Tuesday, October 30, 2007

What's Your Pharma Blogger Dream Team?

Bloggers operating in the Pharma BlogosphereTM are now sought after as speakers and panelists at industry meetings. Last week, I and several other bloggers participated in a couple of different conferences. In one case, the conference organizers kept the identity of panel members a closely-guarded secret (see "Mystery Blog Panel Revealed").

I have a dream -- to put together a "dream" panel of pharma bloggers based on your input.

Please help me out.

Select your dream members by taking the following poll. You will be able to see the results after you vote. If I left someone off the list, please add that name to the comments to this post.

Thanks!

Select the Members of YOUR "Dream" Pharma Blogger Panel
Mack/Pharma Marketing Blog
Myer/World of DTC Marketing
Silverman/Pharmalot
Insider/PharmaGossip
Giles/Pharma Giles
Shanley/On Pharma
Hensley et al/WSJ Health Blog
Rost/NRx
Fard/HealthcareVOX
Woodruff/Impactiviti
Senak/EyeOnFDA
Carlat/The Carlat Pschiatry Blog
Anonymous/PharmaFraud
Lowe/In the Pipeline
Monseau/JNJ Blog
Pitts/Drug Wonks
Someone Else/Not Listed

Another Award for Rozerem! This one...not so good.

Consumers International (CI), which claims to be the only independent global campaigning voice for consumers, yesterday accused Takeda Pharmaceuticals -- marketer of the sleep aid Rozerem -- of "taking advantage of poor US regulation and advertising sleeping pills to children, despite health warnings about pediatric use." To honor that achievement, CI awarded Takeda a 2007 International Bad Product Award (see press release).

In fact, Takeda was the overall winner!

What earned Takeda this distinguished award was a "reminder" back-to-school ad it ran over a year ago in September, 2006. I first blogged about this in March, 2007, when FDA finally got around to issuing Takeda a warning letter (see "Back to School for Takeda, Rozerem, and Abe Lincoln!").

Why did it take so long for the FDA to issue a warning, well after the school bus door closed? Good question, points out CI in its award notice:
"This particular ad," says CI, "was released at the beginning of the school year and used images of children,chalk boards, school books and a schools bus. The accompanying voiceover stated: 'Rozerem would like to remind you that it's back to school season. Ask your doctor today if Rozerem is right for you.'

Under the tagline 'Back to School'

"It doesn’t take a PhD in marketing to see that this is an effort to persuade parents to seek out the sleeping drug for their children -- to help them get through the stress of term starting.

The advertisement ran without noting the very serious side effects that this drug can have, including increased thoughts of suicide in already depressed patients. Takeda pharmaceuticals also failed to mention the precautions on its packaging about children using this drug. According to the product labelling:
PRECAUTIONS (relating to pediatric use)
Use in Adolescents and Children
ROZEREM has been associated with an effect on reproductive hormones
in adults….It is not known what effect chronic or even chronic intermittent use of ROZEREM may have on the reproductive axis in developing humans.

Pediatric Use
Safety and effectiveness of ROZEREM in pediatric patients have not been
established. Further study is needed prior to determining that this product may be used safely in pre-pubescent and pubescent patients.
"That such a potentially harmful drug should be geared towards young children is outrageous.

"Almost as outrageous was the token action taken by the Food and Drugs Agency (FDA) -- the body that regulates pharma company behaviour in the US:

"It took six months for the FDA to tell Takeda to remove the ad -- long after the relevance of a 'back to school' promotion had gone. Takeda is a US$10 billion dollar pharmaceutical company. It spent $118 million on advertising ROZEREM last year, yet the FDA issued no fine and no penalty. Just a slap on the wrist.

"This case," says CI, "demonstrates the lengths to which some drug companies will go to increase sales of their products, how direct to consumer advertising can promote irrational drug use, and how weak regulation can foster irresponsible corporate behaviour. This company is our overall award winner for irresponsible behaviour for 2007."
This, of course, is not the only award Rozerem has won this year. Just recently, I announced that Rozerem received the Bronze POE Award for "Most Innovative DTC Campaign" (see "Awards: POE vs. MM&M. I Pick Winners!").

That marketers and consumers can have such divergent views of Rx brand behavior and award-worthiness is a testament to the Rubber Chicken Crowd (see "Awards. What Are They Good For?"). Speaking of which, I will be attending the MM&M Awards in NYC this Thursday. Maybe Takeda/Rozerem will also win one of those!

Monday, October 29, 2007

Awards. What Are They Good For?

Awards, huh, yeah!
What are they good for?
Absolutely nothing
Uh-huh
Listen to me

Ohhh, awards, I despise
Because it means gala dinners
Of rubber chicken and butter knives

Awards mean tears
To thousands of advertisers’ eyes
When their ads are broadcast on nightly TV
But never affect consumers’ lives

Awards, they ain't nothing
But a heartbreaker
Awards, friend only to the magazine publisher
They’re an enemy to all pharma kind
The point of awards blows my mind
Awards have caused unrest
Within the new media generation
Disrespect then co-optation

Ooooh, awards, have shattered
Many a young man's dreams
Made him cynical, bitter and mean
Drug pipelines are much too short and precious
To waste time vying for awards today
Awards can't increase DTC's ROI
They can only raise an ad agency's pay

Creativity, ROI and good communications
Tell me, is there no place for them today?
They say we must give awards to know what’s best
But Lord knows there's got to be a better test

Awards, huh!
Good God y'all!
What are they good for
Stand up and shout it
Absolutely nothing

With apologies to the Motown 1970 hit “War” by Edwin Starr.



Read this to learn one thing awards are good for!

Friday, October 26, 2007

J&J Blog, Shire PR: The Whole Story and Nothing But the Whole Story!

Wednesday was another day spent at the ExL Digital Pharma conference in Princeton, NJ -- and it was a day well spent!

I caught up with Marc Monseau, Director of Corporate Communications at J&J and editor of the JNJ BTW corporate blog. He spoke about using corporate blogs to get the whole story out to counteract the selective reporting by the media.

I also jousted with Marc in a point-counterpoint debate about whether or not the pharmaceutical industry should embrace Web 2.0.

Synergy Between PR and Marketing
I'll get to the Marc's presentation and our debate, but first let me say something about the presentation by Mike Boken, Senior Product Director at Shire. He spoke about creating synergy between PR and marketing in the context of Shire's annual "ADHD Experts on Call" program that took place on September 19, 2007 (see Shire Press Release).

Normally, I am not a big fan of PR used in the service of marketing (see, for example, "Marketing Disguised as PR" and "PhRMA Intern vs. the Pharma PR Agency!"). Boken himself admitted that there are two types of marketers:
  • those who believe PR is essential, and
  • those who think it's a waste of money
I don't object to PR because it is a waste of money -- on the contrary, I think it is very cost-effective (see article, reprint fee). I object to stand-alone PR whose only goal is to get products favorably mentioned in the media. That is what I call "marketing by other means" (op cit).

