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Tools for success

Pharma marketers should equip themselves for the patient self-care revolution

A spanner and wrenchWith the shift in the healthcare spending environment and the move towards greater austerity, the Government and the Department of Health (DH) are expected to ask the public to take on more responsibility for maintaining their personal health when treating minor illnesses. This move follows  publication of the DH's 2008 Pharmacy in England: building on strengths — delivering the future White Paper, which laid out a new approach to the recognition, diagnosis and treatment of common ailments and diseases.

Pharmacies and their staff will be asked to provide a wider and deeper community health role to take pressure off GP surgeries. People are also being encouraged to learn more about minor ailments such as headaches, dermatitis and backaches, so they have the knowledge and confidence to choose accurately the at-home treatment or over-the-counter (OTC) option that best suits their needs.

This trend is what many observers are referring to as the self-care revolution.

In the UK, treatment for minor ailments consumes, on average, 18 per cent of a GP's workload: time, it is argued, that could be better spent identifying and treating more 'serious' illnesses. There are also financial as well as efficiency implications: of the 57 million GP consultations involving minor ailments that take place every year, 91 per cent result in a prescription, costing the NHS £371m every year.

But it doesn't have to be this way. There is a large number of drugs with impressive safety records already available; pharmacy education is improving and there is a growing recognition that a GP does not need to be involved in all medical interventions. In the present setting, the NHS could make a £10bn saving if patients attempted self-diagnosis before visiting their GP.

Over the years, people have become well versed in healthy eating and personal wellbeing. However, in general people remain reluctant to trust their instincts when it comes to self care and some are cautious about putting their health in the hands of pharmacists or retailers. People have unlimited access to information on the internet but do not have the confidence to apply that knowledge. Manufacturers are in a prime position to help educate pharmacists and retailers, and in turn the public, by providing them with the educational tools and direction they need to carry out a safe and successful self-diagnosis process.

Manufacturers can also apply to reclassify certain products, switching them from a prescription only medicine (POM) to a pharmacy (P) licence. Recent switches have included products that treat obesity and benign prostatic hyperplasia. In general, the possibility of future switches has been welcomed; however, a large-scale pharmacy and public education programme to accompany each switch would be required. This would ensure that these products are dispensed and used correctly.

The tools to make self care a reality are already in place, but questions remain. For example, should members of the public be expected to take on the responsibility to self-diagnose their illnesses accurately, without knowledge or guidance? Or should pharmacists and retailers be responsible for educating their staff who have contact with patients and consumers on a daily basis? Should manufacturers be responsible for ensuring their products are sold in compliance with regulations?

Preparing for the revolution
As a first step, to help them to identify the potential issues and, in some cases, opportunities that may arise from the change in how certain illnesses and complaints are managed, it is important for pharmaceutical companies to recognise and understand fully how self care, and an increased role for pharmacists, might work.

When large numbers of people start self-diagnosing there is an increased chance of accidental misdiagnosis or drug misuse. There is also an increased chance drugs could be mis-sold, either in store or via distribution channels such as the internet. Removing the role of a GP from the patient's diagnosis and treatment pathway may allow pharmaceutical companies to build stronger relationships with consumers and pharmacies, but it also increases the chances of misuse, unless these audiences are properly educated. Without this due diligence, the success of the self-care revolution may falter. These are the types of problems that could cause permanent damage to the reputation of a brand.

Already, cases of mis-selling and misdiagnosis have been reported; allegedly, obesity drugs that should not be distributed without a consultation with a pharmacist are being sold online and some people have admitted to becoming addicted to the codeine found in certain OTC painkillers, because they are not taken accurately or under guidance. This handful of examples demonstrates the apparent lack of control some pharmaceutical companies can have over this new situation.

Issues preparedness
Too often, pharmaceutical companies make the mistake of waiting for an issue to take place before reacting, which means they often react too late. Where possible, companies need to avoid issues before they strike by preparing and planning for the unexpected.

Conducting an audit will help to identify potential issues. Once these potential issues are recognised, plans to deal with them can be put in place. A good starting point is to develop three or four simple key messages that can be used to support a drug, its marketing, its licence and the strength of the supporting trial data for questions about efficacy or safety.

These need to be concise and precise, so they can be adapted for use in internal and external communication as well as in supporting collateral materials.

Developing supporting materials
Before an issue involving a product arises, companies should be proactive with their planning by creating a 'tool kit' consisting of support materials that can be shared quickly and easily. One of the most important tools to be included in this kit is the Q&A document, which should include pre-determined answers to every possible question that anybody — patient, journalist or external group — may ask. Once developed, this document can then be used as a starting point for the creation of all other supporting materials. In addition to these, the tool kit should contain all existing background reports, trials or press releases that support the brand and defend it against potential issues. If these do not exist, they need to be developed.

Statements are crucial in the management of media issues to ensure accuracy and transparency. The language needs to be objective and clear, and the statement must deal with the issue head on: there is no room for PR spin here. As honestly as possible, communicators need to explain what happened, why the issue took place, what will be done to correct it and prevent the situation from happening again.

The ideal scenario would be for accidents involving people to be avoided in the first place, which would prevent media issues from arising. To help with this, pharmaceutical companies must identify key third party groups and build relationships, communicate and collaborate with them before any incident occurs. These relationships will allow companies and third parties to educate consumers by delivering clear and accurate drug usage advice. Examples of these third party groups include pharmacies, the wider healthcare community (such as GPs and nurses), the media and consumer and professional groups.

Educating key communicators
With the self-care revolution potentially just around the corner, pharmacy and retail staff will be faced with a new type of consumer interaction; they will be required to play an important role in the consumer's self-diagnosis process.

Equally, pharmaceutical companies have the opportunity to form an important part of the process: they are in a prime position to educate and up-skill consumers on the use of their products. This will help manufacturers control what is being communicated about their product and influence the positive choices consumers are making in the OTC market place.

A report by the Proprietary Association of Great Britain (PAGB) stated that 68 per cent of consumers make the same OTC choice time and time again, proving that it is beneficial for pharmaceutical companies — particularly those who plan to introduce new brands or have recently done so — to communicate effectively.

Training
In an ideal word, every pharmacist, retailer and member of staff would be trained properly to engage with consumers and taught how to diagnose effectively. However, it is not feasible to ensure that 100 per cent of consultations will be 'by the book'.

Companies need to identify key communicators and senior trainers to help educate all staff, including supermarket and pharmacy chain employees. Companies have the opportunity to be responsible, consider the safety interests of the public and improve their image by educating people about their brands and supplying them with further knowledge on diseases. Many variations of training can take place, including organised training days to educate staff on how to engage with consumers and encourage them to discuss their symptoms, or workshops where staff can learn about a particular drug, when and how it should be used, and for how long.

In many cases, pharmaceutical companies will not be able to reach out to everyone who is in a position to recommend their drug and advise on usage, but as a minimum they should try to supply pharmacies, supermarkets and GP surgeries with educational collateral and tools that can be used to train communicators on their behalf. There are so many forms of educational collateral that can be developed, including downloadable patient leaflets, online learning zones, continuing professional development modules or doctor–patient tools on CD-ROM. The key is to keep all tools simple so they can be understood by trainees, who may also be under time pressures.

The need for this shift towards self care is evident. With it now well underway, pharmaceutical companies need to put a strategy in place to help manage the change as safely and successfully, with as little negative impact on the company, as possible. There are only two options available: to wait and see what the final outcome may be or to start preparing now for what may lie ahead. I recommend the latter.

The Author
Karen Dennehy works at Allidura, the consumer healthcare division of Chandler Chicco Companies

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

4th November 2010

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