Tunnel vision

Most pharmaceutical marketers and brand teams will admit, when prompted, that their target audience of physicians uses the internet regularly and is actually becoming increasingly active online. Yet, if you were to ask them if electronic marketing material has an impact on clinical decision making, practice efficiency or the product preference of this target group, many would hesitate to admit that it had.

There remains a belief within the pharmaceutical industry that the internet is largely a mass consumer channel and its strategic value to marketing is, at best, limited. While it is clear that physicians are still very reliant on salesforce interaction and traditional information sources, such as `hardcopy' professional journals, the market is clearly shifting as a growing number of physicians reveal a preference for receiving clinical, educational and promotional material about medicinal products online.

Perhaps the greatest challenge facing pharmaceutical marketers considering online marketing is that most still think of the channel in the most simplistic terms - a website. From the physician's point of view, however, the internet is simply part of a larger and rapidly evolving mix of multi-media interfaces. Online activities increasingly represent a diverse range of applications and resources including email, webcasts, electronic detailing and product information which is accessible 24 hours a day, seven days a week - when and where they want it.

Furthermore, as physicians are bombarded by an increasing intensity of `noise' from a promotional perspective, the ability of marketers to cut through the clamour and engage a physician based on their channel preferences is paramount in securing long-term sales and marketing success.

Despite talk of truly integrated multi-channel marketing, most pharmaceutical marketers still treat the online element of the mix as a unique strategy and fail to capitalise on the bundled value of synchronizing and branding information cohesively across all available channels.

Online preferences
In order to better understand the strategic role and impact of online marketing activities, and consider how pharma marketers can evolve their channel mix based on market trends, we conducted a survey of 1,000 practising physicians in France, Germany, Italy, Spain and the UK in December 2006.

Just over half (57 per cent) of physicians in these five markets consider sales reps to be a primary source of information about new and existing prescription products, yet 50 per cent of all survey respondents admit that they prefer to receive information electronically; via email, webcasts, podcasts, corporate sites or product sites provided directly by pharmaceutical companies.

Furthermore, 38 per cent of physicians in Europe who regularly go online say they frequently change their prescribing behaviour as a result of information they have accessed electronically.

While doctors still regard their relationship with sales reps as key, looking to them to offer a personalised service and provide immediate answers to product questions, it is clear that online communication has the potential to provide timely and relevant information to a significant physician audience, which is much larger than most pharma companies believe to be the case.

When comparing the various online resources and tools preferred by physicians, those interested in receiving product information via email represent the largest single sub-segment (see figure 1, right). This insight illustrates that physicians now view email as a core communication tool which, increasingly, rivals traditional sources of information, such as sales reps.

The mandate for pharma marketers is to think of electronic tools, such as email, as part of their overarching sales and marketing strategy; whether they form a component of the customer relationship management platform, or are embedded within the salesforce automation infrastructure. It is also essential for companies to realise that physicians with whom they interact on a regular basis are becoming increasingly expectant that online technology-based channels will be offered to them.

So, how should this information affect pharmaceutical sales and marketing strategy in the coming years?

The short answer is that companies must meet growing demands and invest in content and resources so that physicians can access product information, news and clinical updates online. Only when companies have invested in the online content will they be able to evaluate the prospect of moving into more evolved strategies, such as facilitating customer service and, eventually, providing multi-channel communication services to engage and educate their audience through the convenience of the internet.

local Portals: primary access
Doctors across Europe who go online regularly seek information from portals aimed specifically at the physician community. Resources made available on the leading portals typically include industry news, journal highlights or abstracts, clinical trial updates and product information, and are akin to global physician sites such as Medscape.com (based in the US).

Notably, the portals favoured by European physicians tend to be very local in nature. Local content is key. While many European physicians speak and read English, even native English speakers in the UK report that they prefer to access bespoke content created specifically for their market, according to the survey results. Based on this, firms should consider expending the additional effort to develop country-specific, or culturally-specific content, instead of launching pan-European portals, or even simply translating the same content within a given site. Research shows that physicians rely on, and appreciate, unique local content.

One of the most commonly used websites by doctors in the UK is www.doctors.net.uk; those in Spain use www.diariomedico.es; German doctors frequently visit www.dimdi.de; French doctors log on to www.quotimed.com; and those in Italy have found interest online at www.doctornews.it (see figure 2, right).

