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When to use medical education

Medical education is perfectly positioned to help pharma convey complex messages about its products through traditional media, as well as digital channels and the development of online communities

A decade ago clients wanted sponsored supplements, advisory boards and a bit of key opinion leader management from their medical education. But times have changed and medical education is now very much a growth area with increasing budget being allocated to this element of the marketing mix.

The reasons for this are varied, but it  seems as if the end of the blockbuster era has contributed to increased demand for medical education programmes. There are less new drugs coming onto the market and in 2006, just 23 new drugs were approved by the Food and Drug Administration (FDA), compared to 114 in 1996.

The pharma industry is also moving from being primary care-focused (which shaped sales and marketing models in the 1970s, 80s and 90s), driven by large marketing budgets behind a relatively small number of 'big brands', to a more specialist market where value can be gained from a larger number of more niche products.

Many of the most exciting and innovative products being launched are highly technical secondary and tertiary care products where advertising and PR certainly have a place, but the complex messages and data are best delivered by tailored educational programmes. These markets are more complex than primary care, with highly skilled clinicians working at the cutting edge of medicine and the widespread use of many drugs in off-licence indications.

Patients are also being encouraged to become experts and take ownership of their conditions which, coupled with the ever-increasing might of the media, means that there is also a lot of work to be done in managing expectations – both of patients and prescribers.

This has been clearly illustrated by drugs such as Herceptin, which quickly became a household name and is, quite literally, seen by some as 'a cure for cancer'. However, in reality only a specific patient population will be suitable for treatment, and funding through the NHS will be limited.

Medical education, in particular, has the power to deal with many of these issues. The core value of any medical education campaign is to understand the needs of the customer and create a programme that addresses these needs, while delivering the brand's key messages.

This is an approach that fits very well with the requirements from the Association of the British Pharmaceutical Industry (ABPI), Prescription Medicines Code of Practice Authority (PMCPA) and other such bodies that say promotion of medicines should be focused on improving patient care.

Medical education is uniquely placed to deliver exactly this kind of programme.

What is medical education?
This is a question I find myself answering fairly often not only to clients but also with family and friends. The easy answer is 'anything that is clearly not an advert or a piece of media coverage'. The truth is not too far removed from this, in that many tactical tools find themselves stuffed into the medical education toolbox these days.

Medical education includes (but is by no means limited to) meetings, exhibitions, mailings, training programmes, key opinion leader access and development, surveys, publication planning, websites, supplements, guidelines, salesforce tools and educational services.
How effective they are really depends on how good we are at choosing the right tool for the job. It's this choice and the skill of those who draw on them that dictates whether they prove to be a blunt instrument or just the tool for the job.

Medical education is certainly still about sponsored supplements and advisory boards, but there's a whole lot more on offer nowadays. While healthcare advertising has been clearly influenced by global briefs, in medical education and PR, this influence is limited as the issues are different in each affiliate country.

Digital media and med ed
The digital age offers us new platforms from which to deliver more innovative and interactive programmes. Taking the core value of producing a programme that appeals directly to the needs of a customer, these new digital platforms are valuable as they allow individual users access to information and education most relevant to them, while still being exposed to core brand ideals. Examples of this include web- casts, web or CD-based distance learning programmes and the use of RSS feeds.

An area of growing interest is the use of discussion forums. Brand managers are looking increasingly to see how the overwhelming interest in consumer forums and social networking sites might be harnessed within the pharmaceutical arena.

It can be done but it is not for the faint hearted. Developing a discussion forum for healthcare professionals (HCPs) to use is a lengthy process, not because it is difficult to build but due to the medico-legal issues to consider and the approval/moderation processes that need to be agreed. In addition, you will need a promotional campaign for any form of online activity to ensure customers are aware of it and are encouraged to use it.

Promotion can be either on or offline, or ideally a combination of the two and should consider the following, both how to gain new users/members and how to keep them coming back.

As with many offline activities this is not a short term activity. Users will take time to get used to the site, to trust it and for a critical mass of other users to join and keep things moving and interesting. The challenge is how to get through this initial period and keep them coming back.

Moving on from discussion forums, the digital holy grail in any market is to build an online community. Once you have a busy forum this could be the next logical step.

This is not one for an individual brand and needs the commitment of the whole business behind it to succeed, as MSD's demonstrates. This site offers a variety of content to its members, including a great deal of educational material, much of it unique to univadis. There are myriad issues to discuss and protocols to agree, but the potential rewards are great.

Mature brands
In the current economic climate there is a growing need for all businesses, including the pharma industry, to increase effectiveness and seek additional revenue streams.

This, coupled with the reduction in primary care blockbusters, has led to increased emphasis on maintaining growth of more mature brands. 

Mature brands are estimated to provide 50-80 per cent of a company's revenue, but often they are not actively managed. This is changing: companies are now looking to maximise income and more effort is being spent on extending the life mature brands.

There are, of course, many challenges for mature brands. Something as simple as maintaining the attention of your customers is a challenge for a mature brand when there is no new data to work with.

Initiatives designed to drive brand loyalty and depth of prescribing through long-term customer relationships are required. Again, this is where many marketers have turned to medical education and increasingly I see opportunities for these brands to use online activities to great effect. Initial set-up costs are significant but once a community is established it can have a great impact for minimal cost.

The ABPI Code
Many of the considerations mentioned here arise specifically from the ABPI Code of Practice. There is no doubt that the Code  is becoming more prescriptive about what can and cannot be done (although online activity is still a difficult area to gauge) by way of product promotion.

In some areas this will mean a sea change in the way pharma and reps operate. We will also need to reconsider what KOL development is and establish new ways of working. It seems to me that this is likely to involve more educational events and activities.

Taking customers to international conferences will also need careful consideration. Some companies have already made big changes in what can be done while abroad, but as with activities in the UK, the key will be to have clear educational goals for any activities. There are some great ways to engage customers while abroad and disseminate your messages back in the UK, they just require some lateral thinking.

Another big change for me when considering the ABPI Code is the move away from looking for the best ways to exploit the grey areas of the Code and instead take on board the idea that it is the impression you create that counts. Just because it isn't specifically disallowed doesn't make it right. If you think you're on rocky ground then you probably shouldn't do it!

The author:
Gail Rowe is a director of LeapFrog Medical, a division of Adventis Health
She can be contacted at or on +44 (0)1494 731 600

14th November 2008


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