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DTC-In-Perspective by Bob Ehrlich

DTC in Perspective: Could Amazon Change the Drug Market?

October 13, 2017 0

The widely reported story that Amazon is considering entering the prescription drug market has made current drug sellers nervous. Could Amazon revolutionize drug sales? Or, would they just be another mail order supplier in a crowded market? The answer is unclear.

Amazon certainly has the strength to cut deals with drug companies, insurers and major employers to supply drugs. If a major insurance company wanted to work through Amazon to try to cut costs it is likely they could shave some expense. I do not, however, understand yet how Amazon would be able to fundamentally change drug delivery or pricing.

Bob Ehrlich
“…they are thinking of ways to shake up the supply chain…”
-Bob Ehrlich

Drug companies have established a complex supply chain with numerous levels of prices across different customer categories. Drug companies have no problem quickly supplying patients through drug stores, mail order houses, or in store pharmacies at supermarkets/big box chains. While certainly a convenient place to shop its many product categories, are there advantages for customers buying their drugs there?

I have increasingly bought more things on Amazon because I get free delivery through Prime. Their service is reliable. It is nice to be able to buy directly from them or their listed sellers. That being said, Amazon is still just a giant online market. Patients already have a vast array of options filling their prescriptions and I never heard anyone complaining how hard it is to fill a prescription. Unless Amazon can significantly lower consumer price, or save insurers lots of money, then the game changing aspect of their market entry is unclear.

I love Amazon and was lucky enough to hold on to my 200 shares bought at $35 many years ago. As big a fan as I am of their company, to change how drugs are sold is not easy. Maybe all Amazon wants to do is be another online option and grab a share of the huge market. Certainly, they have an enormous customer base who would be happy to add drugs on with other purchases.

Of course, Amazon is an innovator and maybe they will be able to add consumer value to drug purchases. Perhaps they will be able to launch retention and compliance programs using their customer research base. Alternatively, they may be able to innovate in disease and drug education. Their major asset is consumer trust and that should never be underestimated. Amazon has a team evaluating entering the market and my guess is they will enter, even if just as an ordinary supplier at the start. Long term I suspect they are thinking of ways to shake up the supply chain to offer substantial discounts to their customers.

Bob Ehrlich

DTC in FocusDTC NewsOne-on-One Interview

A One-on-One with Galderma VP & General Manager of the U.S. A&C Business Unit Alisa Lask: How Digital is Transforming their Patient Communications

October 10, 2017 0

In mid-September, DTC Perspectives spoke with Alisa Lask, the VP and General Manager of Aesthetic & Corrective Business Unit from Galderma, about the evolution of their digital marketing. “Digital has had a really powerful impact on the aesthetics brands,” she noted. Galderma’s aesthetics business unit is already seeing a large usage of their various digital assets, from materials at the point of care to their digital-only ASPIRE loyalty program. Another digital victory for the company is their Facebook Restylane® page, which after launching just a few months ago, is already outperforming competitors in the space.

Lask shared that, over the past few years, another evolution they have witnessed is how many Health Care Professionals (HCPs) are now using social media and how much they are using it. Utilizing a variety of platforms, including Facebook, Instagram, and Snapchat, HCPs are interacting both with Galderma and with patients. This uncovered a big opportunity for Galderma to invest in digital to create their own assets for their partnering HCPs, many of whom have around 10,000-15,000 patients in their databases on average. These materials not only educated the HCPs, but allowed those HCPs to share them with their staff and consumers in the office or waiting room as well.

Innovations to set a new standard

Galderma wanted to make the most of the opportunities digital affords, making one of their approaches an innovative use of video. Aesthetics products, such as Restylane®, lend themselves quite well to digital media. As the industry transitions away from still Before & After photos, Lask explained they created videos that would showcase the natural results of their treatments. “When we launched our two new products, Restylane® Refyne and Restylane® Defyne, earlier this year, the whole philosophy behind those products was that they were designed to be flexible  in animation and in expression in motion for natural-looking results.”

When sending out their first product samples to HCP offices, a video would play when the box was opened, with four different videos being included in each one. With people clamoring to obtain the sample boxes so they could view and share the videos, Galderma took their marketing to another level: text message video. If an individual, HCP or consumer, texted certain phrases to a designated number, they would receive four to five corresponding videos. Of the videos offering through the sample boxes and text message, Galderma developed real Before & After footage, digital animation of the mechanism in action, and the background and science of the XpresHAn™ technology. (XpresHAn™ is derived from the three components it comprises: X = Crosslinking; pres = Pressing gels through mesh for calibration; and HA = Hyaluronic Acid.)

