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March 17, 2015

People actively involved in their health and healthcare generally have better outcomes in managing their condition. So how do those of us working in healthcare and healthcare marketing motivate people to get more involved? While we don’t have all the answers, Health Union has learned some valuable lessons and practical tips for enhancing patient engagement since launching our first platform, www.Migraine.com, more than four years ago. Here, we share some key insights from our recipe for cultivating active, engaged patient communities, and hopefully, help marketers avoid common pitfalls.

1. Listen to patient communities
Our mantra – the community is always right! Observe patterns of engagement to learn what interests patients and what doesn’t. Success will come from aligning your agenda to respond to their needs, which will continue to evolve over time. For instance, early in the lifecycle of our RheumatoidArthritis.net community, Health Union created a series of yoga videos that could help patients with rheumatoid arthritis increase strength and flexibility. Unfortunately, we offered a great solution to a problem that our current members weren’t interested in fixing. However, as our RA community continued to grow – and interests became more diverse – these yoga videos eventually became relevant to a certain segment of the community. Engagement often depends on offering the right content at the right time, and it’s important to continually assess the needs of patients as your audience grows.

 2. Segment based on behaviors, not demographics
In our communities, we observe similar behavior patterns at various phases throughout the patient journey. For example, in people with type 2 diabetes, we recognized that patients who were newly diagnosed, adding a new medication, or lapsed treaters were all relating to tips-and-tricks-type of problem solution articles. So, we created a profile for these “frustrated quick-fixers” and developed a strategy to develop this type of content on many different topics. Once you recognize a behavior segment, seek to understand what’s driving those behaviors and find multiple ways to meet the true underlying needs.

3. Meet people where they are
Make it simple for people to engage, regardless of how much time, knowledge, or interest they have. The easier it is for people to engage, the more likely they are to do it, and keep doing it! While this seems obvious, it is important to keep in mind that what is easy for one person, may not be easy for another. Provide multiple, unique, and easy opportunities for people to participate where they are and according to their comfort level. We often initiate engagement on Facebook (without requiring a site visit) since patients are already there and willing to participate with a like, share, or comment. On our websites, anonymous polls enable “lurkers” to participate. We also build content to meet the needs of different types of community members. While some content is simple, basic information that can quickly answer commonly asked questions, other content is more detailed with higher-level scientific data.

4. Validate concerns or challenges first, and then offer solutions
Most people know what they should do to improve their health, but they don’t take action, for many reasons. Choosing healthy behavior is difficult. We’ve learned that we can increase engagement and empower our community members when we acknowledge and validate the challenges of making health improvements before offering solutions.

Many people with migraines become frustrated when encouraged to exercise by their healthcare providers. For some, exercise can trigger a migraine attack; for others, migraine is chronic and getting out of bed is exhausting in itself. Exercise tips and advice are often met with negative reactions among the migraine community. However, when we acknowledge that exercise can be a challenge for people with migraine and offer varying ways to increase physical activity while managing potential migraine triggers, we create a positive connection and encourage healthier behavior.

5. Align interests and opportunities
Once you learn what interests and motivates your audiences, provide more opportunities for them to get involved. Use past performance to guide strategy. Experiment with variations on proven areas of interest to create new ways to engage. For instance, we received an overwhelming response to our annual Migraine In America survey, making it clear that people with migraines are seeking opportunities to be heard, share their opinions, and compare experiences. As a result, we started building more feedback mechanisms into our communities – from quick polls and questions for our Facebook community to creating specific opportunities for patients to opt-in for survey invitations from corporate and academic partners.

While there are many ways to create and maintain patient engagement, these principles are some of the most critical for success.

Editor’s Note: This is the first installment in a two-part series from Health Union. Check out our April issue of DTC in Focus to read about making engagement a habit and how these principles apply to adherence and patient support.

Amrita Bhowmick


February 18, 2015

Programmatic advertising, the automation of media buying and selling using technology and data for hyper-targeting, is one of the ad worlds’ hottest trends. Research firm eMarketer recently estimated that digital display ads bought programmatically in the US grew 137% to more than $10 billion in 2014, and now account for 45% of all display ad sales. eMarketer expects programmatic spending to increase another 47.9% this year and by 2016 to reach $20.41 billion, or 63% of U.S. digital display ad spending.