Shire's use of PR had a different goal: drive people to a call center activity with a strong Web component in order to engage ADHD experts. It was a one-day event for which Shire also placed ads on major Web sites in an attempt to "own the Internet on that day." The marketing goal was to sign up potential patients and caregivers for follow-up promotion of Aderall XR, their ADHD product at that time.

Power of Celebrity Endorsement
A key component of the program was the use of a celebrity -- Ty Penington, host of ABC's popular "Extreme Makover: Home Edition" -- who suffers from adult ADHD, which was an approved indication for Aderall XR. Since then, Shire replaced Aderall XR with Vyvanse, which is indicated for children diagnosed with ADHD. Today, Ty can only say "I wish I had this product when I was younger."

It was interesting that the use of Pennington in media-rich Internet display ad significantly increased clickthrough rates by roughly 200-300%. On the other hand, Ty didn't test well in print ads. I am not sure who the test market was -- children or adult caregivers.

There was much more to this program -- too much for me to cover here. I hope to cover Boken's WHOLE STORY in more detail -- including an ROI analysis -- in an upcoming issue of Pharma Marketing News. So, stay tuned.

J&J Authenticity=Trust
Marc's presentation focused on his experience as a blogger over at JNJ BTW blog. I and other bloggers in the Pharma BlogosphereTM have followed his progress closely (see here).

I think that Marc is "authentic" -- a term that cropped up repeatedly during the conference. By that I mean he is very open and honest. I trust him and by extension, I also trust J&J -- to a degree (let's not get silly, OK?).

Note to other pharma communications directors: Trust ... that's a possible benefit of having a corporate blog. But, you need to follow Marc's example.

Marc, coming from the "dark side" of journalism (and moving to what some would call the "darker side" of the pharmaceutical industry), presented this unique perspective on the evolution of the news media:
The many diverse news sources available today has led to the commodization of the news -- even the WSJ will have to realize this and start delivering it's product free online!

This has put pressure on media businesses to distinguish their news from other news. How do they do this? Through the rise of "reporters as personalities!" An example would be, I suppose, Wolf Blitzer on CNN. But I immediately thought of Peter Rost who took over reporting at Brandweek's NRx blog. Rost is a "personality" who replaced a real journalist -- Jim Edwards -- who left Brandweek to study at the Columbia School of Journalist to become an even more real journalist! Now, the Brandweek strategy is perfectly clear to me when before I was confused (see "What's Brandweek's NRx Strategy?")!

Anyway, Marc suggested this commodization of the news has lead to "infotainment" as opposed to real news. This so aptly described NRx that I almost fell out of my seat (note: Marc did not mention NRx in his presentation; I'm just projecting here).

This, in turn, has lead to "mistakes, mistakes, mistakes" and a loss of trust in the news media, says Marc.
The role of JNJ BTW then becomes to "correct" these mistakes, according to Marc. As an example, Marc cited a recent Businessweek cover story -- Little Green Lies -- which raises questions about whether being environmentally-friendly can be good business. Marc was pissed off (my phrase, not his) about the short-shrift given J&J in the story (for more on that, read Marc's post: "The Business of Green").

Marc wrote his blog piece after deciding that a letter to the editor, etc. would be ineffective, even if published. He could tell the WHOLE STORY of J&J's green lifestyle via the blog, thank your very much.

Fun with Mack & Marc
The real fun, however, started when Marc and I teamed up to do our audience-participation point-counterpoint routine. It was such a great success that I am thinking of patenting it. But I'm afraid J&J might sue me, so I won't!

Seriously, our shtick was to take opposite sides of the question: Should Pharma Embrace Web 2.0? I took the point, which argued "yes, full steam ahead" to every obstacle and Marc argued the "No, wait a minute" side.

To make it easy, I suggested that Marc and the audience consider me a Web 2.0 vendor with little pharma experience making a pitch to a brand team.

The following was the outline of how we saw this point-counterpoint "debate" unfolding:

Regulatory Compliance Issues
  • POINT: It’s a no-brainer; it can easily be done. Take notes from Pfizer – have a dialog with FDA. If all else fails, don’t worry; FDA is not watching!
  • COUNTERPOINT: The regulatory area is gray. No one wants to be the test case for an approach where the true value has yet to be quantified.
Transparency
  • POINT: What’s the big deal? Just do it! There may be a thing or two you need to learn through trial and error, so get started now!
  • COUNTERPOINT: There is little room for errors, especially when industry is under close scrutiny by regulatory and legal observers.
Organizational Issues
  • POINT: Empower your internal advocates – your employees – to participate. Get buy-in from the top . There are some CEOs who write their own blogs!
  • COUNTERPOINT: Yes -- But it’s also a matter of education and cultural change.
Adverse Events, Off-Label, Fair Balance
One of the main fears pharma has about Web 2.0 is being responsible for the online publishing of adverse drug events, off-label uses of drugs, and mentioning of benefits without fair balance about risks.

It was interesting that Len Starnes, Head of eBusiness, Primary Care at Bayer Schering Pharma, AG, thought that the US was preoccupied with the disclosure of adverse drug events whereas in Europe and Asia where he works there is "no issue with reporting side effects." In other words, just do it!

There were obviously many more issues discussed and I plan to write an article later for Pharma Marketing News where I can get into these in detail. Suffice it to say that the audience had so many questions and comments that we never made off the first slide! But we did manage to coverage all the above issues and more!

Thursday, October 25, 2007

Rozerem Expedites Experts' Dreams: Honoraria!

According to Daniel Carlat, MD, author of the The Carlat Psychiatry Report and the Carlat Psychiatry Blog, Takeda -- the folks that brought us the sleep aid Rozerem -- paid Gary Richardson, M.D., who is a prominent Takeda speaker, and colleagues to write articles in a Takeda-sponsored edition of Clinical Symposia (see "Takeda's Clinical Symposia: It's all about Rozerem").

"In addition," says Carlat, "[the website] SleepJournalClub.org [is] chaired by Richardson, funded by Takeda, and provid[es] CME credit for reading journal articles on insomnia. I suggest you click on 'archived events' and scan through the 11 articles posted thus far. I went through this exercise in an effort to determine whether the articles chosen were biased either in favor of Rozerem or againsts (sic) its competitors."

Carlat's conclusion:

"In my analysis ... 7 out of 11 articles in this Takeda-sponsored CME [Continuing Medical Education] program are promotional of Rozerem.

"Mais bien sur, you say. Why else would Takeda pay Richardson and colleagues to chair this journal club? If they didn't choose articles that made Takeda happy, these physicians would be 'missing their dreams' of fat honoraria checks!"