Another innovative approach the aesthetics teams took was through their ASPIRE loyalty program, which is 100% digital communications. Consumers can receive educational emails, digital coupons towards products, and sweepstake offers electronically. Meanwhile, doctors can log onto a special portal within ASPIRE to obtain Galderma assets, find out which of their patients have redeemed Galderma offers or promotions, or track which of their patients may have lapsed in their treatment so they can provide necessary follow ups. Taking a digital only approach has not had a negative impact – Galderma’s response rates are just as good, if not better, according to Lask.

With an obvious expected increase in spending in digital and social media in the future, she said, “Having a social and digital strategy is status quo. I think the real focus is more on how digital and social are going to change, so we have to evolve our spending and budget.” With the challenge being adjusting investments, Lask added, “we all have to learn how to be a lot more nimble so we’re allowed to pivot quickly as the digital and social channels change.”

Ensuring relevance

Infographic shared with consumers, depicting the ‘Natural Expression in Motion’ theme.

Historically, pharma has often lagged behind other industries when incorporating digital or social media into their marketing due to a lack of clear FDA guidance. “There is no doubt that digital is changing faster than any of these regulations can keep up,” Lask noted, so they make sure to partner closely with their legal and regulatory teams from start and every step along the way. Consumers expect brands today to be “honest and candid, but [also] relevant to them.” Balancing such expectations with “the very important fact that we want safe and effective usage of our products … can be challenging and we’re learning as we go in many instances,” she said. Thus, they make sure their assets center on the important safety information, but present it in a consumerized way that people find engaging.

Lask stressed the importance of relevance when developing their educational and branded efforts: “We make sure first that it is relevant for the consumer. There is just so much noise out there, and if we are creating irrelevant material, you can almost guarantee that it is going to be skipped or not used. Then we put our focus on, what is the brand’s essence of our Galderma aesthetic product? It goes back to being honest, candid, and really being true to what we stand for.”

Galderma’s aesthetics brands employ both educational and branded tactics, depending on what is more appropriate at the time. “It’s a combination between education and branded marketing; we feel like you can’t do one without the other,” she said. With these treatments being elective, getting patients to be inspired by outcomes and addressing their primary concern – looking natural – is step one, she explained. Here, educational marketing leads the way. Branded marketing comes into play next to ensure the patient chooses their products, not a competitor’s.

Looking ahead

When preparing future plans, Lask has spotlighted three strategic areas, each one connected in a different way to improving access to education and information. One of the first things Galderma is keeping an eye on are websites such as Yelp or HCP reviews – anywhere that consumers can get engaged with how they find HCPs. She explained that, in the aesthetics market, those are very important to how consumers can figure out where they go for a treatment. Another area of watch for the team is around platforms such as RealSelf.com, which is a community-driven website providing information and research, reviews, and rankings for aesthetic medicines and cosmetic treatments. Lask likened it to the Trip Advisory of aesthetics.

The last key concentration is around retail pop up clinics, she said. It is empowering for consumers to have such access to information and freedom from scheduling appointments. But as a marketer, it provides other challenges – primarily, how do marketers find these places and then also ensure consumers are receiving their materials and relevant messages? Another barrier Lask found is that many of these retail pop up clinics, which are often owned by large corporations now, don’t usually want company branding or materials. She identifies this as a problem that will need to be solved in the future: “how to make sure that we’re able to touch the consumer in those offices as well?”

“The landscape is always changing, but that’s what is fun and exciting about it,” she stated. With more than two million women using aesthetic products currently and another 15 – 20 million more in the US alone who are interested in them, Lask said it is educating and providing them with information so they “really understand outcomes, what they can look like, and what’s possible.”

 

Jennifer Kovack

DTC in Focus

Without POC, You’re Missing the Point (of Script)

October 10, 2017 0

“What’s the ultimate call to action?”

This question was raised in a recent meeting, and I thought it a good one to discuss since we’re in the midst of planning season. Many would say the answer depends on the brand’s end goal. For pharma marketers, however, I say the ultimate action that brands need to focus on is getting patients to ask their doctor for a prescription for their treatment.

Script volume is the be-all and end-all measurement of the effectiveness of pharma marketing. Make no mistake: impressions and click-throughs are important metrics and help drive patients to the doctor’s office. But, ultimately, if those patients aren’t asking their doctors about your brand, your marketing efforts haven’t worked to their full potential.

That’s why Point of Care (POC) is so crucial for brand marketers. It’s the only tactic that puts your brand at the point of script, at the exact moments doctors and patients are thinking about and discussing treatment options. From the waiting room, to the exam room, to the back office, and now to beyond the office, thanks to mobile technologies, POC provides a connection point between your brand, the doctor, and patient. And it’s proven to drive desired behavior (1):
• 84% of patients who saw an ad at the POC are more likely to discuss the ad with their physician
• 77% are more likely to ask their doctor for a sample
• 68% are more likely to ask a doctor to prescribe a specific product

Many brands already realize the value of POC. Reaching $440 million in 2015, POC ad spend is growing faster than overall DTC advertising(2). Zion Market Research’s recent findings indicate that today’s $23 billion POC market will reach $40.5 billion by 2022.