However, one portal that transcends the country barrier - precisely because it provides separate sites for individual countries - is Merck's Univadis portal (www.univadis.com). Not only is this one of the rare online sites operated by a pharmaceutical company that is actually used by doctors, but it reaches physicians throughout Europe. A site like Univadis may still have room for improvement, with regards to depth of content and services, but it represents a major step forward in strategic marketing through the visible recognition that there are opportunities for pharma companies to communicate directly with physicians online via branded channels.

Another significant factor to bear in mind when assessing the impact and strategic value of physician portals is the network effect. Simply put, as specific sites gain popularity they increase their value, both to physicians and sponsors, exponentially over time. The survey data illustrate that there is room for several physician portals within each market, yet certain sites are clearly emerging as market leaders. These have the added benefits of an increasing number of physician visitors coupled with growing investment, which ultimately manifests as deeper content and more services, attracting a greater number of regular visitors.

A replacement for reps?
It may be tempting to label any online promotional strategy aimed at a physician as `e-detailing'. However, visiting a corporate site to access information does not qualify as this. The definition used in this study was that of `branded programmes and interactive sessions' offered by pharmaceutical companies. What would qualify as e-detailing, however, is for a sponsor to invite a doctor to visit a site who then participated in a structured promotional programme about a product.

Although this seems to be splitting hairs with respect to the definition of e-detailing, it is important to categorise various online efforts and strategies correctly, to better understand the short-term and long-term strategic value to the sponsor.

While the figures suggest that e-detailing is close to saturation point in the US, reaching around 50 per cent of doctors, the European market is still relatively young both in terms of development and uptake. Less than 40 per cent of European physicians say they have participated in an e-detailing programme in the past 12 months (see figure 3, right). However, this is not due to a lack of interest on the part of European physicians - who in many cases (43 per cent) are not even familiar with e-detailing as a concept - but rather, a limited supply of formal programmes being offered to doctors across the region.

This limited awareness and supply of e-detailing programmes in Europe mean that a unique market opportunity exists. Several pharmaceutical firms are developing and implementing European e-detailing programmes, with Pfizer and Lilly driving the majority of market share and activity today, the survey showed.

However, the market here is still relatively untapped, allowing savvy, ahead-of-the-curve companies to capitalise on physician interest at a time when e-detailing is still somewhat of a novelty.

Corporate critical mass
The latest findings from our research indicate that 47 per cent of online physicians in Spain, France, Germany, Italy, and the UK visit the corporate websites of pharmaceutical companies.

The clear market leader in Europe is Novartis, followed closely by Pfizer. Other companies with leading sites and a strong presence include sanofi-aventis, Roche, and Merck. Although the market reach for individual corporate sites remains rather limited (at least when compared to the scope of salesforce interactions), some of these leading pharmaceutical corporate sites now engage 150,000 or more physicians on a regular basis (see figure 4, right).

When taking into account how much money is typically spent in order to get the attention of each individual doctor via the sales rep or through promotional investment, the economics and the cost-per-interaction online become very compelling to strategic market planners.

Despite the impressive reach of some of the leading corporate websites in absolute terms, however, European doctors using the internet say that these sites need significant improvement to meet their professional needs. Some corporate websites are able to meet their expectations, but the majority fall below the midpoint.

Accepting the fact that physicians are engaged online is the first step in a much longer journey to developing, designing, and executing a truly integrated multi-channel marketing strategy. Only when companies begin to account for the true size of the online physician audience, and how online channels affect offline decision making, will they begin to see the logic in boosting investment in these corporate gateways which, in due course, will also function as two-way customer service sites.

An online strategy is not simply building a website with product information and updating it a few times a year. A truly integrated strategy that incorporates online activities must be based on the channel preferences of the physician audience and incorporate tools such as email, product sites, webcasts and e-detailing.

Innovative marketers must think of information requirements from the physician's point of view. Medics are spending increasing amounts of time accessing information online. Europe's pharma marketers should plan for this physician market of the future.

The Author
Mark Bard is president of Manhattan Research, a global market research group. He welcomes comments on this article via: mbard@manhattanresearch.com