Jerome "The Bus" Bettis Promotes Auvi-Q With and Without the Important Safety Information

Celebrity spokespeople seem to be all the rage in pharma marketing circles these days. I wonder, however, how closely the FDA is watching celebrity endorsements such as former NFLer Jerome Jerome “The Bus” Bettis's promotion of Sanofi's talking epinephrine injection, Auvi-Q, which is marketed for the treatment of life-threatening allergic reactions (anaphylaxis) in people who are at risk for or have a history of these reactions.

Bettis is not just promoting anaphylaxis awareness on TV shows such as the The Doctors. On TV, Bettis is actively demonstrating how the product works and naming brand names. But he

1. does not disclose that he is being paid by Sanofi to endorse Auvi-Q, and 
2. does not mention the "important safety information" (ISI), which is required by FDA regulations whenever a pharma company or its agents promote brand name products and the conditions they treat.

Here's how Bettis hawks Auvi-Q on The Doctors:



Now, compare this to the following 3.5-minute video from the official Auvi-Q Playbook Site:

Whoops! Unfortunately, there is no option to embed this video, so I am just showing you a screen shot. You can see some ISI around the frame, but note that fully ONE-HALF of this video is devoted to communicating ISI via scrolling text and voiceover! I recorded the voiceover:

listen to ‘Auvi-Q ISI’ on Audioboo

Ah! The advantages of celebrities and unregulated TV endorsements!

Will 2013 Be the Year of "Digital Pharma?"

Today, I posted on Twitter "HCP digital spend by pharma to equal that of print this year, forecast says." That tweet is getting a lot of retweets and Mike Young (@Brandshaping) responded "The times they are a changing."

I am afraid my tweet may be misleading. I should have said "HCP digital MEASURED MEDIA spend by pharma to equal that of print this year, forecast says."

My tweet points to a chart I created from data published in a whitepaper from Compas: "Follow the Money-- a Point of View on HCP Media Trends in Pharma" (find it attached to this post). Here's my chart:

This looks pretty impressive. But let's make sure we understand what we are talking about here.

First, this is about "measured media" spending focused on healthcare professionals (HCPs). "Print Media" refers to ads in medical journals, "Reprints" refer to reprints of medical journal articles that sales reps hand out to physicians, and "Digital Media" refers to online ads placed on sites frequented by physicians (e.g., WebMD). "All Other" includes Convention Media (ads at medical conventions), In-Office Media (I'm not sure what's included in this; whatever it is, it's less than 1% of the total spend), Point of Care Media (patient record forms, prescription pads and the like), and Direct Mail.

This analysis does NOT including detailing spend, which is the biggest promotional spend by pharma.

As discussed in a previous post to Pharma Marketing Blog, the pharma industry spends about $17 billion on TOTAL physician promotion: $15 billion on detailing and $2 billion on meetings (see "U.S. e-Detailing Spending Up 74% in 2012. Yet Pharma Still NOT "'Digitally Mature'"). I assume these numbers include digital, but NOT measured media spending, digital or otherwise. Digital promotion is only 5.2% of the $17 billion total. This means that the U.S. pharma industry, which spends nearly $1 billion on professional digital promotion, has a long way to go before it reaches "digital maturity" on a par with other industries. I estimate that "par" to be 20%.

The Compas whitepaper does not indicate the dollar amount of measured media spending focused on HCPs, but I am certain that it is minuscule compared to the $17 billion mentioned above. That means, therefore, that even if HCP-focused digital measured media spending is "on a par" with print measured media spending in 2013, it is still just a drop in the overall HCP promotional bucket.

Measure Differently for Healthier Returns

This week my friend Shwen Gwee, Chief Digital Officer at Chandler Chicco, volunteered me to lead the ROI "Group Roundtable Discussions" at the Social Media for Pharma Conference in Princeton, NJ. This conference was organized by Advanced Learning Institute, one of my clients.

As always, discussions of "return on investment" in pharma marketing are fraught with difficulties, especially when talking about consumer and patient focused marketing efforts and even more especially when these efforts involve social media.

I came away with two insights from the discussions I led:

1. Other than scripts written, practically everything pharma marketers measure for ROI analyses are surrogates for scripts written, and 
2. pharma brand managers move in and out of brands too frequently to consider alternatives to ROI, such as ROR ("return on relationship"), which some experts propose to measure social media effectiveness.