But why do so many brands still find it challenging to choose between their tried-and-true digital tactics and POC? It shouldn’t be one or the other: digital and POC go hand in hand. For you Trekkies out there, I like to make this analogy: POC is the Montgomery Scott to your Captain Kirk. POC takes your digital ad and transports it to the exact locations you want, placing it in front of the exact audience you want, at the exact time they, and you, need them to hear your message—compelling the ultimate action of asking their doctor about your treatment. Then, it gives you clear insight into how that message changed doctors’ prescription-writing behaviors—and how much revenue was generated as a result. It doesn’t get much more impactful than that.

It’s planning season. You’re analyzing the risk versus reward of your tactics to determine a marketing mix that’s going to bring in the biggest buck. Why not include a tactic that delivers direct revenue—guaranteed. Be confident. Invest in POC and know you’re entering 2018 with a clear understanding of the impact your brand will have.

 

References

(1) Kantar Media for the Point of Care Communications Council, “Point of Care: Why Care?” 2017
(2) ZS Associates, “Right Place, Right Time: How Health and Wellness Companies Are Capitalizing on the Rapidly Growing Point of Care Communication Channel,” 2014

Linda Ruschau

DTC-In-Perspective by Bob Ehrlich

DTC in Perspective: Why Can’t We Do Better for Consumers?

October 6, 2017 0

My question to the DTC community is why can’t we come together with FDA and make DTC advertising more understandable.

I am not talking just about risks but also benefits and indications. We are all letting the approved label dictate how we say what we say. That label information is generally not consumer friendly. Consumers see advertising, not as a whole sales pitch, but merely the start of a buying process. DTC, because of regulations, seems to be treated as requiring an entire pitch where virtually everything must be discussed. Look at cancer advertising for example on non small cell lung cancer. I’ll use Keytruda as an example which is required to say it is indicated if PD-L1 is positive and there are tumors with no abnormal EGFR or ALK gene. Huh? Merck has to say it but does any consumer know what any of that means? I doubt it.

Bob Ehrlich
“Surely there is a better way.”
-Bob Ehrlich

What we have are technically oriented government regulatory bureaucrats in a non-technical DTC world. They should spend their time making sure everything said is true but also understandable. Instead of forcing Merck to discuss abstract qualifications on who might benefit, consumers would be better served knowing more about clinical results. Wouldn’t it be better to say Keytruda only benefits a segment of lung cancer patients and only your doctor can say if you might benefit? After all, patients do not self diagnose PD-L1 or their gene abnormalities.

FDA can make the 60 or 90 second ads much more consumer friendly and increase comprehension if they acted more like common sense regulators. They know many ads are data crammed and difficult to follow but it is their view that the label is like the Ten Commandments. Thou shall not deviate. So we get required language that is just wasting valuable air time that might be redirected towards giving consumers information they need and more importantly understand. I know Merck would probably like to do that. I also think OPDP would like it that way because I know the people there are trying to do right. Do we really think Congress intended consumer confusion in the 1970s when they wrote the regs never contemplating DTC?

Has OPDP pushed back on the Congressional committee regulating drug promotion that we need new promotional regulations? We can recognize that consumers just want mass media advertising to inform them that something might help them. They do not need the whole story rather just enough information to ask their doctor or search the Internet. Using the excuse that the regulations require all this complexity is abdicating the role FDA should have. We want drug DTC claim ads to be accurate and disclose serious risks. Surely, there is a better way. It will take FDA, Congress and drug makers to collaborate to determine how to improve. This is simple really and FDA should lead that effort.

Does anyone feel that we have done the proper job educating consumers when arcane medical terms are dominating DTC? Regulators tick off required boxes on their label checklist for DTC knowing full well consumers are often left clueless. My suggestion is OPDP have hearings on how to completely over haul DTC communication for today’s media environment, instead of using the excuse that they are captive to regulations written almost 50 years ago.

Bob Ehrlich

DTC-In-Perspective by Bob Ehrlich

DTC in Perspective: Obamacare Stays, Drug Companies at Risk

September 29, 2017 0

With the failure to come up with an alternative to Obamacare, Congress has left drug companies in a more precarious position. The goal was to make health care more free market oriented and less government controlled. That would have created more competition among health care providers and insurance companies. Patients would have more choice and more responsibility to use their health care dollars more wisely.

