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Not just a go-between

Healthcare communications has grown up and is set to play a key role in pharma's future

Public relations has witnessed a period of rapid growth in the past five years. Testament to its rising importance is the increase in dedicated PR and communications roles both in-house and within agencies. In part, this has been at the expense of more traditional elements, such as advertising, where revenues have dropped. So what is driving this change and what does the future hold?

There are various growth drivers. One is the increasing importance of the patient and the strength and sophistication of some patient groups. As the National Institute for Health and Clinical Excellence (NICE) has grown in importance, so has the role of the patient lobby.

Patients are actively seeking information to make informed healthcare choices, and easier access to information, particularly via the internet from US-based sites, has been a key factor in this, with health sites being some of the most frequently visited on the web. Patients with unmet medical needs are now far less willing to settle for second best or to accept a healthcare professional's advice without question.

This is more pronounced in certain age and socio-economic groups but the trend will continue - the Alzheimer's patient lobby is a good example. It is a disease, predominantly of the old, that challenges every organisational skill of those with the condition and which can be all-consuming for their carers. Yet even under these difficult conditions, their carers are fighting for patient rights.

Another major consumer trend, providing opportunities for PR activities, has been the growing interest in health-related subjects by the media generally. Health pages have become some of the most popular and are critically important for their circulation and revenue. The Daily Mail newspaper, for example, (read by 11 per cent of the UK adult population) credits much of its recent growth in circulation to the rise in the number of women who read its health features. Health editors need a regular supply of content and good communications professionals can help to satisfy this.

Future trends
A significant challenge for the future will be managing patient demand for useful and relevant information directly from the manufacturer. We are in the odd situation where patients are able to access information, albeit of variable quality, on the internet including via US-based, product-specific and professional healthcare websites, yet are unable to get appropriate information from manufacturers in the UK.

To many patients this is seen at best as unhelpful or obstructive, and for those prone to conspiracy theories, as a cynical attempt to deny them the right to information on their drugs. Furthermore, patient information needs are not static, particularly among those living with chronic and multiple conditions. Patients may require different types of information at varying stages of their illnesses.

Good quality, balanced and relevant information directly from manufacturers, in a form that patients can understand - and I don't mean direct-to-consumer advertising - should be one of the resources patients can use to help them make informed choices.

What is needed is tailored information - something between a patient information leaflet, basically the instructions for use, and a summary of product characteristics (SmPC) or a European public assessment report (EPAR), which are regulatory documents that are not really designed for patients. The European Commission is planning to consult on this.

Communications professionals will need to take the lead in ensuring all stakeholders play an active part in the consultation process. We need to ensure there is sufficient flexibility within any new legislation to enable pharma companies to finally meet patient-consumer information needs.

Improving public perception of our industry is possibly the greatest challenge that we face both now and in the future. The Commons Health Select Committee in 2004 and the subsequent tightening of the Association of the British Pharmaceutical Industry (ABPI) Code of Practice, have been a turning point, with firms taking the recommendations and implications very seriously.

This expectation of higher standards will continue across all elements of the marketing mix and, with the 2007 launch of the first Good Practice Guide, the Healthcare Communications Association (HCA) aims to be at the fore in driving these. This guide will be pivotal in setting standards and providing frameworks to ensure healthcare communications are implemented appropriately.

Opportunities abound
A variety of external factors have created opportunities and helped to boost the role of communications. However, a greater internal focus on measuring the effectiveness of programmes has also made a significant contribution to the perception of the value of communications. In the past, in some quarters, PR portrayed a slightly fluffy image - all a bit nebulous and perceived as fairly narrow in range (media relations) with too many people claiming its effect could not be measured. Systematic evaluation of the impact of PR activity and growing expectations of effectiveness metrics are helping to change this attitude.

The HCA Evaluation Toolkit, launched in 2003, was the catalyst for making systematic evaluation of healthcare communication common practice. The better agencies were evaluating their programmes prior to this, but the introduction and widespread use of the toolkit raised minimum standards.

In 2007, the HCA, now five years old, will take the systematic evaluation of programmes a step further with the launch of a cost versus impact tool, aimed at helping people choose how best to apply the different elements of the communications mix in order to maximise effectiveness.

Healthcare communications will continue to thrive despite new constraints. Moving forward, new challenges will arise, however, through true collaboration between healthcare communicators in both pharma firms and the agencies, the discipline will become an even more important element in our industry's success over the next five years.

The author
Julia Cook is chair of the Healthcare Communications Association. The Good Practice Guide will be available to HCA members early in 2007

2nd September 2008

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