The Sleep Journal Club is sponsored by Takeda and many of the physician authors have financial ties to Takeda, such as these:

Gary S. Richardson
  • Advisory Boards: Takeda, Sanofi-Aventis, King, Cephalon
  • Speakers' Bureaus: Takeda, Sanofi-Aventis, King
  • Contracted Research: Vanda, Cephalon, Takeda
Gary K. Zammit
  • Grant/Research Support: Ancile Pharmaceuticals, Arena, Aventis, Cephalon Inc., Elan, Epix, Forest, GlaxoSmithKline, H. Lundbeck A/S, King Pharmaceuticals, Merck & Co., National Institute of Health, Neurim, Neurocrine Biosciences, Neurogen, Organon, Orphan Medical, Pfizer, Respironics, sanofi-aventis, sanofi-synthelabo, Schering-Plough, Sepracor, Somaxon, Takeda Pharmaceuticals North America, UCB Pharma, Predix, Vanda, Wyeht-Ayerst Research
  • Consulting Fees: Aventis, Cephalon, Elan, GlaxoSmithKline, Jazz Pharmaceuticals, King Pharamceuticals, Merck, Neuorocrine Biosciences, Organon, Pfizer, sanofi-aventis, Sepracor, Shire, Takeda Pharmaceuticals
  • Ownership Interest: Clinilabs, Inc., Clinilabs IPA, Inc., Clinilabs Physicians Services, PC
I would be surprised if Zammit has any time to actually treat patients!

So much for unbiased CME!

To add insult to injury, an article in the New York Times, entitled "Sleep Drugs Found only Mildly Effective, but Wildly Popular," starts out with "Your dreams miss you." -- the tagline infamously associated with Abe Lincoln and a beaver in Rozerem DTC ads, which, according to Lee Weinblatt, Founder and Chief Executive Officer of PreTesting, "don't work for many reasons."
"First of all," said Weinblatt "we found out [through testing] the beaver was a turnoff. Whenever test group respondents would focus on it, their interest went down like a rock. In addition, they remembered the beaver and Abe Lincoln, but they couldn't remember the name of the product. On top of that, we found the ad was very poor in terms of "Is this brand unique?" Readers had no idea what made this product different." (See "Direct to Consumer: All Eyes on You.")
Well, STEPHANIE SAUL, the author of the NY Times article, must have felt obliged to compensate for the deficiency of the Rozerem DTC campaign. She ended her article thusly:
"Rozerem, with its unusual advertising campaign, has at least one benefit over other medications. Because it works by a different mechanism from the others, it is not a controlled substance and apparently does not affect the ability to form memories. It may be the sleeping pill of choice for elderly people who have trouble falling asleep, but suffer memory problems."
I wonder if Stephanie received an honorarium from Takeda as well?

P.S. To hear more of Lee Weinblatt's views on Rozerem DTC ads, listen to the recent Pharma Marketing Talk podcast: "Your DTC Ads Stink!"

P.P.S. To hear more of Daniel Carlat's views on pharmaceutical company support of CME, listen to this recent Pharma Marketing Talk podcast: "Welcome to the CME Laundromat!"

Awards: POE vs. MM&M. I Pick Winners!

DTC Perspectives, a pharmaceutical industry trade publication that focuses entirely on consumer marketing, announced the winners of its sixth annual Perspectives On Excellence Awards (POEs) last night at the Awards Dinner on October 24th.

Unfortunately, I was unable to attend because of my watercolor class at Bucks County Community College. Here's my first watercolor painting:


I had some trouble with the shadow, but otherwise I think it looks pretty good! Let's see Peter Rost or Ed Silverman do that!

Anyway, back to the POEs. And the winners are:

Most Innovative DTC Campaign
  • Gold Celebrex
  • Silver Gardasil
  • Bronze Rozerem
Back in September, I predicted that Celebrex and Gardasil would win top honors, whereas respondents to my poll picked Rozerem and Gardasil/Tamiflu (see "POE: DTC Forevermore").

I don't know why my readers thought the Tamiflu DTC campaign was innovative -- as I said in my post, I never wrote about it, so how could it be innovative?

As for Rozerem, my guess is the ad agency responsible for this campaign has too much time on its hands and repeatedly voted for it in my poll! This Web 2.0 stuff and "wisdom of the crowds" can too easily be manipulated (see "Web 2.0 Pharma Marketing Tricks for Dummies").

Whatever! Meet Me at the MM&M Awards Bash!

Yes, I will be donning my rented tux and attending this "gala event" at Tavern on the Green in Central Park, NYC, on Thursday, November 1.

Now, this is a classy awards ceremony compared to the POEs, which is a Po' Man's event by comparison! I mean, where would you rather accept an award for your ad, which I have no doubt that you will receive one day: at the Parsippany Sheraton or at Tavern on the Green?

Being Tavern on the Green, I envision most of the 500 pharmaceutical, agency, and publishing executives attending to arrive in limousines, whereas I will show up in a taxi! Oh Lord, won't you buy me a town car, my friends all have limousines?



The only bone I have to pick with MM&M is the fact that Rozerem is repeatedly listed as one of the finalists in several categories! This despite my criticisms. But don't just take my word for it -- see what Lee Weinblatt, Founder and Chief Executive Officer of PreTesting, has to say in the recent Pharmaceutical Executive Magazine ("Direct to Consumer: All Eyes on You") or in my podcast interview with him ("Your DTC Ads Stink!").

But enough for now. After the ceremony, I will have more to say about the MM&M awards -- hopefully accompanied by photos of me hobnobbing with the pharma advertising elite!

Wednesday, October 24, 2007

A Milestone: The Five Hundredth Post! Thank You!

Today marks a milestone for Pharma Marketing Blog: the five hundredth -- more or less -- post (#500 is "Pharma Grapples with Barriers to Adopting Web 2.0")!

It's a small accomplishment considering the many other blogs in the Pharma BlogosphereTM that have exceeded this quantity of posts a long time ago.

But I'd like to think of each of my posts as a "pearl of wisdom" that I carefully craft and fuss over. As you know, it takes time to make a pearl and it takes time for me to write each post to give you a unique perspective on pharmaceutical marketing.

I am very thankful to the many readers who visit this blog every day, participate in the discussion through comments and who greet me at industry meetings! It's nice to know my effort is appreciated, even if you do not agree with everything I say.

Pharma Grapples with Barriers to Adopting Web 2.0

Yesterday, I sat in at several presentations made at ExL's Digital Pharma conference in Princeton, NJ. Underlying practically every presentation and in my discussions with a few attendees, was the issue of barriers that pharma companies themselves are putting in their way to using Web 2.0 tools. Before I get to that, however, I'd like to summarize a few of the presentations I found of interest.

Sermo -- Are Members Really On Board with Pfizer Deal?
Daniel Palestrant, Founder & Chief Executive Officer of Sermo, gave a presentation in which is described how Sermo works and how "clients" gain access -- for a fee -- to the wisdom of the Sermo crowd. For those among you who do not know, Sermo is an online community of about 35,000 physicians who post discussions about their clinical practice and other issues of importance to them. Sermo's clients include pharmaceutical companies like Pfizer (see "Pfizer Has a Gold Mine in Sermo" and listen to my podcast conversation with Palestrant).