Bob Ehrlich
“DTC will likely weather the political storm.”
-Bob Ehrlich

Proponents of Obamacare say more free markets would mean less guarantees of coverage. The Congressional Budget Office has said the Republican plans would have led to many millions losing coverage. I do not want to take sides here. I will say that we do need a compromise that gets votes from both sides to have a long term plan that can endure changes in party control. Obamacare is helping many patients with pre-existing conditions, while hurting many others who are paying higher premiums with super high deductibles. This cannot go on as we are all paying too much for coverage. Our plans are increasingly becoming useful only for major illnesses, not covering routine expenses.

How do drug companies fare in this failure to repeal Obamacare? I am afraid they will now be a target for both parties as a driver of increased premiums and higher deductibles. Congress will have to deal with these issues and will look to drug companies to cut costs. Single payer will not pass, but we can expect to see more government involvement in pricing. Bernie wants reimportation from Canada which he says will save consumers $7 billion a year. He and many others want Medicare to have negotiating power with drug companies. Others in Congress want to end DTC or use tax policy to make it a non deductible expense.

California wants to legislate a notice period for drug price increases and mandate insurers tell them what percent of premiums are the result of drug costs. Other states will also try to add measures to embarrass drug makers with marketing disclosures.

Most patients will support measures against drug makers. We all want lower costs. Few patients understand the industry arguments that innovation justifies higher prices. While most Congressmen understand the need for a profitable drug industry, many think that profit is excessive and will be willing to cut that level of profits. Bernie thinks he knows how much is a fair profit and is perfectly willing to risk innovation for Canadian level prices.

DTC will likely weather the political storm because of commercial free speech provisions. The question is will drug companies voluntarily stop DTC if Congress demands it as a price to prevent reimportation or Medicare price negotiations. Drug makers will do what they need to to keep free market pricing. Unfortunately that means DTC is vulnerable to horse trading.

Drug companies like using DTC and its expanding use is proof they get a good ROI. Remember, however, that DTC spending is only about 1% of US Rx sales and might drive about 2% of sales. It is true that some brands are driven heavily by DTC but most establish 90% of their sales through physician promotion. So, can the drug makers stop DTC and still be successful? Most brands can and will adapt to a no DTC world.

My conclusion is the advertising lobby will prevent any punitive provisions affecting DTC. After all, the same media companies who bash drug companies regularly in their news coverage depend on DTC ads for a large portion of revenue. What is clear is the risk of those DTC restrictions are higher than ever before and we in the drug advertising world must stay involved in defending DTC as a positive force for educating consumers.

Bob Ehrlich

DTC in FocusGuest Columnist

Online Health Communities: A New Frontier in Health Research

September 22, 2017 0

For years, many luxury goods retailers, concerned about exclusivity and control, either sniffed at or completely ignored the internet as a marketplace.

Now, a recent McKinsey & Company Marketing & Sales report tells us “Nearly half of luxury goods buying decisions are already influenced by what consumers hear or see online.” The same report predicts that by 2018, “global digital sales for women’s luxury fashion are expected to grow from a current 3 percent of the total market to 17 percent, for a total market size of $12 billion.”

Conventional wisdom also underestimated the internet’s power as a source for health information, but a Pew Research Center study shows “80% of internet users have looked online for information about any of 15 health topics such as a specific disease or treatment.” The same study finds “34% of internet users, or 25% of adults, have read someone else’s commentary or experience about health or medical issues on an online news group, website, or blog.”

Likewise, conventional wisdom held that patients would never use social media for health information. However, Health Union research found that 26% of the patients used Facebook once a day or more for health information and more than half (52%) use it at least monthly.

Hubs for medical innovation

While the emergence of social media tools and online health communities as hubs for medical innovation might seem far-fetched, their importance in a digital environment can’t be overstated. We now live in a world where communication is multi-directional, information is more accessible, and experience-sharing is simple and fast.

But what can online health communities contribute to health research?

DTC Perspectives | DTC in FocusNot surprisingly, descriptions of a patient’s experience are most valuable when they come directly from the patient. Posing questions to an online community or monitoring conversations aids in the observation of trends in habits, desires, symptoms, and other information otherwise unavailable or difficult to obtain. Trends can be analyzed and online communities can provide feedback regarding product attributes that patients and caregivers find most important. Observational studies can inform researchers about real patient experiences and patient-driven research can serve as a starting point for future trials or as verification of previous results.

Online communities also offer valuable input for clinical trial design and feasibility. While the current belief is that patients are generally not involved, we’ve found that patients are very interested in contributing to the study design process. Patient advocates can add value to study development by identifying challenges and helping to create patient communications.

The rise of patient-driven research

We are witnessing a growing trend of patient-driven data from wearable technology from companies like FitBit, Garmin, and Apple as well as from direct-to-consumer health testing such as 23andMe or recently FDA-approved tests that can detect a predisposition for late-onset Alzheimer’s or Parkinson’s disease.

