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Uncharted waters

Why is pharma still tentative in its use of e-marketing channels?

SunsetPharmaceutical marketers have not embraced digital marketing because they lack an understanding of what they can achieve by using it. Addionally, campaigns need to prove a return on investment and many of those who have dabbled in the e-channel say they have not seen the expected results.

These were the findings of a survey carried out in early 2008, by Onyx Health, to assess how UK brand managers are using the e-channel in their marketing plans, and what challenges they face in doing so. It found that 43 per cent of those questioned have undertaken e-detailing as their main digital marketing activity. It is anticipated that this figure will rise to 69 per cent in 2008, despite 17 per cent of respondents saying their e-detailing campaigns fell short of achieving their objectives. and OnMedica, two major suppliers of e-detailing, give guidelines for an effective digital campaign. They agree that for a campaign to be successful, it must be created specifically for the e-channel; existing detail aids must not simply be converted to an online format; key messages must be included on the first page of the e-detail and e-details must last no longer than three to five minutes.

It appears that electronic continuing medical education (eCME) programmes and webcasts will feature highly in most marketing plans this year. Around 53 per cent of brand managers plan to carry out webcasts to reach customers who cannot attend medical events and 50 per cent of brand managers plan to launch a range of eCME programmes for their customers. This is not surprising considering the majority of e-marketing programmes are driven by med ed and PR firms.

Access barrier
The survey revealed that companies mainly target GPs to overcome the access barrier. Around 30 per cent of respondents target hospital doctors, pharmacists, practice nurses and specialist nurses. Funders, however, are largely ignored, despite their need for evidence-based information.

Some 65 per cent of respondents said they are concerned about patient bloggers and around one-third about medical and pharmaceutical bloggers, however only 8 per cent are planning to actively engage with them. Around 72 per cent of respondents have not even considered the impact of medical social networks on their business, which is particularly worrying considering that SERMO, a major medical social networking site in the US, will launch in the UK this year. SERMO bring clinicians together in an online environment to share best clinical practice, accelerate the emergence of trends and share their collective intelligence. It provides a platform through which they can either challenge eachother or collaborate on ideas. The site created a storm in the US when a number of doctors were able to highlight, very quickly, both the positive and negative attributes of certain pharma products.

On a global level, Pfizer took a step towards engaging with SERMO and, as a result, its medics are now able to participate in online discussions, providing they identify their affiliation to Pfizer upfront. Pfizer also asked clinicians what they most wanted from the company and the overwhelming response was for Pfizer to listen to what doctors had to say instead of assuming it knew what they wanted to hear.

The same can be said of medical bloggers. Pharma firms can engage with bloggers providing they give them the information they require and not just what they want the bloggers to receive.

There are now a considerable number of medical bloggers in the UK, largely driven by the pharmaceutical advisory community. Matthew Robinson, pharmaceutical adviser in Blackpool, sends out daily bulletins about key prescribing issues to those registered to his blog ( The National Prescribing Centre has also created an on-line community where medicine managers exchange views daily on pharma products.

The challenge for pharmaceutical companies remains just how to actively engage.

Engaging with bloggers
The PMPCA recommends that pharmaceutical companies do not sponsor blogs. Some argue, however, that this contradicts principles established in relation to other areas of sponsorship. For example, it is possible for a company to sponsor material or an activity and not be considered responsible for it, provided they are not closely associated with specific details of the campaign or materials. The same should apply to blogs.

Companies should engage with bloggers through open and honest dialogue. The pharma company needs to be upfront about its own needs and listen to, as well as understand, the needs of the blogger. It is important that bloggers are given the latest clinical data about brands to prevent miscommunication; once information is on the web it is very difficult to retract. Brand and marketing communications managers should not forget that bloggers can also be useful in getting the right messages out to the market regarding a particular product problem, recall or discontinuation. Do not underestimated their influence.

The e-channel might seem an ideal way to overcome the access to doctors barrier, however nearly 70 per cent of respondents were concerned that doctors would not get on board with the concept of e-marketing.

Around 80 per cent were concerned that doctors would get annoyed with the number of promotional emails they receive, especially in light of the explosion of new sites targeting doctors with medical education and promotional materials. Last year the magazine Doctor launched its internet portal, following in the footsteps of GP and Pulse. While the likes of may only send one email a week to doctors, other sites are not as mindful.

It is not unusual for a GP to get as many as 35-50 promotional emails a day, meaning there is a very real risk of doctors diverting all promotional emails to their junk boxes; just as we saw them close their doors to the army of sales reps in the past.

Those familiar with maximising the internet's capacity use pull methods (such as Google alerts and RSS feeds) to receive only the information they want, and send unsolicitored, irrelevant emails to their junk boxes.

Leading healthcare peer review journals - including the Lancet and the British Medical Journal (BMJ) - as well as many patient groups - have RSS feeds. Doctors in the UK are only becoming aware of this service now, but its use is likely to increase as they start using the internet more for eCME and clinical purposes.

The problem with pharma using RSS feeds is that they focus more on providing promotional material than on offering evidence-based items. There might also be confusion around the fact that RSS feeds pull information from the entire web, meaning customers may be exposed to the promotional activities of other countries.

The solution probably lies with companies such as and OnMedica producing disease specific customised alerts and emails that cover a variety of clinical updates. This could include feature news articles and promotional items for a number of brands, in much the same way specialist journals such as Progress in Neurology and Psychiatry or Geriatric Medicine have done in print.

Grey areas
From a regulatory perspective, 63 per cent of respondents believe the greatest barrier to any e-marketing campaign is a lack of clarity within the ABPI Code of Practice. While many of the existing rules can easily be translated to the e-channel, there are still a lot of grey areas. This is because the Code operates on a complaints system so it mainly responds to issues that have arisen rather than anticipating situations that may arise. Consequently, nobody knows how to do something right until someone else gets it wrong - this presents problems for any innovative marketing initiative and the internet is no exception.

These grey areas are the main reason that many brand managers have decided to sit on the fence and wait, rather than test what can and cannot be done through e-marketing campaigns. In 2007, 31 per cent of respondents surveyed did not undertake any e-marketing activities. In 2008 nearly all respondents revealed they were planning to undertake some form of e-marketing initiative, but 45 per cent will only undertake one or two specific projects as opposed to developing a comprehensive e-marketing plan that blends into their traditional strategies.


How to blend e-marketing into your marketing plan

ï Decide what you need the e-channel to achieve for you
ï Decide what traditional activities could also be used within the e-channel
      - Webcasts of satellite symposium
      - Podcasts summarising key clinical papers
      - Medical educational programmes
      - Banner advertising on medical sites with click throughs to other on-line activities
ï Get the right level of budget commitment early - do not try to do it on a shoe string
ï Include market research to ensure you are able to benchmark and measure the impact of your on-line activities, so you are able to answer those return on investment questions
ï Decide how you are going to involve your sales force so they do not feel alienated
ï Work with your existing agency to see how they can integrate the e-channel into their existing activities to maximise outcomes
ï Remember marketing is about a sustained effort, buying sporadic or one-off activities from suppliers without thinking how they fit into your marketing strategy will leave you disappointed.
61 per cent of respondents felt they lacked knowledge of the e-channel and that this was of great concern t o them, yet 60 per cent of total respondents did not know if training would offer any benefit. While this attitude seems strange, it is a good marker of where the general attitude  of marketers lies with regards to the e-channel. Brand managers cannot rely on the expertise of their boss or their boss's bosses in this area, as it is largely unchartered territory.

The weakness is that if everyone goes for the soft options such as e-detailing, no-one will really push the boundaries and truly embrace e-marketing.

It will more than likely take the development of a professional group to improve knowledge and the standard of e-marketing campaigns, along with staff who specifically focus on the e-channel. If not, there may be a lot of half-hearted projects being implemented that do not achieve their objectives, annoy customers and do not embrace the pharma marketing potential of the e-channel.

The Author
Karen Winterhalter, Managing Director, EMEA Healthcare Practice Group, Burston Marsteller

15th May 2008


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