Setting the record straight

Mapping out the totality of the communication mix in an impact vs cost chart is one possible tool for comparing the relative value of different types of activities. The Y axis charts low to high impact, while X axis maps low to high cost. Activities can then be plotted according to their value and groupings achieved from the attractive 'high impact, low cost' quadrant to the less attractive 'low impact, high cost'. The grid should be plotted by all involved in the marketing planning process following extensive discussion and debate. How it appears will differ according to the stage of the product lifecycle, the market dynamics, data available and other variables.

Source: HCA Survey 2004

How would the ABPI Code define RoI in relation to communications activities? Are we allowed to measure RoI under the Code?
The Code makes no reference to RoI per se. The successful implementation of promotional activities can legitimately be measured by RoI, but non-promotional activities must be measured in an alternative way. Many activities undertaken by communications companies are defined as non promotional, eg, provision of information (directly or indirectly) to the general public, medical and educational services, activities related to clinical research, activities undertaken before the licensing of a product or new indication, and dealings with patient organisations.

What has changed since the RCP report?
Publication of the RCP report earlier this year has drawn attention to the pervading concern about the extent to which patient organisations and HCP education, to name but two examples, are dependent on the industry for their funding. It seems likely that, with time, doctors may contribute more towards their own postgraduate education where, previously the industry has largely funded it, but time will tell. However, it is the pharmaceutical industry's own Codes (National, European and/or international depending on who we are representing) with which we must willingly comply.

If non-promotional pharma activity shouldn't be linked to sales, what measurement criteria is acceptable?
Where the activity is non promotional, RoI is inappropriate. These activities are legitimately designed to create an appropriate environmental change, increasing disease awareness or educating about the changing nature of disease management.

However, the decision to prescribe should be made by the prescriber on the basis of adequate balanced information. Some of which may come from PR activities undoubtedly, and certainly, messages conveyed must be fair and balanced and not disguise promotion but should increase understanding and education, with the aim of better overall patient care. It would be inappropriate to measure the success of the delivery of these educational messages, by measuring sales. Indeed to do so infers the intent was to increase sales suggesting a non-promotional activity was designed to be promotional. These activities however, are no less valuable to the industry, as improved understanding and awareness about diseases and their current management, may well improve care of patients, allowing greater access to drugs, which, in turn, will ultimately benefit the industry.

Are we allowed to set a commercial outcome as an objective?
A commercial outcome could encompass expansion of the market, and this is an acceptable aim without being product specific, but to measure sales of a particular product would be unacceptable. Providing all other parts of the marketing mix are in place, the company funding the market expansion may well benefit by getting a slice of the now larger pie, but that product specific measure would be related to the promotional campaign they are undertaking and not to the non-promotional activities.

Are we allowed to set a strategy which leads us towards a successful commercial outcome, eg, 'creating awareness'?
Creating awareness about a disease, or important and radical changes in the management of a disease, may be acceptable since ultimately this would lead to improved patient care. However, creating awareness of the availability of, or information about, a particular medicine could be interpreted as disguised promotion and would usually be inappropriate. The strategic objective to create disease awareness undoubtedly provides a more receptive environment for other product specific marketing and sales initiatives to take place, but these activities must be quite separate.

Which areas of pharmaceutical activity are particularly sensitive when it comes to measurement?
The success of any activity deemed to be non promotional is always going to be difficult to measure. A tangible effect on the ['bottom line' may be a positive side-effect of these activities, of course, but the success should be measured by measuring whatever is the intent of the activity… and this is not always easy to do. Nor does it always entirely satisfy the company's senior commercial management who, understandably, are driven by the commercial success of the business. For example, pharma companies have often funded non-promotional nurse teams to review patient management with the intent of improving patient care. If as a result of that review, the patient's management is improved and modernised this is of benefit to the patient and is perfectly Code compliant. Patient throughput may be an appropriate measure. The company may also benefit if the prescriber, with all the available information from a multitude of sources, decides that the company's drug is, in fact, most appropriate for the patient. But it would be unacceptable to  measure the success of the programme by measuring the effect on local sales as it would immediately link the (apparently) non-promotional activity with sales of a particular product, thereby turning the activity into a promotional activity – a clear breach of Code.

Measurement of success of patient support programmes may also present a problem, but since they are usually product-associated and only available to the patient once the decision to prescribe the drug has been made, it may be acceptable to measure success in terms of compliance with prescriptions which, in turn, reflects better patient management. However, increase in number of prescriptions as the sole measurement of success, could give the impression that improved sales figures were the sole motivation for providing the programme. The intent must be to provide patient support towards better health so a variety of measures should demonstrate that the programme is of benefit to patients and not simply a means of increasing sales.

Which areas in the PR and communications field could be particularly sensitive when it comes to measurement?
Disease awareness programmes must demonstrate the success in achieving greater awareness of the disease and not awareness of the company's related product. Of course there is likely to be a product promotional campaign involving sales teams and marketing activities at the same time, and creating the right environment can enhance these programmes, but the measurements of success should be specific to each initiative.

Likewise, a media campaign, which is by definition non promotional, should be measured in terms of understanding and awareness of the messages communicated within the campaign. The same is true of medical education through non-promotional scientific meetings supported by the industry. Improved education should lead to better understanding of the management of disease, which in turn, benefits patients. Although this education will form part of the information which leads to the decision to prescribe, it would be inappropriate to measure the success of the educational programme in terms of the number of prescriptions for a specific product, written by those attending the meeting.

In short, the objectives behind any non-promotional activities are likely to be environmentally based and these should provide the basis for the measurement of success of the activities. If success is measured in terms of RoI, the activity is linked to promotion. Since the majority of activities undertaken by communication companies tend to be non promotional in nature, we need to devise novel ways of measuring success.