At the same time, we see an increase in patient-driven research. Although it is a less-controlled form of study, there is potential for it to complement controlled, scientific studies. And while there is a possibility for inaccurate data, there is significant potential for fast, large-scale, and low-cost data collection.

As an example, consider a recent online community’s participant-led study of the effects of lithium on patients with amyotrophic lateral sclerosis (ALS). The study had no control arm and required patients in the community to self-report their experience and ALS symptom progression while taking lithium.

The results from the community indicated there was no connection between lithium and symptom progression. Researchers then completed a scientific study, analyzed the patient data, and compared the experimental group to a control arm utilizing existing electronic patient records. Researchers concluded that the results of the patient-driven study held validity. These results also confirmed the findings of a previously conducted clinical trial investigating the same hypothesis  —  that lithium did not affect ALS progression.

Though these types of trials can have academic merit, they are not a suitable replacement for FDA-approved clinical trials. However, they show promise as a means of validating previous study results, or generating interest in a particular treatment method.

What motivates patients to participate?

Health Union’s latest survey data from nearly 20,000 individuals representing 12 different chronic conditions finds the majority of respondents (64%) are interested in participating in clinical research. We find the same trend among condition-specific communities such as migraine (74%), rheumatoid arthritis (64%), and inflammatory bowel disease (57%).

Community members are motivated by a desire to improve the quality of medical care for themselves and others, and to help researchers understand what it’s like to live with the condition. Other insights we’ve uncovered influencing motivation are also personal and compelling:

  • “As a young person who was diagnosed with something that can make you feel helpless, research and taking charge by devoting my career to making a positive impact has pulled me through.” — Stephanie B., MultipleSclerosis.net
  • “Being able to say they actually wanted my opinion…can make a person feel validated and important.” — Katie G., Migraine.com
  • “I think the patients [researchers] are looking to recruit would be more apt to be part of a clinical trial that has patients and researchers working together.” – Cathy C., MultipleSclerosis.net

Tapping into the desire to participate in clinical research, online health communities can broaden the scope for recruitment of research participants beyond traditional methods and often accelerate the speed of enrollment.

The incredible potential of online communities in health research

Online health communities can change the efficiency, feasibility, and speed of health research while engaging a larger population than ever before. Trials have the possibility to be designed for maximum retention and recruited with more efficiency.

The possibilities within this realm are vast and, if treated with appropriate caution, can have a tremendous impact on patient care along with the quality of health research and innovation.

Amrita Bhowmick

DTC-In-Perspective by Bob Ehrlich

DTC in Perspective: FDA Seeks Input on Risk Disclosure. More Study or Action?

September 1, 2017 0

The FDA is starting the process of possibly reducing the required number of risks presented in television ads. They have opened a docket to solicit public input on 8 questions they raised. I expect this process to be lengthy as speed has never been a guiding principle of the FDA’s Office of Prescription Drug Promotion (OPDP). They are taking their usual approach of being extremely cautious in making changes to their risk disclosure guidance.

Bob Ehrlich
“OPDP already has enough data.. to issue a revised guidance…”
-Bob Ehrlich

This is not the only area of a slow pace in recognizing the changes in consumer communication. They have, for years now, failed to recognize the role of DTC in social media and delayed any useful guidance that recognizes how consumers actually use the Internet. Thus, it is still prohibited to actually use a drug name and indication without the fair balance, as if consumers do not know how to click through to get more information.

Their own recently published research showed that less risk presentation is better for consumer comprehension and retention. For them that finding is the start of a rigorous research process to see if their hypothesis that “less is more” in risk presentation should be implemented in terms of changing their guidance.

Some conclusions are obvious and action is sometimes better than continued study. While I know OPDP is deliberate in making any changes to guidances, we have had broadcast ads for 20 years already. That is slow even by government standards. It is painfully apparent that DTC ads are presenting way too many risks and that litany approach is ridiculed by satirists and critics. Consumers complain about the many risks presented and have been for years. What does FDA do about it? They seem to want more and more studies so they can come out with a “perfect” guidance. This attitude is hurting consumers. A whole generation will have watched DTC ads with too much confusing risk information before FDA finally acts. OPDP already has enough data and should have the people with the judgement skills to be able to issue a revised guidance today.

Studying how risks are presented in DTC ads made sense in 1997 in the introductory DTC broadcast period. For them to just begin to study reducing the number of risk disclosures after 20 years is both puzzling and concerning. OPDP frequently says as a reason for slow progress on studies is that they have constrained human and budgetary resources. Yet they have managed to conduct several studies on things that many in the drug industry find tangential and not actionable. They should have focused more on this area as comprehensible risk presentation is critical information for consumers. They must develop a better strategic focus on what are their priorities for DTC research. If you look at their research web page, you see a lot of projects that seem to be all over the map that may satisfy the curiosity of their researchers but has no actionable benefit to consumers.