The only way around #2 and to leverage social media effectively, is to have high-level leaders who oversee many brand teams, who "get" social media, and who encourage the adoption of social media in all patient-oriented communications.

While I have criticized many pharma executives of being "social media dummies" (see "Pharma C-Suite Social Media Dummies: Can They Be Trained?") there are a few pioneers out there. Laura Kolodjeski and Dennis Urbaniak at Sanofi US Diabetes were mentioned by several people at the conference -- and they were recipients of the 3rd Annual Pharmaguy Social Media Pioneer Award (see "Dennis Urbaniak, Joan Mikardos, and Laura Kolodjeski of Sanofi US Receive the 3rd PharmaGuy Social Media Pioneer Award"). Urnaiak is a VP and is the role model to which pharma "social media dummies" should aspire. (Urbaniak, I know, is not in the C-suite... yet!)

Today, Dyan Bryson, Managing Director, Inspired Health, was my guest on Pharma Marketing Talk. The topic was "Why is Putting the Patient at the Center So Difficult?" One point Bryson made at the end of that interview had relevance for #1. Bryson urged pharma marketers to "measure differently" by going beyond IMS NRx (new prescription) data and following what happens AFTER the prescription is filled to better understand the patient and implement "patient-centric" marketing. Here's the relevant snippet of that interview:

listen to ‘Dyan Bryson on Measuring Differently’ on Audioboo

You can hear the entire conversation by listening to the following podcast:

Listen to internet radio with Pharmaguy on BlogTalkRadio

Pharmaguy to Present at the Roche Digital Academy

PharmaGuy (aka John Mack, me) will present at the Roche "Digital Academy" in June, 2013. The Digital Academy is a project that has enrolled over 80 Roche employees who will participate in a 6-month Master Course of study created in collaboration with the School of Communication IULM in Milan, Italy. Here's my pitch:

Davide Bottalico, MD, Marketing Manager Digital Area, Roche Italy, heads the Roche Digital Academy team shown in the photo on left (Davide, center).

"One of the most common mistakes," says the Roche Digital team, "is to believe that anyone within a company can take care of digital communication. This is a particularly bad mistake for pharmaceutical companies that operate under specific legal and regulatory restrictions."

"Aware of the strategic role as well as of the delicate processes behind digital marketing, Roche has kicked off the 'Digital Academy' in Milan, Italy. The Academy aims to provide the skills needed to translate the 'revolutionary logic of network relations into business opportunities.'"

The course includes more than 100 hours of classroom lessons, project works and case studies. It also provides lessons on the main tools, dynamics of the web and skills needed to manage digital communications and marketing.

"The initiative welcomes the presence and experience of various companies, external partners, agencies, and individuals such as PharmaGuy, who will share their expertise and case studies of excellence."

The Master Course ends with "Graduation Day" at the IULM University, Milan.

"Study and analysis of the world of web and social media are prerequisites to pave the way for the potential that the new media represent for companies who know how to seize opportunities," says the Roche team. "With this important investment in the education of its employees, Roche wants to be a pioneer in the digital marketing space."

Roche Digital Academy - Key Numbers:

• 81 Learners
• 11 Lecturers (among Academics and Professionals) 
• 15 Partners: Educom - Axenso - Vidiemme - Synesis-Mccann - Argon - Cegedim-zanox - AboutPharma - AdnKronos-Altran - ZS - Elsevier-Energy
• 1 University of excellence partner: School of Communication IULM, Milan
• 1 Prestige consultant: the Digital Strategist Paola Peretti, author of the book "DIGITAL MARKETING"
• 127 hours: 60 hours of classroom lessons + 9 hours of Project Work (for 5 groups) + 22 hours of case study
• and...

One Pharmaguy :-)

Disclosure: I have received a fee from the organizers to make a presentation as part of the Roche Digital Academy.

Merck in the Mirror: Profits, Not People, Come First. Shame!

"How can Merck look itself in the mirror?", asks Josh Bloom of the American Council for Science and Health (see here).