Why the tremendous growth in programmatic? With the rapid increase in digital media over the past decade, there was simply too much inventory for humans, both buyers and sellers, to keep track of. Previously, the inventory that was hardest to monetize was aggregated into popular exchanges, bought and sold through real-time-bidding (RTB).

Buyers were purchasing “remnant” inventory via RTB. Premium inventory on premium sites was still limited. Enter “programmatic direct” or “automated guaranteed” – as the Interactive Advertising Bureau calls it – which allows advertisers to buy guaranteed premium inventory in advance from desired publishers. While programmatic direct made up only 8% of all programmatic sales in 2014, according to eMarketer, it’s expected to reach 42% by 2016.

And that’s where pharma advertisers should take notice. While RTB-based programmatic buying focuses on audiences, usually through some kind of cookie-based tracking, often behavioral in nature, programmatic direct brings the focus back to the editorial environment of context and content where pharma brands like to be.

DTC advertising, after all, has lagged behind every other category, as per Nielson reports citing a 22% decline in display ad spending from 2012 to 2014. For an industry specifically dubbed “direct-to-consumer,” DTC has often appeared to be neglectful of where consumers are actually looking for product information – online! eMarketer, after all, noted that since 2013, consumer digital use has even surpassed TV viewing.

The situation is compounded when you consider how quickly consumer mobile use is growing. comScore reportedin August that mobile use had overtaken desktop use. And while 44% of programmatic spending in 2014 was already on mobile, eMarketer projects that number will also surpass desktop this year.

DTC, alas, is also lagging in mobile. Funmobility’s Mobile Advertising Trends Report 2014 found pharma dead last in mobile spending amongst nine categories, and concluded: “This provides a gap in marketplace saturation that savvy advertisers can capitalize on.” The solution? “Preferentially target mobile ads to tablets, not smartphones. Tablet owners tend to have more disposable income, are 3x more likely to make a purchase based on a mobile ad, and use their devices primarily for web browsing – which is the behavior that health and pharmaceutical ads need to encourage, in order to educate users about their product.”

Of course, most pharma marketers are already vying for standard destinations and portals. But they can add programmatic strategically to improve the efficiency of their media plans, find relevant patients with larger reach, and get access to targeted consumers at lower cost. Here are some possibilities:

  • Contextual – Target via contextual analysis at the page level to reach patients in relevant environments along the patient pathway.
  • Overlaying first and third party data sources – IMS, Crossix and Symphony, to name a few, offer different products to better target relevant patients across the exchanges.
    • For Example, look-alike segments…cookie-based, without following patients
  • Geo-targeting – Use prevalence of a condition, script-level physician data, or patient data to improve campaign performance.

With safety being paramount to the placement of any campaign, the proliferation of brand protection services offiers pharma marketers the ability to verify context, block non-human traffic, optimize for viewability, and more.

So, for pharma media planners feeling the pressure from increased CPMs caused by lack of quality inventory and too much competition for premium inventory, adding programmatic placements to the media plan may well be the perfect prescription.

Bill Jennings


February 18, 2015
Why innovate? It’s a question frequently asked by many pharmaceutical marketers. From a campaign development perspective, innovation is seen as a way to break through the clutter in order to set new benchmarks for success. Unfortunately, in the process, it’s easy to just innovate for innovation sake, and implement the latest thing without regard to how it will accomplish brand objectives or scale in a meaningful way. Measurement is also often an afterthought that mitigates the cultivation of valuable insights and leads to irrelevant KPIs.

Widespread conservatism within the industry, due to regulatory burden, compounds the issue. Unorthodox innovation initiates a waterfall of time-consuming MLR reviews, which can lead to the dilution of the concept itself in order to gain approval. That new thing you were so excited about? Not only has it lost some of its luster, but the window for launch has been delayed to the point that it is no longer considered breakthrough. To make matters worse, the annual planning cycle compresses your once innovative idea to a four-month flight.