I am sure they will get a mountain of feedback from their docket request and they will meticulously wade through that to use as a basis for new studies. I personally know some of the researchers at OPDP and they are top notch professionals. Maybe they are as frustrated as I am. They must be caught in the bureaucratic ways of government, however, to be taking so long to resolve the risk disclosure issue. Maybe it is time for OPDP to move things along or get new leadership. No one in the private sector would still have a job after taking 20 years to resolve such a fundamental issue. Sadly, OPDP is allowed to operate in a different universe of accountability.

Bob Ehrlich

DTC in FocusDTC NewsGuest Columnist

Creating a Compelling Customer Experience for the Digital Age

August 29, 2017 0

The scope of what we call marketing seems to be growing every day. Within the professional lives of many in the business of pharmaceutical marketing, a campaign of one-size-fits-all magazine ads alone was considered sufficient to launch and sustain a multi-million-dollar brand. Then came television, then the internet, then mobile devices, and on and on – and with each, the expectations of our audiences have grown. Today customers expect an experience from brands, one that caters to their individual needs through a variety of media, especially digital and interactive media. And for all the progress in the digital space, pharma as an industry has not done a particularly good job of providing these coordinated and customized experiences. How to improve? Read on.

Mobile-friendly just isn’t good enough.

Adapting your desktop website to make it “mobile-friendly” is starting to look a bit backwards, given that more than half of web traffic is now coming from mobile devices. If we really want to engage our audiences where they want to be engaged, we need to be thinking mobile first. Every patient interaction that we seek in the digital space – ads, websites, interactive content, email, all of it – should be created with the mobile experience at top of mind. Old-fashioned responsive design works okay for vanilla text content, but any communication tool with any degree of complexity in it ought to be built for mobile, not just able to adapt to it. Agencies and marketers need to adapt to capture attention in the first 35 characters of email subject lines. They even need to think about thumb fatigue when designing pages that may be too long.

Mobile-savvy patients expect quick hits.

People don’t use mobile devices for the same reasons they use desktops. They don’t go to their smartphones to do in-depth research; they go there to find information fast. So marketers need to be tailoring their mobile experiences that way. A good mobile site should offer access to information, services and tools quickly – services and tools like health trackers, copay support apps, specialist or pharmacy locators, non-intimidating patient education portals, touch-here-and-ring-the-patient-support-center-right-now. Great masses of text or dozens of links on a page are not your friend in the mobile environment. We see a day in the near future where patients can even “FaceTime” with their doctor or nurse for live but remote care. Telemedicine, powered by mobile and a desire to reduce healthcare costs, is about to boom!

Plain old targeting isn’t enough any more either.

Data is everywhere and those that capitalize on it will win. So we need to target more deeply – to hypertarget – and think in terms of the cultural prisms through which our audiences will view our communications. To do this we must move beyond traditional segmentation and actually build whole experiences to match each segment. For example, if your brand might have an opportunity in the Hispanic population, you should be developing your communications for that population from the ground up, not just as an offshoot of the “standard” materials. In the old days marketers used to write everything in English and translate as necessary – but today’s audiences, whatever their ethnicity, are expecting more than that. So cultural adaptation versus plain translation is the key to connecting with multicultural audiences. They are expecting communications and images and services that are attuned to their cultural background, and may be actively turned off by those that aren’t.

Leverage landing pages – and please, let’s optimize them.

A handful of pharma brands are beginning to catch on to the vanity URL and landing page concept – creating landing pages focused on narrower topics within brand.com and then strategically salting ads with them, with the hope of creating a deeper connection. For example, one might embed brand.com/efficacy into a TV ad that focuses on copay information, so that the patient ends up encountering multiple reinforcing messages. The trouble is that, as frequently happens in pharma, too many brands are investing in vanity URLs, tossing them out into the marketplace, but never really following up to optimize their use. With just a little added push – the push of A/B testing multiple URLs in the same ad or multiple ads with the same URL – brands could find out which combinations generate the most click-throughs, the most interest – and the best experience for the patient. The idea is to make every dollar work as efficiently as possible. If patient experiences are to be a matter of priority for your brand, you’d best be paying attention to the outcomes of those experiences and optimizing accordingly.

Mind your language, and how much of it there is.

We love our content in pharma. Maybe it’s how invested we are in our brands, or maybe it’s the regulatory requirements and complex review process, but we as an industry find it difficult to resist loading up our patient communications with everything at once. Yes, some of that cannot be avoided due to the need for important safety information and fair balance. But even on top of those guidelines we tend to be content-verbose, trying to squeeze everything into one experience or capture everything possible in a single registration form. It takes a true digital marketer to have the confidence to keep it short, sweet, and sticky, creating an experience and journey over time that delivers the content and value to the patient in digestible pieces.