"This week, Merck, with some questionable help from the FDA, gave more ammunition to industry critics, who typically maintain that the industry contributes little innovation, and is simply concerned with profits," said Bloom.

"For the most part, this criticism is biased and uninformed, but this time I'm siding with the critics. Because Merck is trying something that is as good an example of marketing without innovation as you'll ever see."

Derek Lowe, respected author of In the Pipeline blog, agrees. "I can't see how he's wrong," said Lowe (here). "What I'm seeing is an attempt by Merck to position itself should the ongoing Vytorin trial actually exonerate the combination idea. Vytorin, you see, doesn't have all that much patent lifetime left; its problems since 2008 have eaten the most profitable years right out of its cycle. So if Vytorin turns out to actually work out, after all the exciting plot twists, Merck will be there to tell people that they shouldn't take it. No, they should take exciting new Liptruzet instead. It's newer."

"If anyone can think of a reason why this doesn't make Merck look like shady marketeers, I'd like to hear it. And (as Bloom points out) it doesn't make the FDA look all that great, either, since I'm sure that Liptruzet will count towards the end-of-the-year press release about all the innovative new drugs that the agency has approved. Not this time."


Merck rewrites its founder's words: "We try to remember that medicine is for the patient investor. We try never to forget that medicine is for the people investors. It is not IS for the profits. The profits follow lead, and if we have remembered that, they will never fail to appear. The better we have remembered that, the larger they have been." – George Corporate Merck


In another news story regarding Merck this week, John LaMattina, Contributor at Forbes blog, laments that even Merck's "Good Deeds Are Criticized." LaMattina's outrage concerned criticism of Merck's (and GSK's) announced HPV vaccination program for cervical cancer in Rwanda.

LaMattina points out that "Pharma isn’t working in a vacuum." Indeed! You can also say that good news about pharma companies (like donations of drugs) do not appear in a vacuum. Sometimes, as in this case, the good news must be weighed in context of the bad news. It's probably true that the bad news stinks for a long time, whereas the good news dissipates, especially when every direct-to-consumer (DTC) ad for Merck's new anti-cholesterol drug reminds people of the "bad" side of pharma, which puts profits -- not patients -- first!

Big Inside Joke About Doctor Surveys: 90% of Physicians Believe They Graduated in the Top Half of Their Class

Richard Meyer, author of World of DTC Marketing Blog, is a big believer in physician surveys, including the survey that the FDA intends to do regarding how physicians feel about direct-to-cinsumer (DTC) advertising.

Rich was interviewed on HuffPost Live recently along with a health reporter and former Zyprexa Drug Rep, Shahram Ahari, who now is a consultant for Pharmedout. The 30-minute interview -- see embedded video at the end of this post -- was titled "Big Pharma's Pill Pushing." The description reads: "Big Pharma spends almost twice as much on promotion as it does on research and development. Drug company revenues climbed more than $200 billion in the years between 1995 and 2010 and so did the number of addicts. How can this be better regulated?"

Rich did his best to defend the drug industry in such an obviously biased setup. The part of the discussion I found interesting in light of my recent post about the FDA physician survey (see "Is FDA Doing DTC, Social Media, & Professional Market Research On Behalf of the Drug Industry?") was Rich's comments about a similar survey by CMI/Compas, which I also wrote about (see "Most Physicians Agree That DTC Advertising Leads to Inappropriate Prescribing -- by OTHER Doctors, Not Them!"), and Shahram's reveal of how pharma sales reps view physician surveys. Here are the two relevant excerpts:

listen to ‘Meyer & Ahari on Physician Surveys’ on Audioboo

"Cognitive dissonance" describes what I referred to in my analysis of the CMI/Compas snap poll of 104 physicians (op cit): "no matter how the question about inappropriate prescribing was phrased, most [physician] respondents were thinking of the effect of DTC advertising on OTHER doctors' prescribing, not THEIRS. It's similar to how doctors feel about free lunches -- they believe OTHER doctors are influenced by free lunch."

Cognitive dissonance is the reason I am not a fan the FDA survey. The CMI/Compas poll, however, is "underpowered" and you simply cannot contend that the results from 104 physicians is in any way representative of the entire population of US physicians.

Here's the entire HuffPost Live interview, if you have 30 minutes to watch it here: