to a number of thought leaders in the industry.

In the list below, though not necessarily in order of priority, are 10 key challenges that span the last ten years and arguably impact on the way we now approach communications.

Increased regulation
Over course of this period the pharmaceutical and medical device sectors have changed almost beyond recognition: particularly in how we interact with a range of stakeholders. There are now strict guidelines associated with attending meetings and congresses, the role of education (CME versus branded communications), working with media and patient organisations. Individual companies will often have policies that go beyond industry codes.

The challenge for many communications programmes is to find opportunities to innovate while being compliant. The challenge for agencies is the lack of consistency across geographies, industries (pharma and MedTech), and companies' interpretations of codes.

The cost debate
Greater scrutiny on the cost of health and what can or should be funded has further fuelled public and policy-makers' interest. Whether or not the industry wanted to engage in this discussion, it has, nevertheless, been drawn into it. Communications strategies should anticipate and address these concerns – by being founded in the value of treatments to patients; as well as their potential value and role for the broader society.

The value of new medications and devices
Linked to the broader debate on the cost of health, is the cost of new and, increasingly, existing treatments. “A key challenge will be to demonstrate the value of our products for patients and healthcare systems against the backdrop of austerity, cost-containment and increasing scrutiny of cost-effectiveness,” commented Philippa Manning, director of external communications for GlaxoSmithKline (GSK) UK.

The need to overcome these barriers to entry has created a new communication focus – market access. Developing and delivering a compelling 'value story' that encompasses scientific, clinical and health economic elements and that resonates with a range of stakeholders is now a central part of almost all brand communications activities.

The rise of the internet and prominence of social media
The speed of information exchange and scale of its reach has created a plethora of opportunities. Yet this direct, often instantaneous and interactive medium still disconcerts the industry as it seeks to address increased regulation and the channel's inherent lack of control.

Guidelines to date have not helped the industry answer the social media conundrum. More broadly, the social media channels themselves are changing – creating further difficulties.

Last year, Facebook ended the whitelist exemption for pharma and forced the industry to re-examine its use of this outlet; moving away from a 'broadcast channel' approach to interactivity. A number of companies have either changed their use of Facebook or removed their site altogether.

“Media is inherently social, whether or not a decision is made to proactively engage in it. The connection between traditional and social media means that there are no longer a distinction between news articles, blogs, Facebook posts, and Tweets. It's now about whether the healthcare industry is aware of what's out there and keeps pace with evolving technologies and trends, understands their role and how they can influence and be part of the conversation,” said Sylvain Perron, managing partner, Sonic Boom.

The changing role of patient advocates
The role of patient advocacy groups (PAGs) has evolved as organisations have matured. PAGs play an increasingly important role in championing improvements in care and access to treatment. Their influence, somewhat driven by the ease in which they can now canvas a groundswell of support online, and also by their role as advisors for governments and health technology appraisal organisations, has increased their importance as stakeholders.

A key challenge will be to demonstrate the value of our products for patients and healthcare systems against the backdrop of austerity, cost-containment and increasing scrutiny of cost-effectiveness,”

Philippa Manning, director of external communications, GSK UK

Yet scrutiny of industry interactions with PAGs and evolving regulations has meant relationships with these groups have changed. Finding appropriate ways to engage and involve PAGs and partnering with them on joint projects and where there are mutual goals is now even more critical.

Importance of emerging markets
In virtually every annual report and analysts briefing, industry executives discuss their plans for future growth in emerging markets. Increasingly, this goes beyond the likes of China and Brazil, to markets in the Middle East, Africa, Eastern Europe and other parts of Asia and South America. As an agency, we are working on a number of accounts specifically targeting these markets.

As communicators, we need to adapt to the wider variance in culture, language and sophistication when working with emerging markets. In many cases, a traditional 'template' approach to communications won't work – whether due to lack of local communications personnel, experience or resources. As a result emerging markets programmes often focus on internal communications, skills building, centrally and/or regionally driven activities and cascade programmes such as 'train-the-trainer' meetings for clinicians.

R&D pressures and productivity
Drier pipelines, fewer approvals and market access/pricing barriers – have all heightened focus on pipeline potential, costs, time to market and success at launch. Not only does this mean companies need to evaluate their pipeline earlier, but carefully anticipate and manage communication around milestones – even down to the timing of interim analyses and communication of study recruitment milestones.