So we need to narrow the focus of our messaging. Let our customer choose what he or she is seeking and provide it, and it alone, with a pathway to more as needed. Lose the long pages with multiple messages. Offer one call to action rather than four. Keep everything simple, scannable, short, and sweet.

Integrate, integrate, integrate.

Pharma companies love to create monuments to their brands. They can’t just offer a diet tool; it has to be the company’s branded diet tool. But customers don’t think that way. Customers want tools that are applicable across the whole spectrum of their lives, and they don’t much care what brand is attached. For example, many patients with diabetes have other health issues, too, like hypertension. In our present brand monument environment, that might mean one health tracker from the diabetes company, another from the cardio company, and maybe even another from the weight loss company, all beautifully lacquered up with each brand’s name. Or, the patient could use Apple’s Health app, which can take inputs from virtually anywhere and cover all of those bases, creating a simpler experience. Which do you think the typical patient will choose?

So we need to start thinking more holistically. If we really want to improve the patient experience, we have to start building tools and services that can be tied together with other tools and services, even third-party ones, rather than just monuments that are unique and proprietary to our own brands and companies. And yes, some companies are doing this already – Novo Nordisk with Glooko, Sanofi with Google, Novartis with Verily. But we need to see more of it. If a truly integrated and productive patient experience is going to be a matter of priority for pharma brands, we are going to have to start partnering across industries and converging when possible to provide patients the ideal seamless experience.

Aaron Uydess

DTC in FocusDTC NewsGuest Columnist

Advocacy and Industry: Weighing Influence and Transparency

August 29, 2017 0

Today’s healthcare environment – with access to therapy and pricing top of mind, new “right to try” laws, possible legislative changes, and big shifts in the ways that consumers get health information – requires more innovative and thoughtful approaches on how to communicate than ever before. For many pharmaceutical companies, advocacy is a highly promising and rewarding way to connect with patients, families, and communities. Now, some of those efforts are coming under scrutiny.

Advocacy organizations exist to help the people and communities they serve, and can have some impressive reach. One great example is the fact that breast cancer mortality is down 38%, influenced by efforts of Susan G. Komen® to leverage science and education, and directly help patients. And there are numerous reasons that industry stakeholders engage with advocacy groups. Many pharmaceutical companies collaborate with advocacy organizations on non-promotional and unbranded activities to support the community in capacity building, education, and to build advocacy skills. Some have more direct brand objectives in mind, and support advocacy organizations with the goal of getting endorsements from the advocacy organization or from patient ambassadors. Some work with advocacy organizations so that they will recommend specific products to their constituents or to speak with legislators on behalf of companies or products.

Transparency is key to building trust

Trust is essential to building fruitful relationships between the community, advocacy groups, and industry. But lack of transparency can undermine these relationships and may have a negative impact on how the community perceives advocacy organizations and by association pharmaceutical companies. Because trust between them and the communities they serve is key, some advocacy groups have chosen not to accept pharmaceutical funding, so they can say that they are completely outside the influence of industry. The reality, however, is that it is extremely difficult for many advocacy organizations to provide the services and develop the reach and consistency they would like based only on their own public / private support and community fundraising. For this reason advocacy organizations are often open to mutually-beneficial partnerships with industry that ultimately help the patient communities they serve.

But the current level of transparency around funding of advocacy groups has recently been questioned. The New England Journal of Medicine and JAMA Internal Medicine published articles that assessed whether advocacy organizations might have significant conflicts of interest because they accept support from pharmaceutical companies. What the investigators found raises questions about the need for added transparency. According to the New England Journal of Medicine article, 80% of large organizations (annual revenue at least $7.5 million) were found to receive industry support. However fewer than 20% reported specifically how much they received from industry sponsors. More than one-third had an industry executive on their board, and another quarter did not state their board members’ occupations. Only about a quarter published conflict of interest policies, none of which specifically addressed industry influence.

Findings published in JAMA Internal Medicine revealed that two-thirds of smaller organizations (median annual revenue $299,140; interquartile range $70,000 to $1.2 million) were funded by industry and more than 10% received more than 50% of their funding from industry. More than 80% from these smaller groups felt that advocacy organizations should be cognizant of the potential for conflicts of interest, but only about half were highly confident in their organizations’ conflict of interest policies. More than seven percent were consciously aware of pressure to align with corporate interests of donors. The findings illustrate how the majority of large and smaller advocacy organizations receive funding from pharmaceutical companies, but do not have applicable conflict of interest policies to preserve transparency – potentially raising questions about credibility and undermining trust.