Marketers should never veer from paving new ground. It is essential that we identify and execute new marketing strategies that best align to our brands, can be effectively measured, and also meet the restrictions unique to our industry. In a time where technology, platform and content evolution is happening faster than ever in leading consumer and HCP channels such as mobile, social and point-of-care, it’s critical that marketers understand the challenges of adopting new strategies and utilize a tactful, big-swing approach to overcome each of them. That said, a methodical approach to prioritizing should be considered so that the new path leads to meaningful success.

Herein lies the innovator’s dilemma. How do pharmaceutical marketers embrace innovation successfully while adhering to the constraints unique to our industry?

For all of us, a brand’s life cycle is finite. FDA approval process and patent law has given us a clear start and end point. We’re all under pressure to use this time and our yearly budgets as efficiently as possible. Unfortunately, the default is to reinvest in tactics that have worked well in the past. While this is not 100% unwise, there are steps to be taken to reset our baseline for success.

  1. Be Selective: Pursue innovative tactics that are conducive to meeting your objectives. Just because everyone is talking about the next big thing doesn’t mean it is right for you. It’s critical we take aggressive bets on the right innovation, as that is how we can raise the bar.
  2. Think Big: Rather than pursuing many ideas at once, focus on a couple ideas that can make a meaningful difference.
  3. Think Long-Term: Twelve month media planning cycles aren’t going to change anytime soon. What can change is the way we think about our most strategic programs. Rather than approaching impact from an annual perspective, you can focus on ideas that you incrementally improve over time. While you may not be committing to a multiple-year program, empower your partners to ideate with you on what a long-term vision could look like.
  4. Consider Immediacy: Immediacy comes in two flavors – launch timing and time to impact. Innovation doesn’t have to mean creating new assets. It could be deploying them in new ways. Giving legs to proven assets not only squeezes more out of your creative budget, but it also allows for a more timely review so that you can move the needle for your brand faster.

As new technologies, channels and strategies surface in our industry, all marketers will inevitably face the innovator’s dilemma. Take confidence in knowing that innovation can truly change the success of your brand. If we as an industry can take an approach to adoption that is thoughtful, sustainable, and scalable, the pay-off will be tremendous for all groups involved.

Ashik Desai


February 18, 2015
The strategic role of content marketing in DTC campaigns is a hotly debated topic. While many industries have shifted their focus to building content that is authentic, educational and even whimsical in the hopes of building a rapport with patients, the healthcare industry is still finding its voice. Brands leading discussions can be perceived as self-serving, and creating authority in a world where brand communications are rarely heard is a challenge.

When determining the role of content marketing for Rx brands in the healthcare industry, our hands may be tied a bit, but it can still be a valuable tool when used correctly. The greatest opportunity for Rx brands is in content with broad appeal, because content has to compete for attention on a level playing field with everything from information to community to entertainment. This means that therapies addressing conditions with larger patient populations are most likely to have success with content marketing.

Given that content can travel across the Internet, many pharmaceutical marketers aren’t comfortable with models that distribute branded content into places their legal teams aren’t able to approve ahead of time. For many, this will mean that initial content marketing tests are best conducted with unbranded communications. Before you start producing content though, developing and agreeing upon a sound strategy is key.

It is important to focus on information patients, KOLs and caregivers want from you. Not trying to be everything for everyone is difficult to accept, but having focus can still allow your voice to be heard.

The recent campaign by Shire Pharmaceuticals does just this. The campaign focuses on driving education and awareness around Binge Eating Disorder (B.E.D.), a condition officially recognized in 2014 by the American Psychiatric Association. When treated, Shire benefits with approval of their drug Vyvanse being the only medication approved to treat moderate to severe B.E.D. in adults in the US. Because of this unique situation, they are in a position to drive the conversation around B.E.D. among patients in a landscape where they are one of the few voices.

When you are in a position to drive a conversation it is easy to be heavy-handed and talk only about your company or brand. This is one of the biggest mistakes Rx brands can make in this area. Eisai Pharmaceuticals developed a content and social campaign around their weight-loss drug Belviq. They have developed a social strategy under their corporate name, which is a step in the right direction, but it is clearly focused only on their own agenda.

It is no surprise that the above message has very little engagement as the entire program is focused on promoting their support and savings programs. Consumers can sense when they are being sold to versus having a conversation with, and will act accordingly.