Running efficient and effective clinical studies has led to a surge in patient recruitment and retention communications.

“Whilst communications to study site staff and patients was once part of 'difficult-to-recruit-for' studies, it is now a central part of many of today's larger trials. Expertise in engaging and educating study site staff across the globe, helping study site staff discuss studies with prospective patients, and ensuring patients and staff remain motivated across the course of a study are becoming crucial to study success,” according to Chuck Johnston, partner at AXON Communications.

The patent cliff
According to the UK patent office, 46 of the current UK marketed drugs patent will expire in 2012 and 2013. We already see different approaches to the increasing 'tail' of branded generics – from forming or growing generic operations to mature brand divisions of companies. With the increased commercial importance of these mature portfolios, we need to find new ways of supporting multiple brands and disease portfolios beyond patent expiration – and often across multiple regions and markets.

Safety scares

The need to adequately prepare for and appropriately communicate around potential or actual issues has changed the issues preparedness policies and the cultures of companies and their suppliers (such as CROs).

Current concerns focus on pharmacovigilance reporting e.g. around adverse events picked up online and via social media. What is clear is that companies now need to be able to react to issues in environments that evolve minute-by-minute and where companies can no longer depend on being able to control the flow of news across borders. This requires a new mindset and culture of issues preparedness.   

Evolving healthcare industry business model
Cost cutting, selling off non-core businesses, and strategic partnerships and licensing initiatives have all been employed by many of the world's leading companies. “It is crystal clear that healthcare systems in Europe need to be rethought and steered back onto a sustainable path. The MedTech industry in Europe is aware of its role and understands that its current business model is coming to the end of its lifecycle,” commented Ingmar de Gooijer, director of communications for Eucomed.

Communications budgets and departments have not been exempt from cuts. However, like with R&D outsourcing, industry now relies more and more on their communications agencies. Agencies must respond by providing the high level of expertise required. In-house communications departments are responsible for larger portfolios of brands across more geographies.

The MedTech industry in Europe has agreed to concentrate on value-based innovation: development of technologies that marry cost-efficiency with improved health outcomes."

Ingmar de Gooijer, director of communications, Eucomed

Changes in client personnel mean, in some cases, agencies provide continuity on brands. The result is a need for agencies that offer ready access to strategic counsel, can act autonomously, have a broader skillset and can harness the bandwidth of communications, and provide flexible resources to alleviate peaks in demands on communications directors and managers.

The next 10 years
What can the last decade teach us, as we prepare for the next ten years? While predicting the future is much like trying to predict the weather, there are a few trends and opinions we can draw upon.

Clinical and societal value
The industry has an opportunity to be at the forefront of the healthcare cost debate and seek to influence its future direction.

“The MedTech industry in Europe has agreed to concentrate on value-based innovation: development of technologies that marry cost-efficiency with improved health outcomes,” commented Ingmar de Gooijer, Director of Communications for Eucomed.

Direct and innovative engagement with the multitude of stakeholders
As regulations have become more complex, so have industry's relationships and interactions with stakeholders, yet new technologies offer a more direct and innovative channel.

“While the proliferation and uptake of digital media channels offers the opportunity to target our audiences more effectively, understanding their consumption patterns and use of digital channels will be critical. This is compounded by the fact that influencers and decision-makers are multiplying - we will need to find new ways of working to reach and engage these stakeholders,” says Philippa Manning.

Breaking down communications barriers
New demands have created new roles for communications, including market access and clinical trial communications. As the industry evolves its business model, how should communications specialists also evolve?

“Traditionally communications has been siloed into separate disciplines - medical communications, public relations, public affairs etc. These silos are arguably breaking down in today's environment, particularly in the area of market access. Communicators will need to think more laterally and work more flexibly: to reach new stakeholders across more countries, support brands at different lifecycle stages and across specialised disease areas, and deliver on the needs of both companies and those they collaborate with,” added Ralph Sutton, international managing partner, AXON Communications.

Sam BarnesThe author
Sam Barnes
is director and head of public relations at AXON Communications and can be contacted on

2nd July 2012

From: Marketing



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