Social Media in the BioPharmaceutical Industry

Jennifer Sayer

20Nov2011

Social Media is changing the way marketers communicate with consumers.  In healthcare, social media is empowering patients, facilitating physician networking, and increasing transparency through increased speed of information flows and real-time consumer reaction.  This new paradigm is at significant odds with the pharmaceutical industry’s traditional approach to marketing (See Table 1), and Pharma is struggling with how best to approach the new model of manufacturer-consumer interaction afforded by social media.

Table 1:  The Differences Between Traditional BioPharma Communications and Social Media

How might drug manufacturers better navigate this changing environment?  Clarescent recommends several key steps for pharmaceutical companies:

1. Lean towards non-branded use of social media
2. Facilitate connections between and redefine key external stakeholders
3. Listen continuously and respond quickly
4. Build a positive corporate image with increased outward focus

Lean towards non-branded use of social media

Healthcare consumers are skeptical of pharmaceutical companies, and this healthy skepticism is evidenced in consumer advocate responses to the FDA’s call for feedback around forthcoming guidance on “Promotion of FDA Regulated Medical Products Using the Internet and Social Media Tools.”  83% of the consumer comments to the FDA were anti-pharmaceutical, and among consumer feedback was a concern that social media would be used as yet another medium for drug advertising.  One consumer advocate suggested that “the last thing this country needs is more advertising by drug companies.”⁴

A 2009 survey of more than 2000 consumers corroborates the skepticism voiced to the FDA, revealing that over 85% of consumers would not want to use Twitter to interact with a drug company.  The reasons cited for this preference include mistrust of the pharmaceutical industry as well as an aversion to the idea of being “sold to” by drug companies: ‘I don’t trust them to tell me the truth,” “They would try to sell me.”  In the same survey, however, consumers note that drug manufacturers could bring value by providing disease state information, tools, and credible resources through the use of social media.

The key learning from healthcare consumers is that they are wary of drug companies and view branded information skeptically.  At the same time, they have real needs around their disease that could be met through pharmaceutical company efforts.  Therefore, instead of pushing branded promotion and DTC ads through social media outlets, we recommend that companies consider providing unbranded patient support through disease state education, useful tools, and references to other credible, non-branded sources of information.

Facilitate connections between and redefine key external stakeholders

Patients view patient advocates, peers, and physicians as reliable sources of healthcare information.³ While the 2009 consumer survey suggests that consumers are fearful of a social media “sell job” from drug companies, 62% of those same consumers see significant value in the use of social media tools to communicate with health care practitioners (HCPs) and experts.  Whether used to consult with a physician as a means to save the time required for an office visit, to ask minor questions of a disease expert, or to network with peers to understand others’ experiences, patients view social media as a way to reach out to trusted sources to better understand their own condition. ⁵

Novartis’ CML Earth is a great example of how a pharmaceutical company has helped to connect key stakeholders through a unique social media platform.  CML Earth is a social network site targeted to Chronic Myeloid Leukemia patients, advocacy groups, caregivers, and HCPs.  Through the site, users can access an interactive map that shows the location of individual network members.  Members can search for and network with other patients, caregivers, HCPs, and patient advocates – in their local areas or around the world.  By hosting a network that enables key stakeholders to interact and share experiences, Novartis has used social media to meet a key need of its CML patients – that of connection.

Patients are driven to connect with peers and experts around healthcare-related issues.  However, social media forums for connecting these stakeholders area not always available for specific conditions.  We suggest that pharmaceutical companies provide social media tools to facilitate this connection.  In doing so, companies can fulfill a significant patient need while building a positive image within the disease community.

Listen continuously and respond quickly

The case of McNeil and the social media backlash to its ads for Motrin illustrate the need for a drug manufacturer to be able to listen to social media and to respond to crises accordingly.  On a Friday in September 2008, McNeil launched a campaign in magazines and online, including a “light-hearted” video they hoped would become viral.   The ads were targeted to new moms who carry their babies in slings, and emphasized while that “wearing” your baby might be “in fashion” and make you feel close, the practice can be physically taxing.  By the end of the day you may be sore and need Motrin.

The immediate social media response of moms to the ad was pure outrage.  Thousands protested the Motrin brand on Twitter while other angry moms blogged and posted angry response videos.  Countless moms pledged to never buy Motrin again.  The company had not been listening and had no planned approached to dealing with the outrage, but by Sunday night responded by taking down the entire corporate web-page.  By Monday, they had issued an apology that has been criticized as being stiff, clumsy, inhuman, and cold.^8.9

The Motrin “Angry Moms” incident highlights the need for drug manufacturers to both listen to and respond to social media trends in real time.  Companies must continuously monitor social media to retain awareness of how their brands are positioned and how consumers are responding.  Further, drug manufacturers must alter internal approaches to enable rapid responses to issues fermenting in the social media space.   The current copy clearance procedures within the pharmaceutical industry are not sufficient for responding to the real-time interactive reaction and dialogue afforded to consumers by social media.  Moving forward, companies must change these procedures.  Doing so would have enabled McNeil to better respond to the Motrin social media crisis with a voice that was human rather than corporate.  This also requires a change in the organizational mind-set to being nimble and to listen.

Build a positive corporate image with increased outward focus

Studies show that healthcare consumers are distrustful of pharmaceutical companies and thus are reticent to be engaged.  As such, increasing positive perception among consumers is critical for ensuring the pharmaceutical industry’s success in social media.  Despite numerous social media blunders such as the McNeil Motrin example, there are a few interesting case studies for the use of social media by drug manufacturers to increase it’s standing with the public and to “humanize” it’s corporate image.

Johnson and Johnson’s BTW corporate blog, established to connect the people of Johnson and Johnson with outside stakeholders, is one such example.  Launched in 2007, the company describes its blog as the voice of the company, asking “…everyone else is talking about our company, so why can’t we?”  While the limitations of communication are clearly stated to consumers on the first page, the blog serves as a forum to respond directly to external questions and to address sensitive issues such as drug recalls.  The blog is edited by former Bloomberg Business reporter Marc Monseau.  While Monseau does most of the writing, others within the company frequently contribute, covering topics that serve to “humanize” the company such as employee activities and corporate philanthropy.  Further, a blog roll on the site provides links to non-Johnson and Johnson sites and blogs that share information about health and human welfare.

While blogs such as Johnson and Johnson’s may be commonplace in other industries, BTW is unique within the pharmaceutical industry.  Johnson and Johnson’s move to create a voice from within the company has been heralded as “bold and courageous” within a heavily regulated environment for which the FDA has provided scant guidance.  While risky, BTW has enabled the company to humanize its corporate face and to improve its ability to communicate outwardly with consumers.  It is the company brand, not the drug brand,  that becomes the face to social media. Other drug manufacturers would do well to learn from their example.

References:

1.   Comscore custom research, May and June 2009 (n=1002)

2.   Berkman and Syme, 1979, “Social Networks, Host Resistance, and Mortality:  A Nine-year Follow up Study of Alameda County Residents,” American Journal of Epidemiology 109:186-204

3.   “Social Media in Healthcare,” Red Shoes PR

4.   “Consumer Advocates Step Up and Submit Comments to FDA Regarding Regulation of Social Media,” Pharma Marketing Blog, March 21, 2010

5.   Social media and drug companies, “What is the Value”, Rich Meyer, Online Strategic Solutions (N=2000+, 2009)

6.   John George,PhiladelphiaBusiness Journal, October 10, 2008

7.   Nielsen Online, “Listening to Consumers in a Highly Regulated Environment,”8/2008

8.  “The Most Important Branding Investment for Pharma this Year:  a Crisis Communication Plan for Social Media,” Leigh Householder, Med Ad News, 2011

9.   “Offended moms get tweet revenge over Motrin ads,” USA Today, November 19, 2008

Biologics: The Importance of Patient and Physician Service Offerings

The pharmaceutical industry’s focus is shifting. While the industry has traditionally focused on small molecules and blockbusters, the number of biologics in pharma pipelines is now exploding. In 2007, worldwide sales of biologics increased by 12.5% to $75 billion, almost twice the 6.4% increase in sales of traditional pharmaceuticals. Biologics are used by only 1% of Americans, but currently account for 15% of total drug spending. By 2010, experts estimate that 4% of Americans will be using biologic treatments, comprising approximately 60% of US drug spending. In order to prepare for the increasing number of biologic products poised to enter the market in coming years, the pharmaceutical industry must prepared to support physicians and patients through the complexities they face when prescribing, administering, and paying for biologics. As a recent Clarescent LLC study reveals, manufacturers’ services in support of biologics are valued and necessary for both healthcare practitioners and patients, and a network to provide these services is expected to become the norm to successfully compete in the market.

The increased efficacy of biologics is driving the growing interest and utilization. For many patients suffering with chronic diseases such as MS, rheumatoid arthritis, psoriasis, cancer, and others, biologics offer hope through improved long-term outcomes over traditional pharmaceuticals. This increased efficacy is not without a cost, however. Since biologics target patient groups that must meet very specific requirements around disease stage, progression history, and past treatments, volume use is low. The low volume of patients on biologics coupled with the high development cost contributes to expensive treatments. Depending on the disease, treatment with biologics usually costs several thousands of dollars per year, significantly higher than traditional pharmaceuticals historically used to treat the same conditions. (See Table 1). Insurance plans often refuse to cover these treatments, and those that do usually place biologics on unfavorable tiers with prior authorization required. Patients on Medicare may find themselves in the “donut hole” only a few months into the year, resulting in significant personal expense. These issues present patients on biologics with a high out-of-pocket cost and due to the financial burden many patients fail to comply with therapy. In response to this financial burden and the consequent risk of non-compliance, some manufacturers have implemented low co-pay and patient assistance programs to enable qualifying patients to receive free or low-cost drug.

In contrast with traditional pharmaceuticals, biologics are large molecules, and most require administration subcutaneously or intravenously. If a doctor’s office is unequipped to support IV infusions, the patient must be referred to an infusion center for administration of the drug. To ensure proper use of self-injectable biologics, patients require injection training from health care professionals and must have timely access to medical professionals when follow-up questions or issues arise. Due to the unfavorable formulary status of most biologics and the almost universal requirement for prior authorizations, medical office staff members spend considerable time and effort navigating the intricacies of insurance plans prior to initiating treatment for their patients. Further, the patient requires ongoing education on their chronic condition, out of pocket drug cost, payment options, and available sources of support. These “patient-servicing” activities in support of the prescription and administration of biologics place considerable strain on clinic staff. In order to alleviate this strain, some biologics manufacturers offer support services directly to office staff to assist with benefits investigation, disease state education, injection training, and other patient-directed services which have traditionally been the burden of clinic staff to provide.

As the results of a recent Clarescent LLC study in MS indicate, currently-available manufacturers’ services help alleviate the financial and administrative burden of biologics for patients and health care practitioners, and a set of patient and HCP focused services is required to successfully compete in the biologics arena.

Clarescent LLC interviewed 30 Multiple Sclerosis (MS) healthcare professionals to establish the current landscape of manufacturer support offerings and to identify where key support gaps still exist. Because nursing staff represents the front-line for MS patient care – initiating benefits investigation and prior authorization efforts, conducting injection training, fielding patient phone calls, and following up with compliance-related issues – RNs from clinics and infusion centers from across the US comprised the majority of MS professionals interviewed for the study.

Study research indicates that all manufacturers of biologics for the treatment of MS offer some level of support for both physicians’ offices and patients (See Table 2), and MS professionals report that almost all competitors are delivering these services at a high performance level. Study participants have rated all available support offerings as highly valuable and have placed a special emphasis on reimbursement support that alleviates the burden of investigating a patient’s benefits and obtaining prior authorization for a particular treatment (See Figure 1).

A universal theme among study participants is the time-consuming nature of ensuring that patients will be reimbursed for treatment. The paperwork required by health plans is burdensome, and, due to the medical background required to navigate insurance complexities, nursing staff is pulled away from patients and into the process. Despite their medical expertise, RNs are not intimately familiar with all insurance plans and often need assistance with “translating” benefits summaries into language that they and their patients can understand. The length and complexity of this process can prevent patients from starting treatment in a timely manner and, as such, MS professionals report that the availability of services to assist with ensuring patient reimbursement for treatment can ultimately drive prescription choice. MS drug manufacturers have responded to this issue by offering benefits investigation and prior authorization services to patients and office staff. For most manufacturer-sponsored programs, paperwork for enrollment is completed by office staff when a particular treatment is chosen. Once the patient is enrolled in the manufacturer’s program, the manufacturer investigates the patient’s benefits and assists the office staff with prior authorization.

MS professionals report that a newly-diagnosed patient’s first concern is usually their out-of-pocket cost for treatment. Even when treatment is covered by insurance, a high formulary tier implies high co-pay, and insured patients can face hundreds of dollars in monthly costs. Manufacturers have responded to patient out-of-pocket expenses through co-pay or other patient assistance programs through which patients are guaranteed some maximum co-pay for a limited amount of time or can receive reduced-price drug based on annual household income. MS professionals are positive about these programs, as they help promote patient compliance by capping a patient’s out-of-pocket expense.

Despite the high value and performance ratings given by MS professionals to current manufacturer support offerings, Clarescent’s study reveals some opportunities for improving reimbursement and patient support for MS biologics. Currently, most reimbursement support programs require that patients and office staff complete and fax paperwork to the manufacturer. In order to minimize paperwork for office staff, manufacturers should consider making enrollment and access available to office staff and patients online. Additionally, some manufacturer co-pay programs are heavily reliant on a patient’s annual income for determining assistance eligibility. In order to ensure that all patients receive necessary treatment, MS professionals recommend a more comprehensive approach to evaluating a patient’s full financial picture than income alone. Further, to minimize confusion and streamline access to patient and reimbursement services, competitors may benefit from considering a “one-stop-shop” approach to providing services through a single “patient advocate” as opposed to providing different contacts for each different service. Due to the debilitating effects of MS disease progression that often interfere with a patient’s ability to drive, MS professionals recommend providing transportation services to ensure that patients are able to consistently attend their clinic and infusion center appointments.

Clarescent’s MS study highlights the time and effort required by healthcare practitioners to initiate and maintain biologic therapy for their patients. Manufacturers acknowledge this burden and have responded by providing a set of support offerings designed to assist with reimbursement, patient training, and education. As voiced by MS professionals, services offered by manufacturers in support of treatment enable them to ensure that their patients start treatment in a timely manner and, most importantly, remain compliant with therapy.

In the MS example, a high bar of service offerings has been set and must be met to merely enter the market. The same can be assumed for other indications and therapeutic areas as companies increasingly develop biologics to target chronic diseases. Moving forward, the pharmaceutical industry may want to consider biologic therapy not merely as the drug itself, but as the “full package” of treatment and manufacturer service offerings. As our MS study reveals, patients and professionals view these manufacturer services as valuable and necessary, and the availability and quality of these services will play an increasing role in driving prescription choice as more biologics come to market.

References
1. IMS Health Data, Medical News Today, 19Jun2008
2. N. Lee Rucker N.S.P.H., “Biologics in Perspective: Expanded Clinical Options amid Greater Cost Scrutiny,” June 2007
3. Diane Parks and Steven Lo, “A Place for Biologics in the Managed Care Environment: An Evolving Perspective”
4. Clarescent LLC Study, December 2007

Tables and Figures

Table 1: Annual Treatment Costs – Biologics vs. Traditional Pharmaceuticals

Condition Prevalence Biologics and Annual Treatment Costs Top Traditional Pharmaceuticals and Annual Treatment Costs
Rheumatoid Arthritis 2.1 million people in the US Enbrel
Remicade
Rituxan
Humira
$15,000-$22,450 Aspirin
Ibuprofen
Methotrexate
Prednisone
$100-$300
Multiple Sclerosis 300,000 people in the US Avonex
Copaxone
Rebif
Betaseron
Tysabri
$12,700-$28,400 Prednisone
Dexamethasone
Gabapentin
Phenytoin

$200-$1,400
Cancer 10.5 million Americans living with cancer Procrit
Gleevec
Sutent
Herceptin
Avastin
Erbitux
Rituxan
$5,500-~$32,500 Cyclophosphamide
Doxorubicin
Methotrexate

$100-$1,600
Osteoporosis 10 million in the US Forteo

$6,700 Fosamax
Actonel
Boniva
$750-$1,000
Diabetes 18 million people with Type 2 diabetes in the US Novolin
Lantus
Novolog
Humalog
$1,100-$2,000 Glimepiride
Glipizide
Metformin
Avandia
$190-$1,100

Table 2: Available Services Provided by Manufacturers of Biologics for Multiple Sclerosis

Figure 1: MS Professionals Ratings of the Services Provided by MS Biologic Manufacturers (Scale of 0 to 5)

Your Movements Speak for Themselves: Space-Time Travel Data is Analytic Super-Food!

Location based data (mobile device location based transactions) is at the horizon, or maybe even here today. Thoughts for application of location based analytics to the healthcare industry.

• don’t need district managers and sample sign offs; track the reps mobile device (doc time, windscreen time, …)
• understand what conferences a doc goes to and who she talks with to get peer advice (including reps from competitors)
• where was a patient before they decided to come to the doctor and where did they go afterwards (to fill a prescription at the pharmacy or to the gym to change their behaviors); tracking emergency room visits (retrospectively)
• where are my peers who are supposed to be in a meeting with me now
• which other pharma CEO is at the same restaurant at the same time as my company’s CEO (time to sharpen the resume)

http://jeffjonas.typepad.com/jeff_jonas/2009/08/your-movements-speak-for-themselves-spacetime-travel-data-is-analytic-superfood.html#

Digital Divide … ciao

Used to be there was talk about the digital divide, between the haves and the have nots.

No it is not the divide between the rich and the poor countries that I am talking about.   While true, there are people in London today who do not have a digital life and those in Malawi who do.

The digital divide that is disappearing, with a greater impact, is the one between our ‘real’ life and our digital life.

Counting down days to when my Nike running shoes will tell my ipod how fast I am running and it will download on the fly and play songs that I like listening to at that pace.  Based on the reoommendations of a connection whom I’ve only met on the net.

End of wonder days for biotech?

Biosimilars approved in Japan and White House making noises that 7 years is enough market exclusivity for biotech products.

Google as the KOL Influence Mapping 2.0 tool?

As our relationships get digitized and move online, mining these relationship networks for health care providers will quickly and simply provide us the KOLs and their rankings.