Sermo physicians spent over 4,000 hours last week on the site. Palestrant attributed the success of Sermo not to the popularity of the Internet among young doctors -- 55% of Sermo's members are between the ages of 40 and 59 -- but to the fact that physicians are "lonely." They don't play golf any more, said Paltestrant. Perhaps that's due to pharma cutting back on all-paid "junkets" to golf resorts!

I wondered what other group of people in the 40-59 age group also was lonely that I could target for membership in an online social network. The best I could come up with was divorced men and women! But they probably already have a network.
BTW, if YOU are a lonely pharmaceutical marketing person working within the pharmaceutical industry or in one of the many agencies that service pharma, I have a social network just for you! See "An Online Community to Call Our Own" and visit the Forums at Pharma Marketing Network.
Palestrant was given the presidential privilege of NOT being required to answer questions from the audience, so I couldn't ask him the one question I had, which concerned his poll of Sermo members regarding pharma clients.

Palestrant said that over 50% of Sermo members consistently said that Sermo should invite pharma companies to be clients. He based this partly at least on a poll of Sermo members conducted between May 19, 2007 and June 2, 2007 that showed 54% favored pharma clients, 18% were against it, and 28% were not sure.

The problem is, there were only 89 responses -- a self-selected group of less than 0.3% of all Sermo members! Hardly a scientific poll as many of my Pharma BlogosphereTM colleagues would say. In fact, most of the poll data that I saw in Palestrant's slides had fewer than 100 responses.

Palestrant said that Sermo also did "extensive focus grouping," but did not show any data from that endeavor.

It will be interesting to see how Sermo's deal with Pfizer and other pharma companies pans out considering that there may be a large contingent -- dare I say a silent majority? -- of Sermo members who are opposed to pharma companies snooping on them.

You can read more about Sermo's deal with Pfizer in the Pharma Marketing News article "Collaborating with Online Physician Communities."

Online Health Literacy Principles
Barbara Pagano, SVP, HealthEd Interactive said in her presentation "Uncovering the 'A ha!' moments on your Website" that pharmaceutical companies needed to learn some Web 1.0 principles of health communication before they delve into Web 2.0.

To illustrate her point, Pagano showed a cute cartoon based on the character "Ed U Ka Te," an Ali G sound-a-like, Ninja boy who has the "power of medical education." His nemesis is the incredibly politically-incorrect "Miss Communication," a nurse poser who locks up the real nurse and runs rampant in the doctor's office disseminating difficult-to-understand medical information to unsuspecting "Joe Average" patient.

Pagano's take-away message was "What you say, how you say it, and how you display it, can save lives." She might have also said "can destroy lives," but she was obeying one of her communications principles of being positive rather than negative -- tell people what to do instead of what not to do. This is a principle I have not yet mastered...to whit:

HealthEd -- which was a client of mine in the past, but not now, and maybe never in the future! -- probably shouldn't show this cartoon too often. Miss Communication's dress code needs some modification and Joe Average needs to be modernized -- today's patients are very savvy about their medical conditions and treatments, thanks in part to the Internet and despite pharma's lame attempts to educate them.

To Develop Guidelines or Not to Develop Guidelines, That is the Question!
I intended to write about pharma-sponsored Web 2.0 guidelines that some presenters and attendees expressed the need for at the conference, but I am running out of time.

I plan to attend the Digital Pharma conference again today and joust with Marc Monseau, Director of Media Relations at J&J on whether or not pharma should embrace Web 2.0 (see my slide deck here) and I need to get prepared. I will have more to say on guidelines and review other Digital Pharma presentations tomorrow or in the following days.

Tuesday, October 23, 2007

Off to Digital Pharma!

Today, I will be spending some time in Princeton, NJ attending ExL Pharma's Digital Pharma conference. I hope to see some of you there.

The presentations I hope to attend include:

How MDs are Both Seeking and Jumping on New Web 2.0 Technologies to Communicate & Collaborate -- Daniel Palestrant. I hope to gain some more insight into how Sermo uniquely empowers physicians. This will add to my article planned for the upcoming issue of Pharma Marketing News, which will focus on drug industry collaboration with online physician communities. I have already interview Dr. Palestrant in a recent Pharma Marketing Talk podcast (listen here).

The Paradigm Shift: Web 2.0 and the New Era Of Pharmaceutical Marketing -- a panel discussion moderated by Joe Shields Director, Consumer Strategy, Enbrel WYETH. I'll be able to meet up again with my good friend Len Starnes, Head of E-Business, Primary Care, BAYER SCHERING PHARMA AG. Glad to see that he has survived the merger!

Driving "Hi-Water Mark" Results Through Innovative and Integrated Online/Offline Strategy and Creative -- by Karen Carr, VP, Health & Wellness Practice, IMC2. I think these are the people that are responsible for Glaxo's alliconnect blog. The presenters promise to talk about how GlaxoSmithKline's alli turned the newest over-the-counter weight-loss brand into an overnight sensation by combining up-to-the-minute behavioral change insights with the newest emerging approaches to digital and relationship marketing.

Leveraging Video on the Web Within A Contextual Format -- a panel discussion. I hope this is more than just how cool video is. They should discuss how user-created video can be used by marketers as in Novartis' FluFlix Video Contest on YouTube (see "Novartis Attempts Perfect Execution of Web 2.0 Trick!").

Anyway, gotta go! I hope to report highlights later.

Monday, October 22, 2007

Pfizer the Headless Chicken!

Pfizer Inc. Chief Executive Jeffrey Kindler's decision to scrap an unpopular drug bucked an unspoken industry rule, according to a Wall Street Journal article ("Pfizer Breaks With Norm by Scrapping Drug"). Namely, products can linger on life support as long as they pose no safety problems.

The article makes a couple of references to Kindler's previous experience as a fast-food (specifically chicken) executive:

"This is a guy who came in from the fast-food business selling chicken, where decisions are made in seconds, and now he's in the pharmaceutical industry with a complex diabetes product that affects patients over decades," says Andrew Forman, managing director of health care at investment firm W.R. Hambrecht.

And this: "...the CEO's public comments indicate Mr. Kindler aims to bring something new to the drug industry: A fast-food-like focus on what the market wants."

All this made me recall the story of Mike the famous headless chicken. Here's an excerpt from the wikipedia entry:
Mike the Headless Chicken (April 1945 – March 1947; pictured above) was a Wyandotte rooster (cockerel) that lived for 18 months after its head had been cut off.

On Monday September 10, 1945, farmer Lloyd Olsen of Fruita, Colorado, had his mother-in-law around for supper and was sent out to the yard by his wife to bring back a chicken. Olsen failed to completely decapitate the five-and-a-half month old bird named Mike. The axe missed the jugular vein, leaving one ear and most of the brain stem intact.

On the first night after the decapitation Mike slept with it under his wing; it was this that convinced Olsen to reprieve Mike from the cooking pot.

Despite Olsen's botched handiwork, Mike was still able to balance on a perch and walk clumsily; he even attempted to preen and crow, although he could do neither. After the bird did not die, a surprised Mr. Olsen decided to continue to care permanently for Mike, feeding him a mixture of milk and water via an eyedropper; he was also fed small grains of corn. Mike occasionally choked on his own mucus, which the Olsen family would clear using a syringe.

When used to his new and unusual center of mass Mike could easily get himself to the highest perches without falling. His crowing, though, was less impressive and consisted of a gurgling sound made in his throat, leaving him unable to crow at dawn. Mike also spent his time preening and attempting to peck for food with his neck.

Being headless did not keep Mike from putting on weight; at the time of his beheading he weighed two and a half pounds, but at the time of his death this had increased to nearly eight.

n March 1947, at a motel in Phoenix on a stopover while traveling back home from tour, Mike started choking in the middle of the night. As the Olsens had inadvertently left their feeding and cleaning syringes at the sideshow the day before, they were unable to save Mike. Lloyd Olsen claimed that he had sold the bird off, resulting in stories of Mike still touring the country as late as 1949.
There's a parable here somewhere. I think it's this: Pfizer, like Mike, now may be running around with its head cut off! It can live for a while and even gain weight without another blockbuster on the horizon, but sooner or later the pot awaits!

Sermo CEO Talks About Pfizer Collaboration

Daniel Palestrant, M.D., Founder and Chief Executive Officer of Cambridge-based Sermo, Inc., was a guest on last week's Pharma Marketing Talk live podcast entitled "Collaborating with Online Physician Communities."

Palestrant claims that the decision to collaborate with Pfizer and eventually other pharmaceutical companies was based in part on feedback from Sermo members.
"Aside from the topical discussions," said Palestrant, "the Sermo community generates quantitative data through multiple-choice polls that physicians can set up whenever they post a message. Through this polling, we discovered that consistently more than 50% of respondents were in favor of having some kind of interaction with the industry.

"Our choice was either one of engagement or contention. We've decided on engagement. Through both structured and unstructured means, our community will be engaging with industry in a very broad and unprecedented transparent fashion."
This is in sharp contrast to the online physician communities of yesterday -- Physicians Online (POL) being the grand-daddy of them all. POL -- active many years ago -- was adamant about protecting their community from interaction with the pharmaceutical industry. Palestrant noted that times have changed:
"As exciting as POL was, at the time [1994-1997], only 20% or less of physicians had access to the Internet whereas today practically 100% of physicians are online," said Palestarnt. "Back then the Pharma world was also in a very different place in terms of their interactions with physicians. So times have certainly changed.

"I firmly believe that it is better to engage the industry rather than block them out. Sermo has developed technology that allows this engagement or flow of information in such a way so that it's a win-win situation for the community and the outside parties introducing the information."
During the podcast interview, Palestrant described the Sermo-Pfizer collaboration in more detail, talked about FDA and adverse event monitoring via Sermo, compared traditional academic-based physician thought leaders with the new breed of online, bedside thought leaders to be found on Sermo, and other topics.

You can listen to the podcast audio archive here or read a summary of the conversation along with other information about online collaboration between physicians and the pharmaceutical industry in the upcoming October issue (preview) of Pharma Marketing News (free subscription here).

Friday, October 19, 2007

Exubera: A Titanic Failure! What the survivors are saying.

The Wall Street Journal today characterized the failure of Exubera as "one of the drug industry's costliest failures ever." Mike Krensavage, an analyst at Raymond James & Associates, was quoted in the same article as saying "This is one of the most stunning failures in the history of the pharmaceutical industry." (See "Insulin Flop Costs Pfizer $2.8 Billion"; subscription required.)

We haven't heard such comments since the sinking of the Titanic! So, the following image borrowed from PharmaGossip (see "Pfizer - Exubera: without a trace") is spot on as the Brits would say.


Image source: PharmaGossip
[If you'd like to see more blog images depicting the failure of Exubera, see my post over at Pharma Blogosphere ("'Round the Sphere: Best Exubera Failure Headline/Graphic. And the Winner is...").]
There are plenty of other similarities between Exubera's failure and the failure of the "unsinkable" Titanic. I am specifically talking about Pfizer's hubris and marketing's poisoned Kool Aid. Like the builders of the Titanic, the Exubera marketers felt they had an "unsinkable" product that would quickly reach blockbuster status and make the company a bundle.

According the WSJ, at a meeting with analysts in 2006, Karen Katen, president for human health and one of current Pfizer CEO Kindler's rivals for the top job, told investors that their "average forecast for Exubera sales in 2010 -- $1.15 billion -- was too low; Pfizer put it closer to $2 billion." Compare that to a Credit Suisse estimate of $8.7 billion in world-wide sales for all insulin in 2006.

Maybe the Pfizer board knew something was up last year when it ditched Ms. Katen and chose Kindler as CEO? Perhaps some of them even profited from the inflated Exubera sales estimates before side-lining Katen?

A Litany of Problems

WSJ: "Although the drug was approved in January, it wasn't introduced fully until September because of manufacturing problems. Once on the market, diabetes specialists said it was hard to use. Patients need to insert packets of powder into the device measured in three or nine milligrams -- not the units doctors are used to. The company had problems getting insurance companies to cover the treatment at a favorable rate, and a British medical committee said Britain's health authorities shouldn't pay for it at all because it didn't offer advantages over less-expensive therapies. Exubera costs about $5 a day while injectible insulin costs about $2 to $3 a day."

Pfizer marketers must have drunk their Kool Aid: "Still," says WSJ, "Pfizer promoted the drug until the bitter end."

What Are the Survivors Saying?
Pfizer employees have so far survived "one of the most stunning failures in the history of the pharmaceutical industry." Here are some choice comments from posters over at the Pfizer Company board on CafePharma:

Wrong Drug, Wrong Time , Wrong Delivery System!
"This is the worst thing I have seen in 15 years - OUR NEW OFFICIAL POSITION IS SURRENDER - Jeff Kindler - you are the Jimmy Carter of corporate America - no better way to convey confidence than to give up - This drug had no chance from day 1 - the launch was an absolute joke - a standard by which all other companies should not launch drugs - partial targeting, limited supplies, selective call cycles. Then we tell the inept APN division that they are losing the drug months before they actually do - so what do they do?? Big shocker --- they put it away for months - never talk about it, blow off contractual obligations to major targets who went to speaker training and were expecting to do talks -- and then.... my favorite - we hot potatoe the drug to the division that is carrying our flagship 10billion dollar product on the eve of managed care annihilation - and fly thousands of reps to Arrowwood to be fed and lodged for days so they could watch a video conference that could have been done in a webcast at the cost of millions of dollars - we then get 6 months to raise this drug from the dead. And just when we getting some momentum -- pull the plug - I am embarrassed beyond words - never thought I would live to see the day that the House That Steere Built would run from a challenge that was only a challenge because of the mistakes that we made. Lilly or Tekada would have made this a billion dollar drug - we don't remember how to do that anymore"

A RESPONSE: "You are dead wrong here..neither Lilly or Takeda or anyone else could have made this piece of shit a $100m drug...wrong drug, wrong time , wrong delivery system..S/A knew it, do did the developer but hunted for idiots and found one! That drug was doomed but we were grasping for a winner, any winner to replace the lost drugs!" (Access Thread Here)

Pfizer Hubris
"You gotta be kidding, surely Pfizer knows this product is has absolutley (sic) no chance of success. Do they think that if they wish hard enough that it will turn into a blockbuster?"

A RESPONSE: "If you worked for Pfizer you'd know that Pfizer believes that by shear force of will they can do anything.

With enough will power you can make Exubera profitable.

With enough will power you can make employees happy.

With enough will power you can make black hole sites profitable.

With enough will power you can make a drug pipe line using only sycophants, politcians (sic) and diplomats as your researchers.
(Access Thread Here)

Life After Death?
"On a different note, doesn't anyone realize that Exubera is a whole lot more than a drug? Its a new technology that will open the floodgates on development of other Pfizer medications that are currently only administered by injection. I believe the success of the process is worth more to the company than the product ever was going to be. I truly believe that the success of Exubera has already been attained in some eyes. Approved commercial use of a system that can take a liquid and safely convert it to be administered in an inhalable form. I once read somewhere that Terre Haute was being labeled by Pfizer as its Inhale production facility for the world. I think Exubera is just a piece in the proverbial puzzle for Terre Haute. The facility already has the square footage available to contain multiple product lines."
(Access Thread Here)


P.S. Have you taken our "Kevlar Kindler" poll yet?

Will Kindler Survive the Exubera Bomb?
Yes
No

Thursday, October 18, 2007

Exubera Bong Bombs!

Pfizer announced that it will no longer market Exubera, an inhaled insulin device that it just began to promote heavily on TV.

"We made an important decision regarding Exubera, a product for which we initially had high expectations," said Jeff Kindler, Pfizer Chairman and Chief Executive Officer. "Despite our best efforts, Exubera has failed to gain the acceptance of patients and physicians. We have therefore concluded that further investment in this product is unwarranted."

Exubera had long been the butt of many blogger, patient, and even physician joke. Back in May, 2007, I hinted that the product would fail unless Pfizer came up with more innovative ways to promote it than by the usual DTC campaign (see "Pfizer's Exubera Strategy Needs a Bong Blog!").

One of my blog readers, Sunil S Chiplunkar, crafted this little diddy:

Pfizer with high hopes, launched the Exubera bong
Thought it would click like a gong
But missing is physician exuberance
All it got was malevolence
So will Exubera bomb?

Very prescient, I would say!

Is Kindler Next to Go?
Exubera is the second Pfizer product to bite the dust on CEO Jeff Kindler's watch. Kindler escaped blame for the torcetrapib failure (see "torcetrapib: "$800 Million" Failure but Kindler Safe"). At the time of the "$800 million" failure of torceptrapib, I commented that "neither Pfizer nor its new CEO Kindler can afford another '$800 million' loss."

It appears that the Exubera failure has cost Pfizer MUCH more than $800 million. According to Frank D’Amelio, Pfizer's Chief Financial Officer:

"The Exubera pre-tax charges of $2.8 billion related primarily to the write-off of assets associated with this product, as well as the accrual of other exit costs. More specifically, these charges are comprised of approximately $1.1 billion of intangible assets, $661 million of inventory, $454 million of fixed assets and $584 million of other exit costs."

That's $2.8 billion dollars -- about 3.5 times what the torceptrapib failure cost! Which goes to prove that the risk is less if pharma companies develop drugs in-house rather than purchasing them from an out-house (read this).

Will Kindler survive? You tell me by taking my little poll:

Will Kindler Survive the Exubera Bomb?
Yes
No

Kevlar Kindler?

It appears reader sentiment is that Kindler WILL survive! He's definitely got on his Kevlar underwear!

But if this post over at the Pfizer company board on CafePharma is any indication, Kindler may not have much time left:
"one has to wonder... will the Pfizer board hold Kindler and his management team accountable for these results? Kindler inherited a bag of sh*t and he can't be blamed for the torcetrapib debacle, but one year has passed since McKinnell was tossed and there is absolutely no indication that this CEO and his team are capable of anything except dramatic organizational announcements and job cuts. Where's the long-awaited business strategy and vision? Why did it take over a year to figure out a strategy to reform PGRD? Does anyone except Jeff and the ELT believe these changes will yield meaningful results anytime during the next 5 years?

"You can't keep 90,000+ employees in a constant state of transition, demand organizational agility and speed, spend over 12 months building expectation that the leadership is thinking through an innovative business plan to improve the situation, then fail to deliver anything that resembles a detailed vision for the future of Pfizer. At some point, management needs to tell Pfizer's investors and employees what they plan to do and when they plan to do it.

"Time's up Jeff. It's time to deliver your plan, or it's time for new leadership."

-- RossMacLochness, "The Emporer Has No Clothes?"

Wednesday, October 17, 2007

Parick Clinton Speaks About Drug Safety and Has a Special Offer for You!

ClintonPatrick Clinton, Editor-in-Chief of Pharmaceutical Executive Magazine, was my guest today for a Pharma Marketing Talk podcast entitled "Pharma Business Strategies in Times of Change."

You can Listen Online to the audio archive or click on this button () to play the audio via Windows Media Player.

Pat has some interesting comments about communicating risk information as well as what the industry needs to do to move away from its dependence on blockbuster drugs.

More importantly, however, he offers listeners a fantastic greater than 50% discount on the registration fee for Pharmaceutical Executive’s upcoming 2007 Marketing & Sales Summit, which takes place November 4 - 6, 2007 in Philadelphia. I hope to see you there!

Listen to the podcast for the special code you'll need to take advantage of this great deal!

Tuesday, October 16, 2007

Pfizer has a Gold Mine in Sermo!

"For now, we see in a mirror, darkly; but then face to face: now I know in part; but then shall I know fully even as also I was fully known." -- Cor. 13:12

The recent announcement of the Pfizer-Sermo deal has been discussed by practically every blogger in the Pharma Blogosphere and beyond!

Is Pfizer in this to promote its products to Sermo docs? Reading all these blog posts and articles would lead you to believe that that is what's behind the deal.

If you look at Cafe Pharma, for example, you will find that some Pfizer sales reps wonder if this signals the "Beginning of the End for Sales Reps."
"Look people," says one rep, "the days of old are gone. Companies will have more and more docs working for them, giving other physicians our message. [Whether] it be through Sermo, conference calls, video playbacks, internet, etc. But the sales rep will always be in existance (sic), just at about 1/2 the numbers we are at now."
But will the message appear as through a "darkened mirror" as Paul envisioned our knowledge of God in this life? Or do physicians need face-to-face interaction with reps (or with pharma's hired physician guns) to fully know the benefits of drug treatments offered by pharma?

If the attitude of Sermo docs is anything like the attitude of Cafe Pharma sales reps, I envision Pfizer receiving a cold shoulder welcome. Maybe even a flurry of flames? In fact, Ed Silverman over at Pharmalot quotes a few choice Sermo anti-pharma posts, which he got from a doctor friend:
"I am not a fan of PhRMA…and I am especially not thrilled at the idea that they will now have one more way to 'get at' physicians via Sermo." Writes another: "Any influence from Pfizer has to be absolutely marked and labeled loud and clear! I am sick and tired of industry people sneaking in their subtle, hard-to-detect influences into everything and every media corner money can buy.” Another warns: “No Pfizer docs acting like reps in here!" Says one doc: "There is no way Pfizer is interested in anything but marketing in this ‘partnership.'" (see "Docs On Sermo-Pfizer Deal: ‘You Let The Enemy In’").
Several bloggers and articles written about this deal warned about off-label promotion by Pfizer to physicians. Ed Silverman, for example, said:
"But the venue could, conceivably, create myriad scenarios in which, say, off-label info is conveyed or trial results are somehow whispered prematurely or selectively" (see "Pfizer Strikes Deal With Sermo’s Online Doctor Forum").
"It is risky territory for Pfizer, though," says WSJ reporter Avery Johnson. "The drug industry's interactions with doctors are highly scrutinized by regulators and lawmakers for signs that they are offering financial incentives to drive sales or promoting their drugs for unapproved uses." (See "Pfizer-Doctors Web Pact May Get Looks.")

Fard Johnmar over at HealthcareVOX thinks Sermo will police posts made by Pfizer:
"However, despite these concerns, we must remember that Sermo has a lot to lose and little to gain if it allows Pfizer’s physicians and marketing department to use the social network in inappropriate ways. Sermo is only as good as its physician community. If it becomes apparent that Sermo has become nothing but a front for drug firms . . . bye bye Sermo (see "As Sermo & Pfizer Link Up, Some Worry About Off-Label Marketing").
The off-label promotion issue is really a red herring. The last thing Pfizer wants is some doc on Sermo reporting that it has engaged in illegal off-label promotion via Sermo posts. Besides, Pfizer would be pretty stupid to do something like that in a medium that records every word written by every poster!

No, it's not off-label promotion that Pfizer is interested in. In fact, I do not think Pfizer is interested in promoting its products at all through interaction with Sermo docs. After all, there are only about 30,000 docs on Sermo out of approximately 700,000 total docs in the US!

And what does Sermo know about these docs? Only that they are licensed physicians in a particular specialty or general practice. It knows squat about their prescribing behavior. How can you market to docs willy nilly without knowing their scrip writing habits? Or if their scrips increase after marketing to them?

So What Does Pfizer Expect to Get Out of This Deal?


Pfizer expects to recruit docs to influence other docs, that's what!

Here's what Pfizer can learn through its Sermo deal:
  • Which docs on Sermo are our friends?
  • Which ones have the highest ratings among other Sermo docs and therefore are likely to be influential?
  • Which docs seem interested in becoming consultants or doing clinical trials?
If Pfizer can identify and communicate specifically with these docs through Sermo, then they may have a gold mine.

Sermo itself may not reveal the identity of its physicians to Pfizer, but that isn't necessary for Pfizer to be able to contact specific physicians who allow private messages with other members or include their contact information in their profiles.

Having this source of Web 2.0 enabled physician evangelists, Pfizer can then pay them to spread the Pfizer gospel throughout the Net.

"Then shall I know fully even as also I was fully known."

Monday, October 15, 2007

Pfizer Facebook a la Sermo?

Pfizer and Sermo -- a Web-based community where physicians share observations from daily practice, discuss emerging trends and provide new insights into medications, devices and treatments -- today announced a "strategic collaboration designed to redefine the way physicians in the U.S. and the healthcare industry work together to improve patient care."

I don't know about "improving patient care," but this deal sure seems likely to improve Pfizer's access to physicians, which, if typical of the industry as a whole, has been waning due to physician push back and state laws limiting free gifts to physicians, among other reasons.

At the core of the agreement between Pfizer and Sermo is the only form of free gift to physicians that Pfizer and other drug companies have left to give: drug treatment information without the pushy salesperson.

That, of course, leads to the issue of off-label promotion as pointed out by Ed Silverman over at Pharmalot:

"Of course, this opens a Pandora’s box. There’s nothing to say Pfizer or any other drugmaker shouldn’t participate in online forums. But the venue could, conceivably, create myriad scenarios in which, say, off-label info is conveyed or trial results are somehow whispered prematurely or selectively." (See "Pfizer Strikes Deal With Sermo’s Online Doctor Forum".)

Will the FDA Pay Attention?

But Ed hit the nail on the head with this observation:

"The FDA, if it pays attention [my emphasis], will likely have its bureaucratic hands full keeping track of countless postings to ensure such agreements don’t devolve into one large, ongoing and inappropriate marketing machine."

Despite the recent passage of PDUFA, which gives FDA more money and power to review DTC ads, it does not provide more funds to FDA to review online promotions aimed at consumers OR physicians. It's still a WILD, WILD West out there in Web 2.0 land as far as the FDA is concerned.

I pointed this out in a recent Pharma Marketing News article (see "Web 2.0 Pharma Marketing Tricks for Dummies"; subscription required or pay for reprint).

Other Objectives
Pfizer plans to pursue a number of other objectives through its collaboration with Sermo, including:
  1. Discover, with physicians, how best to transform the way medical information is exchanged in the fast-moving social media environment
  2. Create an open and transparent discussion with physicians through the innovative channel offered by online exchange
  3. Engage with the FDA to define guidelines for the use of social media in communications with healthcare professionals
  4. Work with physicians to develop a productive exchange between pharmaceutical professionals and the Sermo community
#1 suggests that this collaboration is merely an experiment or "pilot," which is the traditional way pharma companies have approached the Internet. $Millions are spent, nothing much accomplished, and the project is forgotten. Who at Pfizer, after all, is really in charge of digesting the results of this experiment? No one, really. Product managers don't care about "transforming the way medical information is exchanged." They care about transforming the way scripts are written for their products. It's strictly "show me the money!" with them. That's why only 3% of pharma marketing budgets is devoted to the Internet.

#2 is what I discussed above. It's really nothing new -- pharma companies have been educating physicians within their online communities since 1994 when I first started doing this kind of thing with a company called "Physicians Online," which was acquired by WebMD a long time ago. Let's move on; there's nothing to see here (at least nothing we haven't seen before).

#3 -- LOL! How can you engage the FDA if it's head is in the sand or some other orifice that shall go unnamed?!

#4 is an interesting objective that I would like to learn more about and explore with you in the future. Stay tuned!