While consumers hate being sold to, they do appreciate and trust authorities. Focusing your information to the right audience is important, but proving to be the authority on that information is what will gain traction and trust with your audience. Biogen Idec recently announced a partnership with two athletes who will act as patient advocates for the company’s multiple sclerosis campaign, MSInspiration.com. Both Tyler Campbell (former NFL prospect) and Chris Wright (former NBA player) suffer from the disease and take Biogen’s MS infusion treatment, Tysabri. The goal of MSInspiration.com is to drive MS sufferers to submit their own inspirational stories just as both Tyler and Chris have. Chris Wright (@self_madeest89) is regularly promoting the site as well as his own foundation while Tyler Campbell’s Hall of Fame father Earl (@earlccampbell) also actively promotes the effort.

This is a great example of a brand knowing they cannot always be the face of a content campaign and get the results they want. Instead they align themselves with an authority figure that can help get the message out.

A common hurdle most pharma content marketing campaigns face is keeping content fresh. A large part of this can be attributed to the seemingly insurmountable challenge that regulatory bodies can present in approving content at a pace that will keep patients engaged. With legal reviews, what goes in is not always what comes out, and unique and creative content is usually the first thing to hit the cutting room floor. Knowing this variable isn’t going away, it stresses the importance of thinking strategically about what role content marketing plays for your brand and if it is a channel worth pursuing. If you are not able to produce the content that is truly meaningful to your target audience, an alternative channel or platform may be a better option.

While there is no doubt that content marketing can have a large impact for Rx brands when done right, it is not always a feasible option for everyone. Before content development begins, it is important that the appropriate marketing teams think strategically about the role it plays and quantify the value to determine its worth.

Chris Tuleya


February 18, 2015
Direct-to-consumer marketing efforts for many prescription drug brands rely not just on appropriate clinical targeting but on creative executions that are emotionally relevant and resonate deeply with appropriate patients. That creative, whether it’s a television or a print ad or a website or a brochure, needs to be grounded in a big creative idea that breaks through in a world crowded with health messages and experiences clamoring for patients’ attention.

We’ve been expanding our discovery of the target patient beyond their clinical profiles, disease conditions and standard demographics, and digging into the attitudes and behaviors of the target as a member of a generation. Baby Boomers (and Generation Xers and Millennials, and every other generation as well) have shared the same formative experiences, historical events and life stage milestones, developing generational attitudes and behaviors to culture, consumption, life, work, love – and health. We take these generational mindsets and apply them to the health and wellness experience of the target audience, especially when our Strategic Planners brief our creative teams on DTC television and digital marketing projects.

In one recent briefing on a specific disease condition, Tonic’s strategists ensured that the creative teams were steeped in Gen X’s favorite TV shows and music, their undeserved reputation as directionless slackers, their focus on family, as well as a typical day-in-the-life of a busy Gen X working mom. Our creative teams learned that the Gen X woman is a fan of the TV show “Parenthood”, is sentimental about Bon Jovi’s “Livin’ on a Prayer”, doesn’t think her post-college job at the thrift store meant she didn’t have a plan, has her work-life balance planned down to the minute, and puts her family first. All of this helped build a textured portrait of a very demanding patient who needs a treatment solution that meets their clinical needs and is easy to take, as well as one that doesn’t interfere with the hard-won and finely calibrated lifestyle and family life that Gen X values so greatly

Whether the brief is for Baby Boomers with diabetes or COPD, or Millennials or Gen Xers with allergies or HIV, Tonic strategists ground the creative teams in the experience of the generation with pop cultural references like hit songs and popular movies as well as news events and historical timelines. These shared experiences have shaped the values and beliefs of the generation and when these are extended to, say, how a person with allergies feels about their medicine or someone with HIV feels about talking to their physician, the stage is set for powerful insights that can inspire vibrant and resonant creative ideas.

“The more detailed the picture of the target is, the more the content we make for them will get their attention,” says Tonic’s Chief Creative Officer, Phil Silvestri. “Knowing the target is a Boomer or a Millennial helps us bring their broader lives into the creative, making it mean more to them.”

The creative teams have been reinvigorated and inspired, producing fresh creative ideas that are resonating with target audiences from all generations.

Katie Rogin


November 19, 2014 0

By Mike Rutstein

 

How many cures can you count in your lifetime? For the majority of us living today, that number is likely few, if any.

