Modern tribe

Recently, a BBC headline exclaimed that the use of the internet and social media had 'exploded' in the UK. This 'breaking news' will come as absolutely no surprise to anyone who hasn't been marooned on a desert island for the last two years.

However, it is worth thinking about the incredible impact social media has had on all aspects of our lives. The phrase 'social media' itself was only coined about six years ago, but already we take for granted these personal communities. They extend across the globe and allow us to exchange information and opinions — sometimes with relative strangers, or at least with people we haven't met physically — in real time. Nothing seems to have a true existence anymore unless it is immersed in a 'community'.

Healthcare, already such a personal and emotive subject, is playing a central role in this revolution. I do not think it is an exaggeration to say that social media could be the greatest change to healthcare in the UK since the inception of the NHS. This time, however, the patients really are in charge.

Although we may still hear discussions about patients looking for information online, this is now old news, as patients throughout Europe are actively engaged in healthcare communities. So let's get some of the inevitable statistics out of the way, shall we?

Results of the recent 'Cybercitizen' survey by Manhattan Research tell an incredible story: in Europe, 52 per cent of people actively use health 2.0 to manage their own or a loved one's condition, with around 80 per cent of Alzheimer's and cancer caregivers actively engaged in healthcare communities. These figures are staggering and indicate that simply supplying information alone is no longer enough.

It is not surprising therefore to learn that these health 2.0 consumers are twice as likely as the average e-health consumer to request a specific prescription: this group is formed of influencers and others rely on them to make decisions.

Market access
Contrary to what we hear in the press about the famous rationing, the NHS has always managed resources through demand. Health 2.0 has not only changed the patient's path to treatment, but has also redefined his expectations. In these challenging times, market access is rightly seen by many as the most important function in the modern pharma business.

Tremendous resources are spent developing economic models, engaging with commissioners and refocusing field resource on to the dreaded 'payer' (a term that I really don't like but for which I can never think of an appropriate substitute).

The truth is that the real secret of market access in general terms is the patients themselves. As a group they will no longer accept second best. The existence of communities like Twitter, Facebook and patientslikeme has meant that everyone from the local GP to the National Institute for Health and Clinical Excellence (NICE) and the Department of Health (DH) itself has been placed in a position where they are asked difficult questions by patients.

HCP engagement
We certainly should not forget the healthcare professional in all of this. Among physicians in Europe, 74 per cent use blogs, forums and other social media channels everyday to help manage patients. I have heard anecdotes about doctors using Twitter to 'crowd source' a diagnosis. What is more interesting is that nearly 50 per cent of these same physicians would like to recommend online information, communities and resources to their patients.

These physicians see the pharma industry as the most appropriate generator of such resources; many commented specifically that the increase in patient engagement offers a great opportunity to pharma companies.

Opportunities for industry
I am passionate that health 2.0 is not something pharma companies should fear, but is instead a significant opportunity. I have worked in the industry for a decade and have always been proud to do so: our jobs are based on improving lives — although mistakes are made I cannot see pharma as anything but a force for good.

However, the latest 'Trust Barometer' survey conducted by Edelman and presented at the beginning of the year showed that only 53 per cent of the general public trusted pharma companies. Thank goodness for bankers and the insurance industry.

This high level of mistrust is a terrible indictment of our ability to communicate what we stand for and what we offer to society. Trust is built over a long period of time and Twitter certainly does not offer any quick fix.

This is not about platforms, but about a change in behaviour, which will force us to abandon the 'command and control' attitude and develop more open and transparent communication. If people want to know how much money we have donated to Haiti, the specifics of a clinical trial programme or the true value of a new medicine, we should be prepared to have an answer.

To achieve the ultimate goal, there are three stages: listen, join the conversation and become a valued member of the community.

Listen
Most companies talk about listening, but this mostly refers to analytics and buzz reporting. As a self confessed geek, I love working with this kind of information, which does have real value — it is that we need to understand the digital landscape. However, despite monitoring the analytics, in the UK we very rarely encourage people to contact us and develop a dialogue.

The GSK for You website in the US is an example of information, resources and contact details developed for consumers, but this example is rare. Many companies have not yet reached the level of displaying telephone numbers on their websites. This is an important point to note, because the industry is requesting specific guidance for digital media while falling short of providing information that is permitted under the current ABPI Code.

Develop a dialogue
Corporate Twitter, disease-focused Facebook communities, YouTube channels get people in communications and marketing excited and other people in the business a bit nervous.

Where we have the credibility this can be very successful. The Johnson & Johnson social media engagement in the US is much lauded and has numerous successful projects including a 12,000 strong Facebook community for mothers of children with ADHD, and a similar community for adults with the condition. Sanofi-aventis has an integrated project for people with diabetes, comprising the resource website GoInsulin.com, a YouTube channel and an iPhone app that locates restaurants and offers nutritional information.

These examples are of course from the US, but with the right objectives this can also be achieved in Europe and the UK. Janssen-Cilag has a Twitter account in the UK, which sends tweets about general healthcare news rather than about J&J's products. Being seen to be non-promotional is important because, generally speaking, people do not join social networks to be sold to: they want to collaborate, educate and be educated as well as entertained. We can meet this challenge.

Bull by the horns
The holy grail of social media engagement, which is very hard to achieve, is to become a valued member of the community. There are, however, examples where the relationship the company has with the consumer enables it to reach this position. Once again the J&J YouTube channel and social network BabyCenter can lay claim to this. With 2 million visits every month, the UK BabyCentre is the top site for parents and parents-to-be in the UK.

If we want to look more specifically at direct pharma offerings, we once again have to cross the Atlantic and see the interesting work both UCB and Novartis are doing supporting communities on patientslikeme. The hugely popular US website is coming to the UK and could offer a great opportunity to link directly with patients to capture real world data and enable us to respond more fluidly to the patient experience.

This brings me neatly to the challenges of implementing social media strategies. Managing adverse events (AEs) is probably the most popular reason cited as a barrier to pharma involvement in social media, but, with concern for objectivity and patient safety, engagement can be a great strength.

The same must be said for negative comment and the possibility that the company can come under attack at any stage.

This is, of course, true. In the modern world of instant comment and real time global communication it is not possible to control the entire conversation. Bad things are said about our industry, and so inevitably bad things will be said about your brands and your business. In my opinion, unless we are part of this conversation we have no channel of meaningful reply: statements in defensive corporate speak, highly structured and rigorously approved Q&As and nice corporate websites (with no engagement but photographs of happy, smiling people) just will not wash in the future.

I personally look forward to the UK pharma industry seizing the bull by the horns over the next six to 12 months. I expect to see many more integrated social media projects launched, some will be successful, some not. With this will come the realisation that the risks of engagement are much less than those of not stepping up to the challenge.

We may have to give up some of the control in exchange for the capacity to influence, if not, how can we reach out to the public and be a force for good in the challenging years to come?

The Author
Alex Butler is the communications manager at Janssen-Cilag

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