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When big is beautiful

Charlie Buckwell explains why global medical communications programmes are the way forward

A globe surrounded by a stethoscopeThe ongoing change in pharma, which we observe and experience as a daily reality, is often characterised as a tipping point, involving a radical shift from the 'old model.' A striking feature of recent commentary on this change has been real difficulty in expressing what the new industry model might look like, and what it might mean for people in pharma, their customers and their suppliers.

One trend that I believe is inherent in the emerging model is the growing importance and strategic role of medical communications, which is increasingly at the centre of thinking and strategy. This reflects a broader move towards the science, towards customer insight and towards two-way dialogue, and away from a model founded on traditional selling and broadcast advertising.

Historically, the area of medical communications has been placed in a narrow box, especially in terms of its position with domestic clients, usually focused on accredited medical education. For some time, though, we have operated outside this box. I view class-leading medical communications as a broad discipline, bringing together scientific excellence, strategic insight and great delivery, rather than a single channel. The consistent force in this broad medical communications mix is a foundation in the evidence, and the desire to engage with customers in meaningful ways around that evidence. In medical communications, I believe the science must be valued at the heart of customer interactions, to the extent that such engagement is designed around the science.

A top global medical communications agency will not outsource or subcontract content development as a primary feature of its business model. It will value scientific content as intellectual property and expertise to be nurtured over time in order to provide continuity and maximum benefit to its clients. This means building strategic and creative medical communications, and customer engagement programmes, as founded on the science and driven by content, rather than as tactical executions.

Having a deep understanding of the science and its implications for patient management enables an agency to provide a strategic challenge to its clients and engage with opinion leaders in a different way. I see the focus of medical communications as driving translation of the science into clinical practice. In other words, activating evidence.

This may seem overly subtle, totally obvious, or somewhere in between, depending on your perspective. However, I believe it is fundamental to understanding what drives medical communications.

In practical terms, a class-leading medical communications offering should provide strategic-to-tactical scientific communication and market access solutions, covering healthcare professionals, payers and providers. Increasingly, there is demand for medical communications targeting patients and the general public, reflecting the growing focus on public health initiatives. Best-practice medical communications solutions provide both physical and digital initiatives and channels appropriate to a specific need, as well as enable synergies between global and national activities.

On this latter point, traditionally, medical communications have been handled more by global clinical and marketing teams than national teams, but this is changing. There is growing demand in all major countries for domestic medical communication programmes, outside the sphere of continuing medical education – often described in the US as 'promo med ed.'

Demand for integration
There are many drivers of the increasing importance and demand for medical communications (see box). These can be summarised as three fundamental shifts:
1. A move towards the science and away from a traditional selling and broadcast advertising model
2. A move towards greater clarity and alignment on global communication strategy, combined with greater insight and acuity regarding national and local customer needs
3. A move towards dialogue with customers and consumers and away from monologue, developing integrated multi-channel medical communications, focused on building mutually beneficial customer relationships.


Drivers of increasing demand for medical communications

• The move towards more complex, targeted therapies, in increasingly difficult-to-treat diseases – need for education and engagement around the science; significant input needed to shape the science
• The drive for cost-effectiveness and efficiency versus lack of access to customers via "traditional" sales and promotional channels
• The need for greater alignment around an agreed global communication strategy, but with greater acuity and insight into local customer needs, healthcare infrastructure, culture, drivers of decision making
• Increasingly complex communication channels characterised by dialogue rather than broadcast – the need for more tailored communications driven by customer insight and "pull" rather than "push" alone
• The continued move towards evidence-based medicine, requiring increased leverage of evidence-based information and assets, including expert opinion
• The need to demonstrate clear evidence of economic value alongside clear evidence of clinical value – integrated payer programmes becoming the norm
• The need to address transparency, regulation, scrutiny, reputation issues – a move towards the science and away from personal selling and broadcast advertising
• The need for expert opinion to be supported in having a voice and a platform, in balance to the non-expert opinion enabled via social media
• The need to better translate clinical trials into clinical practice, in order to close the clinical gaps between evidence and reality
• The increasing focus on medical communications initiatives targeted specifically for audiences such as nurses and pharmacists, to reflect their increasing role in patient management
• The increasing demand for patient adherence and support programmes in order to optimise both the clinical and economic value of a given therapy
• The increasing focus on disease prevention, involving a broader and more heterogeneous mix of stakeholders, all requiring the evidence base to be communicated in specific ways for specific needs.


In practice
I believe global medical communications agencies must place themselves better to meet the needs of global, regional and national pharma clients, wherever they may be based. Specific medical communications expertise must be developed for national clients, alongside specific medical communications expertise for global clients.

In building this capability, great emphasis must be placed on protecting high standards of scientific excellence, strategic added-value and quality delivery, supported by a consistently reinforced client-centred culture, with robust learning and development and best practice frameworks. Above all, the integrity of the science must be maintained, while creating opportunities for engagement.

UK perspective
Looking at this from a UK perspective, I see three principal avenues to add value for clients:
1. Optimising the value provided to UK national clients, to meet increasing demand for UK-specific medical communications programmes, tailored for UK regulations, infrastructure, culture, stakeholders, to fit within the mix. Where required by clients, this will include integration across the mix, utilising global network capability to engage advertising and promotion, digital and other expertise.
2. Optimising the value of global medical communications initiatives for UK national clients. Driving value and synergies from investment made globally in data generation, advocacy development and educational initiatives which could benefit UK domestic audiences. One important reason for building an integrated medical communications network is to maximise the value chain from origination of data, often at global level, to utilising that data in a particular country and ensuring its translation into real-life clinical practice. Often this will involve 'translatory' medical communications, whereby data are put in context of the national healthcare infrastructure, culture, patient management approaches, regulatory framework, label specifics and so on. In this way it becomes more meaningful and actionable in an everyday clinical context.
For me, this is how the true activation of evidence is defined. In practice, this means optimising the link between work done at a global level, for example, on publications and opinion-leader engagement, with work done at a national level to translate that data and knowledge into a national and local context.
3. Optimising the value provided to global clients based in the UK. Providing a coherent, functioning global network as a local-to-global source of insight and input into strategy and as a route for supporting global-to-local communications.

This multi-local expertise enables more customer-centred communication strategy, planning and execution, with instant access to healthcare professional and patient communities around the world, including patient advisory boards and alliance with key institutions.

Through this, bespoke disease-specific programmes can be developed, built on true multi-country insight, which can quickly address questions of local relevance, utility and channel selection. This is especially important in disease areas with vast cultural differences across countries in their approaches to patient management.

A top global network must also be able to facilitate the exchange of expertise in the specific regulatory environments in different countries.

A true network
Ultimately, we will bring together specialist expertise for global, regional and national clients and bind this together in cohesive global-to-local and local-to-global initiatives. Although the pharma industry is not yet widely purchasing this type of medical communications programme in an integrated global approach, it seems a likely development, given the need to maximise cost-effectiveness and efficiencies worldwide.

Active global collaboration will drive a rich and rounded offering for clients, activate the transfer of knowledge and data from global to local, and customer insights and learnings from local to global.

Building a truly functioning global network for medical communications may appear a bold, ambitious step right now. In the not-too-distant future, it is more likely to be seen as a minimum expectation for adding the most value to clients.

Charlie Buckwell
The Author

Charlie Buckwell is worldwide head of medical communications for McCann Healthcare, a leading global network, including Caudex Medical and Complete Medical Group. Before moving into this recently expanded role, Charlie was chief executive of Complete Medical Group. Previous to moving agency-side in 2000, he spent many years in global and domestic pharma marketing roles.

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17th December 2009


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