While vaccines for polio, chicken pox and diphtheria made a dramatic 20th Century impact in life expectancy (particularly in the Western World), until recently, cures and therapies with curative intent for serious diseases such as cancer and Hepatitis C have been relatively unreliable and not always effective.

For years, conspiracy theory has swirled about with critics showcasing the pharmaceutical industry as an example of the worst part of capitalism with the sole purpose of garnering profit and the incentive to suppress curing disease. These same critics cite economic interest as the main reason why no medical breakthroughs or cures have been made for the most common diseases. Despite resounding proof demonstrating dramatic progress across a number of disease states, economic outcomes data and improvement in quality of life measures, the swirl continues and the pharmaceutical industry remains a lighting rod for criticism for stalling progress in the name of profits.

But something surprising is starting to happen. Cures and therapies with curative intent are here in Hepatitis C, and they are coming in cancer, as well as other serious diseases. And everyone, from the pharma suppliers to providers, to payers and patients, is suddenly scrambling to figure out what all of this means.

From Chronic to Cured

Historically, the model in which pharma and its marketing machine have operated against for most serious diseases has been driven by maintenance and chronic care. And that means ongoing disease management, a long-term and complex patient journey, a lifetime of prescription therapy (often trial and failure of multiple medications) compliance challenges and a heavy recall schedule.

But a new cure creates new healthcare norms for all.

As marketers, we’ve been taught and trained to play the long game. To build brands slowly and purposefully over time. And to recognize that where one therapy has failed, another may successfully help manage and control a condition from progressively getting worse.

However, in the case of a condition like Hepatitis C, new cures mean that every key stakeholder is suddenly faced with the prospect of quickly eradicating a virus. The treatment paradigm shifts from trial and error with unreliable therapies and long-term disease management, to short course therapy with 90%-plus efficacy. From spreading financial exposure over time, to upfront cost amortized by eliminating longer range consequences including hospital costs and potential liver transplantation. From a stagnant pool of warehoused patients, to an aggressive waterfall driven by intense patient demand. From a single reliable cure, to multiple cures with (in some cases), almost parity effectiveness. And everyone fighting for their piece of a relatively small pie.

The first thing that new cures for any disease demand is a change in the way healthcare marketers think about managing their molecules. That starts by hitting the reset button on the planning process. In an environment where multiple cures with relative efficacy are aggressively elbowing for market share, the traditional top-down cascade and slow and steady brand building may not be the strategy that that will win the race. Marketers need to strike rapidly and aggressively to establish themselves as “The Cure Standard.”

Getting there is about a lot more than just being first or pouring on the money. It’s about:

  • Socializing the advent of a new cure to permeate popular culture and create talk value
  • Building a bond with patients and demonstrating that you truly understand them and how their lives have been impacted by their disease on a physical and emotional level
  • Establishing credibility – a critical component in all communications given skepticism around the ability to cure disease
  • Redefining the “value” proposition; providing perspective and helping patients understand the longer term health and economic value of treating today
  • Creating an unparalleled experience in a parity world and providing a specific cure choice that goes well beyond just product features and attributes
  • Recognizing that, with some cures, the patient journey may be relatively short, so the treatment experience needs to be fulfilling, yet simple and easy to navigate.
  • Leveraging the influence and power of cured patients (and their stories) to further establish a specific Brand as “the standard of cure”

The future is Here

With a robust clinical portfolio, ongoing promotional presence and positive patient response, historically, brands have been able to reach standard of care status and astronomical heights over time. But the future is here and, in the case of Hepatitis C, new cures are changing the game for everyone. In other categories such as cancer, researchers are unraveling, cutting and manipulating DNA, combining nanotechnology with medicine, exploring gene therapy and creating immune response that allows the body to act as its own therapy.

While it is unlikely that we will experience a flood of new cures in different categories anytime soon, DTC marketers should begin to think through the broader business implications that a cure potentially carries. On the surface, many traditional marketing principles still apply, but establishing a “Standard of Cure” is not business as usual. Consideration needs to be given across a number of areas including the influence of culture, the changing dynamics around the patient journey, and the importance of establishing an unparalleled patient experience.

Mike Rutstein