Advocacy organizations are not the only ones coming under scrutiny. Since 2013, the federal government has issued subpoenas to a number of pharmaceutical companies to analyze their ties to patient assistance charities. The investigations continue, and now involve many top pharmaceutical stakeholders. These inquiries are similar to those concerning financial ties between industry and physicians and their institutions, and potential conflicts of interest that could influence physicians’ clinical decisions. Financial ties must be disclosed to avoid a potential conflict of interest, or even the appearance of a conflict of interest, so that patients’ welfare remains the primary interest.

Advocacy is stronger with transparency

Should the pharmaceutical companies stop supporting advocacy organizations? Absolutely not. However, all parties should be transparent about their relationships and financial support. Recently, Stat News reported that a pharmaceutical company was found to be a secret funder of a patient advocacy organization that was working to secure more government funding and insurance coverage for treatment. Because this charitable donation was initially concealed, “outing” the company as a financial supporter became the news story. This shifted the focus from the potential positive impact of support for this advocacy group, and possibly diminished the advocacy group’s important role and ability to address a critical community need. Transparency is an effective way to help advocacy groups avoid the pitfalls of implied or actual bias concerning their work, removing a potential barrier for positive impact on the community.

Just as pharmaceutical companies have to publicly disclose payments to physicians, and many physicians are required to disclose any potential conflicts of interest based on industry relationships, it is reasonable to ask advocacy organizations to disclose their industry sponsors and the financial support they receive. This could be similar to a Sunshine Act for advocacy – only hopefully with less complexity! The goal is for all stakeholders to feel confident that everyone is transparent and playing on a level field and lets communities feel positive about the organizations representing them.

Denise Erkkila

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DTC-In-Perspective by Bob Ehrlich

DTC in Perspective: Point of Care (POC) Marketing Challenges

August 25, 2017 0

I see doctors more than I used to due to my advancing age. That gives me a chance to see more point of care marketing as I go to my many specialists for a variety of ailments. I often wonder how much patients are receptive to being educated while in the waiting room or in the exam area. Most doctors’ offices are a media smorgasbord of general interest magazines, health pamphlets, TV’s playing news or promotion for products physicians sell.

Bob Ehrlich
“Clutter is a significant barrier for POC media companies…”
-Bob Ehrlich

Clutter is a significant barrier for POC media companies trying to prove to drug makers an acceptable ROI for their products and services. Patients also have their own entertainment system with their mobile devices and the growth of in office Wi-Fi makes them a viable entertainment option in waiting rooms. The challenge for POC companies providing information on disease or branded products is how to get their share of attention in that valuable 10-20 minute waiting period.

The days of just providing and expecting positive results from general disease information through a video, wallboard, or publication could be numbered. More needs to be done to grab attention given the numerous media alternatives available. That means POC companies are going to have to invest more in researching how patients actually behave in the waiting room. That is, what draws them to put down their mobile device and watch a POC video, interact with a tablet, or read a wallboard or custom health magazine. As patient choices expand, drug companies are going to expect some sophisticated analysis of patient in office viewing habits.

POC generally has reported higher ROI than mass media. The POC media companies are going to have to work hard to keep that advantage. It is clear that every drug company is looking to take full advantage of the marketing opportunity at POC. That physician office is the pivotal point in generating an Rx. Every drug maker wants to maximize that pre-exam time frame with disease and/or branded information.

We are seeing consolidation of POC companies through acquisitions. Having fewer and larger players with deeper pockets makes it more likely we will see new patient behavioral research. I would expect, as a drug marketer, to have the POC media companies do lots of testing on how to generate patient attention. Their technologies now allow for streaming in a highly targeted manner. That could mean different messaging down to a local physician level taking into account patient demographics. Drug makers are going to expect POC media companies to increasingly present innovative ways to get patients to pay attention in an increasingly cluttered waiting room.

I was in my ophthalmologist’s office this week and was entertained by a POC module from Outcome Health, formerly ContextMedia:Health. They had a reporter on the street interviewing people with trivia questions on eye issues such as incidence of eyeglass use and contacts. I noted everyone in the waiting room was watching as it was a different and attention grabbing way to educate patients. We all had our mobile devices in our hands but took a break to see the answers to the trivia.

What I have noticed through my many physician visits is that there is still massive opportunity to bring media innovation to the waiting and exam rooms. There are a number of great companies in this space and continuing consolidation will bring more consistency to what patients see. Drug makers will welcome being able to expand POC use with larger media companies controlling more offices. That consolidation may make it harder, however, for start-ups to compete but hopefully we can still have opportunities for the small entrepreneurs. After all, the current POC giants all started relatively recently as small businesses with a new way to educate patients.

Bob Ehrlich

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