To meet patient’s need for speed, Pharma needs more lawyers

What kind of crazy talk is that? Everyone knows that it is the legal and regulatory teams and the whole review committee process that keeps Pharma moving at a lugubrious pace. Certainly that’s the biggest excuses I hear for why patient complaints languish in the blogosphere or why websites aren’t updated on a regular basis.

It can’t be the shear size of the pharma organization that slows decision-making. Larger companies have shown they can be nimble when it counts. Take Apple, the largest company in the US and how their rapid fire response to the Taylor Swift incident. It took Apple less than one day over a weekend to reverse a policy about paying royalties during the Apple music trial period. And Apple’s senior vice president of Internet Software and Services, Eddy Cue, communicated it simply with a tweet.

Moving faster requires real teamwork, the type of teamwork highlighted in Fortune magazine’s recent profiles of the small teams within big companies like Nike, Starbucks and J&J. And it is shared goals that fuel these integrated teams’ stellar performance.

In my opinion, Pharma’s sluggishness comes down to the antiquated brand team structure. Most teams are comprised of three marketing sub-teams (HCP/Patient/Payer) overseen by a legal/regulatory/medical review committee with an entirely different reporting structure. Operating in siloes, these different departments often have different, and often, conflicting goals. The legal and regulatory departments are charged with protecting the company and the brand marketers are charged with growing the business.

But what if the Pharma brand team was a fully integrated team—with marketing, legal and regulatory all aligned around improving patient outcomes?

More crazy talk! What if reviewing patient comments, whether online, over the phone and deciding how to respond, was a daily job shared by all? What if lawyers attended focus groups? How about the regulatory team member meeting with patients at an advocacy event? What if everyone was co-located? What if marketing/legal/regulatory acted as a unified SWAT team dedicated to listening, responding and creating new ways to improve patient health?

For the SWAT team concept to work legal and regulatory colleagues must function as full members of a brand team, not just as a panel of judges at weekly review committee meetings. That’s where the idea that Pharma needs more lawyers (and regulators) comes in to play. Moving faster means brand teams should include marketing, legal and regulatory expertise to make decisions on a daily, if not hourly basis.

With consumer expectations regarding company response time rising across all industries, speed needs to be the rule in Pharma rather than the exception. And contrary to expectations, moving faster requires ongoing, rather than foregoing legal and regulatory input. Simply put, Pharma needs more lawyers (and regulatory experts) to move at the speed of patients.

The Orphan Impact: Small drugs drive big changes

Seems everybody’s talking orphan drugs these days. No wonder, according to EvaluatePharma’s 2013 Orphan Drug Report, orphan drugs are estimated to reach 15.9% of total worldwide prescription sales by 2018. But the orphan drug impact goes beyond sales numbers. I believe that the patient centricity blossoming in the rare disease divisions will eventually spill over into the primary care divisions of pharmaceutical companies.

With the big blockbuster primary care drugs, development success lay primarily with company research departments. The halls of Pharma echo with stories of researcher heroics—how the lone scientist kept a molecule from hitting the drug dustbin only to become the next blockbuster.

But in orphan drugs, the heroes are as likely to be individual patient family members as researchers. In some cases the drug literally starts with patient families. Thanks to advances in digital technology and social media, orphan drug patient families play a major role in every aspect of bringing a drug to market, going far beyond traditional advocacy roles. Now individuals are able to leap tall barriers with a click of a mouse to accomplish superhero feats formerly reserved for massive organizations like the NIH and pharmaceutical companies.

Consider the role of patients, families and organizations in:

Disease discovery: Matt Might, a father whose son had a disease entirely unknown to science, leapt over barriers of scientific self-interest to find other patients and give his son’s illness a name.

A well-known blogger in his field, Matt’s post about his quest helped identify patients like his son across the globe. In the New Yorker article, which describes Matt’s disease naming odyssey, a Duke geneticist, who worked with Matt, sums up the new patient paradigm with this quote:

“It’s kind of a shift in the scientific world that we have to recognize—that, in this day of social media, dedicated, educated, and well-informed families have the ability to make a huge impact…Gone are the days when we could just say, ‘We’re a cloistered community of researchers, and we alone know how to do this.’ ”

Research direction: John Crowley funded individual scientists to fill the treatment void when he learned his daughter had Pompe disease. Ultimately John ended up partnering with one scientist to form a company that eventually was folded into Genzyme. And while his story is certainly one of the most dramatic (to the point of being the subject of a major motion picture starring Harrison Ford), John’s ability to drive the course of scientific discovery is becoming more commonplace in the rare disease space.

Product approval parameters: In June 2014, the Parent Project Muscular Dystrophy (PPMD) patient group, submitted the first ever-patient advocacy-initiated draft guidance for a rare disease to the FDA for Duchenne muscular dystrophy. Patients, through organizations like the PPMD, are now directly driving how Pharma should be conducting their research.
Because of the outsized role patients and their families play in bringing a drug to market, building strong patient relationships is a key marketing investment for orphan drug marketers. For example, Biogen Idec, deployed over 15 community managers to support people with living with hemophilia even before they had an approved product.
There are already signs of an “orphan drug spillover effect” on primary care marketing. Consider Sanofi’s community manager position in their Diabetes franchise. Or more recently, that Sanofi appointed a Chief Patient Officer. And this I believe, is just the start of the orphan drug effect.

Soon the patient centric tactics of Rare Disease marketers will be highlighted in “marketing excellence” meetings all over Pharma. Then questions will come during marketing plan presentations about “why can’t primary care teams start building patient relationships like their rare disease counter parts?” And before you know it, the small seeds of patient centricity will finally blossom throughout Pharma.

How design thinking can elevate the patient experience

Finding purpose in the mundane

What could be more boring than the traditional patient pamphlet?

Many times patient pamphlets are created without the most important ingredient, the patient. The traditional pamphlet is generally a collection of information that the health care marketer wants to impart to the patient. Little thought is put into what the patient wants to know. And even less thought is put into how the patient wants to physically interact with the pamphlet.

A little design thinking could change all that. One of the key principles of design thinking is purpose. Every element should have a customer-focused reason for existing. This requires a deeply rooted understanding of customers and how they interact with a particular object. It is this understanding that can transform the mundane into the marvelous.

One of the best examples I have ever seen is the in-room collateral for the Wanderlust Hotel in Singapore that I stumbled upon at an American Institute of Graphic Arts (AIGA) exhibit. The design team from Foreign Policy Design had a profound understanding of the prototypical Wanderlust guest. The type of guest who checks into the Wanderlust hotel is “curious and interested in discovering, engaging and immersing in new experiences.” They have a desire for personal growth through exploration.

Based on this understanding, the designers reinvented the “almost-useless conventional in-room directory” into a more useful travel tool. The in-room directory was morphed into an itinerary, full of useful local information including “area maps, train and bus maps, local shops and restaurants as well as thoughtful blank pages for notes and sketches.”

The reimagined in-room directory led to a redesigned check-in procedure. As the AIGA exhibit notes detailed, the itinerary “improved the check-in workflow, converting a laborious and dreaded check-in process into something fun, a talking point.”

This proves that one small design element can trigger a cascade of changes that lead to an improved overall brand experience. And the business results? The hotel has been featured in core travel publications including Travel & Leisure, has appeared on almost 500 blogs, and its room occupancy rates have risen.

And no wonder, “Creating a unique customer experience is one of the best ways to achieve sustainable growth, particularly in industries that are stagnating,” according to the consulting firm ATKearny. In industry after industry, higher customer satisfaction has been shown to drive sales and profits.

So back to the patient pamphlet. What is its core purpose? What is the problem that the pamphlet (or for that matter, the website, app or DTC ad) is trying to solve? What other problems does the patient have? Is there a role it can play there? How should it be redesigned?

What happens if the patient pamphlet is reimagined as an itinerary for better health, rather than merely a way to convey basic product information? Could infusing a higher-order purpose into a pamphlet set off a cascade of changes in all marketing activities?

The most overlooked marketing investment

Investing in your customers. That’s what companies, like YouTube, who have their pulse on the consumer do according to a recent article in Digiday. YouTube is helping their customers develop the content that will help them realize their dream of becoming digital stars. But the concept of customer investment goes beyond the digital world. Investing in customers is a business strategy well described in “Who Do You Want Your Customers to Become?” an e-book by Michael Schrage being offered by the Harvard Business Review.

Schrage says businesses can keep growing by asking, “Who do our customers want to become?” and helping them get there by strategically investing in customer capabilities. Invest in customers, because, as Schrage puts it, “your future depends on their future.”

Health care is no exception.

Think of the demands placed on physicians by the Accountable Care Act. To be successful in the future, physicians will need to become:

• Customer service experts since patient experience will drive reimbursement
• Data analysts as the practice collects patient satisfaction data
• Healthcare systems thinkers as practice ratings are dependent on the entire office visit experience, not just the physician interaction

The demands on patients have also increased. Take the experience of Peter Drier who practically become a forensic accountant to track down an unexpected $117,000 in charges associated with his neck surgery as recently reported in the New York Times. Or Matt Might who, according to an article in the New Yorker, had to supersize his social media skills to assemble a group of patients across the globe to give his son’s illness a name.
With the advent of the health care exchanges, Payers who once operated in the B-to-B mode have now found themselves having to develop the type of direct-to-consumer marketing skills pharmaceutical marketers acquired in the 1990’s.

There is no shortage of investment needs when it comes to pharmaceutical customers. Of course there is all sorts of regulation against practice building and incentivizing use. However, by applying a little creativity and keeping the end game in mind—improved outcomes and a better patient experience—the smart pharmaceutical “investor” will be able to eke out a competitive advantage with some well placed customer bets!

Bad Mom, Wonderful Woman: A Tale of One Health Plan

Improved patient experience. As a health care marketing professional, I see the topic everywhere. As a patient, though, it is often nowhere to be found. Here’s my Tale of One Health Plan. One day, one health system, two appointments, two dramatically different patient experiences. In one visit I was a “A Bad Mom,” in the other, “A Wonderful Woman.”

Bad Mom, Wonderful Woman

 

 

 

 

 

 

 

 

 

 

First the “Bad Mom.” At a Children’s Center” in an affluent hospital, my 15-year old daughter and I entered what looked like beige food court in a mall, little booths for each pediatric specialty ringing the room. Threatening signs dotted the walls cautioning against letting your children bounce on the furniture.

I approached a booth with a simple question. “What time was my appointment?” I had made the appointment for 3 pm but had received a confirmation call for 2:45. Asking one of the Booth Ladies, I was told, “I don’t know when your appointment is for, just sit and wait for the doctor.” This patient experience told me that the hospital’s time was more important than my own and that I could not be trusted to come to an appointment on time.

At 2:43, after eventually learning my appointment was for 3 pm, I decided to dash to the hospital coffee shop on the floor below. When I came back at 2:55, my teenage daughter was nowhere to be seen. Going back to the Booth to ask about my daugther’s whereabouts, the original Booth Lady didn’t even look at me, but told her companion Booth Lady, “I told the mother to wait for the doctor. This patient experience told me I wasn’t a person, but an individual filling a role, and doing it badly at that. Bad Mom, Bad!

Contrast this to my mammography later that day. Not only was I greeted by a friendly woman, I was given thorough instructions reinforced on a patient handout. I was then whisked away into a spa-like changing room, complete with honey colored wood lockers, thick terry robes and ethereal Spa music playing in the background. To top it all off, I got a bracelet commemorating breast health awareness month when I left. I was a “Wonderful Woman.”

Yes, this was the same health system. But no one had bothered to think through how an individual person might experience it’s different parts in her different roles: parent, patient and parental caregiver. I know a unified patient experience is possible.I increasingly use another health system in my area, the Summit Medical Group. The receptionists are uniformly friendly, even when you as the patient screw up. For example, one of the receptionists noticed I missed an appointment in another department and made a call to have them squeeze me in so I wouldn’t have to come back again. That patient experience told me I was an important individual whose time was valuable.

Now the medical care I receive in both systems is excellent. But if I needed a new doctor, I would go to Summit Medical Group. And I am not alone in judging a system by it’s support personnel. According to PwC Health Research Institute, 60% of consumers said staff attitudes are a key factor in evaluating their provider experience. The lesson here is to make sure the patient experience is understood and designed from the patient’s perspective. And that starts from the moment the patient picks up the phone to schedule an appointment.

Will agencies become obsolete?

A potential new model

Don’t get me wrong. I love creative agencies. I have hired them, been employed by them and even owned one. But I wonder if creative agencies will survive in their current incarnation.

Consider the following trends:

  1. Disintermediation by vendors with creative capabilities-A recent New York Times article on Facebook entitled, “How Facebook Sold You Krill Oil,” says it all for me. The article describes the “Publishing Garage” sessions Facebook holds with marketers. The purpose of these sessions is to develop “a big sweeping campaign,” as well as specific Facebook ads. Whoa! I thought that is what the creative agency did. Closer to home in the Pharma space, there is a multichannel marketing company, Metanexgen, that will shoot as well as distribute your physician videos, for a fraction of what an agency would normally charge.
  2. Evisceration of the agency strategic function-With client Sourcing departments manically fixated on achieving the lowest blended rate, the creative agency’s ability to bring their strategic staff to the table has declined dramatically.  And agency personnel, who are not at the client table billing, don’t’ last more than one or two cycles of budget cuts. Not with razor thin agency profit margins. A vicious cycle ensues. No longer staffed to provide the strategic firepower, the agency is rarely consulted on strategic issues. As one veteran pharmaceutical marketer told me, “What am I going to learn from a 28 year old account director with 5 years of experience?”
  3. Availability of open-sourced creative solutions-A Pharma friend of mine needed a logo for his pivotal Phase III study. Did he call an agency? No, he went straight to 99Designs and got a great logo for $400. He received submissions from around the world in a matter of 48 hours. Multiple rounds of revisions occurred at lightening speed and he was done. I had a similarly positive experience designing a new logo for a start-up financial company using 99Designs.

Working directly with an open-sourced creative source does however, take time and experience. At this point in my career, I felt totally comfortable. But at an earlier phase with fewer campaigns under my belt, probably not. And brand stewardship, a role generally assigned to the lead creative agency, becomes an issue when dealing directly with vendors like Facebook and Metanexgen.

That’s why I predict that a new “Marketing Integrator/Curator” agency (or creative consultant) will emerge in the future. The current agency business model can’t support a full creative staff by sending a few creatives to a two-day Facebook meeting. This new “agency” will work with clients to select the vendors that make business sense and curate the creative process.

In the pharmaceutical industry, where extrovertic does most of its work, there will always be a place for big agencies launching the big blockbuster brands. Big agencies have the process and scale and creative firepower to get things done effectively and efficiently.

However there will be fewer and fewer of these blockbuster budget opportunities. The emergence of smaller specialty and orphan brands, with their correspondingly smaller budgets, is forcing marketers to reconsider how they get things done. With client-side staffing unlikely to grow dramatically, there will be a critical gap.  Just as nature abhors a void, so do clients. That’s why the Marketing Integrator/Curator role holds a lot of promise for the future.

 

How to integrate social into your existing campaigns

It’s easiest to think of social as an opportunity to be a trusted voice in a very crowded and not always well-informed room.  But the very first step you need to take is to make sure you are being heard.

Here is a checklist for you to use to make sure you’re grabbing the low hanging fruit:

  • Add the appropriate logo and user name to all printed pieces so patients know where to find you
  • Add social follow buttons to your website so it’s as easy as possible for patients to follow you
  • Be very active in the networks you use, and don’t forget to use hashtags
  • Make sure you are consistent in the hashtags you use and that they will help you be found
  • Don’t be afraid to share other peoples relevant content
  • Get out there and join the conversation!  It’s already happening with or without you

And remember, we are always available to provide some advice on how to navigate the social space, sell in the program or even conduct a Social for Pharma class for you and your extended team.

Thanks for letting us share!

Jared Shechtman

Senior Director, Digital Extrovert

Why your Point-of-Care strategy is half-baked

Conferences and vendor consortiums abound on point-of-care marketing. Yet many solutions miss an important point-of-care marketing opportunity: helping physicians extend care beyond the office.

The idea was first suggested to me by one of the most patient centric physicians that I have ever met, Dr. Frank Spinelli.  Dr. Spinelli challenged the audience at a pharmaceutical marketing conference to help HCPs extend the impact of the patient visit using technology, helping merge the online and offline experiences.

Pharma companies that help healthcare providers extend their patient care will find themselves welcomed in the doctor’s office. Why? Follow the dollar: physician payments are increasingly linked to quality of patient care and outcomes.

So how can marketers plan to extend their point of care tactics outside the office? Begin by reimaging the planning process. Rather than the siloed Patient-Physician-Payer approach to planning, charge an integrated team with a mission to:

  • Help prepare both the physician and patient for a productive office visit
  • Enable the patient to easily obtain any required medicine
  • Support and monitor the patient, after the visit

Rather than rush to the conclusion that “there’s an app for that,” take a step back. New ideas often start with new questions. Here are seven questions to prompt your team’s thinking about extending your point of care strategy beyond the office:

  1. What are the critical activities and information exchanges that must take place during the office visit?
  2. Would any activities or information exchanges prior to the appointment help improve the quality or efficiency of the in office experience?
  3. What are the barriers for different patient types to actually paying for and obtaining the prescribed medicine? How should patients and HCPs be talking about costs?
  4. Are there any other healthcare stakeholders—such as nurses, pharma reps, support groups, or associations—who could play a role before, during, or after the office visit?
  5. What can the physician uniquely contribute to the visit? Is it knowledge? Imparting a sense of caring or delivering peace of mind? Providing a solution?
  6. Are there different sort of “in-the-field” support people that could be provided? For example, clinical nurse educators or lay health workers?
  7. What follow-up activities would help ensure the physician treatment plan is monitored and adhered to? Is there any room for the new wearable technology?

Throwing a bunch of tactics together and hoping for the best will result in a mishmash of results. Answering these questions on the other hand, is a good recipe for an integrated point of care strategy, one that helps physicians extend the care they provide.

Jay-Z your DTC

Increase impact and save money

Jay-Z is a modern day master of media.  In applying public relations thinking to his use of traditional paid media, he makes every GRP work harder. When launching a product, whether it be a book or his recent CD, Jay-Z appears to have a three part formula: 1) develop a “talk-worthy” concept; 2) make a big but short-lived splash using traditional paid media and 3) employ digital and social promotion for long-tail promotion.

Consider Jay-Z’s approach to the launch of his album, Magna Carta … Holy Grail. It entailed:

  1. Talk-worthy concept: Jay-Z created a talk-worthy concept of providing his album to Samsung Galaxy owners 5 days earlier than to the general public
  2. High profile media: Launched the promotion in a highly visible, three minute commercial during Game 5 of the NBA finals
  3. Drive to digital: Drove people to the album website where they could download the free app

But the concept is not limited to Jay-Z. Starbucks used this three-step process to build sales using the 2008 election as a media hook.  Their talk-worthy concept was to offer a free cup of coffee to voters. Starbucks advertised this offer on a high profile Saturday Night Live’s “Election Bash” episode. And finally, they sustained their effort with what Howard Schultz calls in his book, “Onward”a torrent of digital and social media activity” to “amplify the 60-second spot.”

What this three step process boils down to is using public relations thinking rather than traditional media planning to deploy brand media spend. The benefit of this PR thinking is that the brand message automatically becomes more relevant to consumers because it taps into current culture.

Health care brands can also tap into popular culture. A well-placed, high impact unbranded communication that really connects with patients about a serious health issue could be an important wake-up call. The high profile unbranded splash would also serve as high impact “screener” to get the attention of your target patients and spark their curiosity enough to follow through to a branded site.

While the high profile splash is expensive, the opportunity to create an on-going drumbeat with digital makes the effort very measurable and affordable. Using this three-step process, extrovertic recently recommended a new product launch plan that relied on one-fifth the advertising expenditures of the brand’s closest competitors.

So how could this be employed on a pharmaceutical brand? Consider the straightforward Astra Zeneca Crestor print ad running in major magazines. A picture of a doctor asking the question, “Is your cholesterol at goal?”

How much more attention would Crestor get if they associated the product with the broader concept with setting and reaching goals and introduced the effort in a high profile sporting event followed by a deep digital push?

So here are two thought-starters on how to Jay-Z your DTC and save money in the process:

  1. Scour your brand for relevant hooks and events. What relevant anticipated governmental or healthcare organization announcements coming up? Can you link your brand to the news in a meaningful way?
  2. Have your agency cost out a media splash/digital long-tail type of plan. Can you save money and increase impact?

Packing personal into non-personal promotion

The Pharmaceutical industry’s “Non-personal promotion” or NPP. What a weird concept. As my extrovertic partner, Bill Fleming says, “In any other industry—the direct mail, digital marketing and telephonic selling—would just be called marketing.”

In fact, most other industries involved in business-to- business (B-to-B) marketing are focused on making every contact, no matter what the channel, more personal. Consider IBM and Cisco.

1. IBM – Using social media to personalize telesales. According to an article in ChiefMarketer.com, when telemarketing and email were failing to produce results, IBM got personal. IBM’s studies showed that IT decision were likely to use social media as a part of their purchasing decision making.

So IBM created social media profiles for a small team of inside sales representatives on Twitter, LinkedIn and YouTube. To make it seamless for the reps, IBM created a robust content calendar and provided hash tags so the reps could listen to relevant online conversations.

The results? IBM got 50,000 LinkedIn connections (up from 535 in the beginning of the test), over 20 major sales wins and has experienced a quicker uptake of their promotional offers. Check out Stuart Michie’s YouTube video for a good example of how to talk about a representative’s expertise.

2. Cisco – Video takes center stage. Again, customer understanding formed the basis of their strategy. According to an article on OnlineVideo.net, Cisco’s research found that 96% of IT decision makers and tech buyers watch videos for business. And most importantly, 84% either forward, share or post tech-related videos. So Cisco started creating videos, over 1,000 new videos a year.

Too expensive? Think again. You don’t need the production values of a DTC commercial or a MOA video. According to Cisco’s Leslie Drate,“it doesn’t really matter how much we spend on producing the video. The results for what we spend $100,000 on could be similar to what we spend $1,000 on. It just has a lot to do with content and audience.”

B-to-B all-star companies keep up with their customer information seeking habits. They adopt the technology their customers use to market to them. It is even possible in health care. Check out GE Healthcare’s YouTube Channel. Or better yet….

  1. Try a social media pilot program. Provide either a telesales rep or payer national accounts manager with a Facebook page. Levels of access to information can easily be controlled. Content could include interesting stories related to your therapeutic area, patient support material or journal articles. According to a QuantiaMD study cited in Ragan’s Healthcare Communication News, over 65% of physicians use social sites for professional purposes.
  2. Get into the video business. Evaluate all your printed materials and determine what makes sense as a video. Distribute the video widely, especially on YouTube. The Google algorithm favors social media such as YouTube and Facebook over other online media properties.