Friday, October 12, 2007

Chantix Californication Dreamin': Viagra II

In the Larry Niven science fiction story, Death by Ecstasy, a belter, Owen Jennison, is found dead on Earth in a locked Los Angeles apartment. His death is an apparent suicide. Hamilton, a friend and former crewmate of Jennison, is called to the scene to investigate. He finds Owen with a droud (a wirehead's transformer) plugged into the back of his head. The latter apparently starved himself to death while continuously stimulating the pleasure center of his own brain.

In the real world of today, there are many legal and illegal drugs and other chemical compounds that people use to stimulate their pleasure centers. One such agent is nicotine. Another is Pfizer's Chantix, a smoking cessation drug that competes with nicotine to stimulate the brain's pleasure center. In other words, Chantix takes the place of nicotine and like nicotine stimulates dopamine production, which "gives you a feeling of pleasure." This is the appeal of smoking.

Below is a page from the booklet that Pfizer sent me when I requested information about Chantix and its Quit Smoking program (see "A Pill, a Plan, a Profit? -- Chantix!"). It explains the whole thing.
Click image to enlarge and read.

What I didn't realize is that the pleasure involves vivid, memorable dreams, which is a "side effect" that Pfizer describes as "changes in dreaming."
NOTE: Pfizer should redefine the dreaming side effect as a "treatment effect" the same way that GSK calls oily fecal discharge a treatment effect of Alli (see "alli Marketer Explains Treatment Effects"). I think this would have great potential in designing new direct-to-consumer (DTC) ads (see below for more ideas about that).
In any case, my brother-in-law, who is taking Chantix to help him quit smoking, first told me about the dreams. He wouldn't tell me specifics, like what he dreamt. I found that interesting, so I decided to mine some social networks to find examples of dreams that Chantix users were reporting.

The Chantix-Hollywood Movie Star Connection
From my research, it appears that a good portion of dreams involve Hollywood movie stars like George Clooney. And there's a decidedly sexual overtone to these dreams. Now I understand why my brother-in-law would not describe his dreams in mixed company!

Here are a couple of examples of women's Chantix dreams that I found at sites like HealthBoards:

"Wow, this is just too funny. I've been dreaming of George Clooney!! Before Chantix, I don't believe that I've every dreamed of him, but for the past week he visits me every night (;"

"Lets see Sunday night which was day1 of the first week I dreamed where Hubby and I were in a hotel where the stairs changed every 3 seconds. Last night my 2nd day I dreamed Hubby and I went to Colorado and we on a rollercoaster that involved 3 mountains in a convertible. Every half mile this coaster place had people stationed at the side of the ride working on cicuit boards and they kept an eye on the people riding as well as the ride itself. One of the people keeping an eye on the ride was Chuck Norris and as Hubby and I got close to him he called out my name and asked me how I was doing. Hubby wanted to know how he knew me. Then tonight 3rd day on Chantix Hubby and I took a nap and I dreamed He, I, Bobby Flay and Flay's wife were at a dance and Bobby flirted with me. I have always had dreams but nothing like this, lol."

A Girl Can Always Dream
"I keep dreaming of Orlando Bloom. Orlando and Johnny Depp keep fighting over me. Sometimes in their pirate outfits, sometimes not. Then I had a dream that I was riding on a motcycle w/ john travolta, (i watched wild hogs that day) and Tom Cruise was the dog sitter and of coarse he was wearing his pink leather collar. Weird! Anyway, I guess the saying 'a girl can always dream' takes on a whole new meaning now."

And not just women are having these dreams. Here's one from "Nick":

"I've had them for 2 of the last 3 nights. Some humorous, and yes, like others have written - a celebrity was featured (it was just bizarre. In the dream i encountered 'The Burt Reynolds Sunglass Factory'). That one was humorous enough, i suppose."

I always thought Burt Reynolds was a man's man!

"Steve" had this dream:

"Anyone remember Valerie Bertonelli? Yeah, tv star, girlfriend to some rocker. Well last night her and I were late getting to our cruise ship. Although we were driving like mad, we could see it down below in the harbor sailing away. She was able to call someone on her phone and sure enough, it begins to turn around. When I get on board they want my ticket but of course I don't have one so they send me to the ticket window where the woman must have been confused because when I got there, she handed me a ticket and a big wad of cash!"

"Yummy!!," said Memaw, "Isn't it funny that no one is dreaming of musicians or NASCAR drivers....just movie stars?"

Yes it is, but not all Chantix dreams are about movie stars. Take Chantix and you may have dreams about your co-workers and find out about your repressed sexual urges. Take this one for example:

"Ok last night was my first night on Chantix. And the dream screwed me up for the remander of the day. I had a dream I was at a party with a bunch of my co workers. My boss was there and a few people in my division and this one guy I absolutly hate named Adam. During this party everyone was chatting it up listening to EXTREMELY loud music and drinking. Halfway throught the dream I noticed a large bay window that wasn't there during the first half. It was open and there were severl shirtless men dressed as barbarians outside around a campfire with swords and rasing them up shouting "give me a beer, give me a beer, give me a beer" As I was watching this display of manlyness someone from my team spilled a Vodak and Cranberry all over me. I found myself walking into what seemed to be a community Uni-sex bath room and undressing and getting into an open shower with 4 other people in my Office including the guy I hate more than life itself. The visual of 4 naked bodies having a water fight with the detachable shower head continued on for what seemed like forever. To say the least when I woke up I was repulsed that I could even have thought up this sort of mess but later chuckled about it through out the day. Now that I have read all of your dreams I can see I am not alone. I wonder what tonight will bring!"

Boy Oh Boy! A psychoanalyst could have a field day with these people! But what does it have to do with pharmaceutical marketing?

A few people mentioned that they would MISS Chantix when they stop taking it and one person said this:
"My dreams are awsome (sic). If someone had told me about this side effect I might have taken the drug sooner."
Viagra II?
Comments like those make me think Pfizer has a "Viagra II" in Chantix and may not realize it! The dreaming "side effect" may be more valuable than the original indication! I'd like to take Chantix just to experience the dreams and be able to remember them, which is another benefit people talk about.

Imagine if Pfizer could somehow take advantage of these patient reactions and redesign their ads with that in mind. They should hire the Rozerem ad team and do a "Your dreams miss you" campaign. But instead of featuring sexless Abe Lincoln and a beaver that no-one could have sexual fantasies about, Pfizer's new Chantix ads should have a "Californication" theme, with George Clooney or some other Hollywood hunk as the spokesperson.

Here's my vision of such an ad:

A woman says "I dreamed I quit smoking..." followed by a fade to Clooney who purrs "It doesn't have to be a dream! I quit. You can too! Meet up with me at the Chantix Support Site."

Pfizer: Please make out the check for my consultation fee to John Mack or cash. Thanks!

Thursday, October 11, 2007

Statins and Heart Disease: Look Behind the Curtain

I noticed that Ed Silverman picked up on a statin study published in the New England Journal of Medicine (NEJM) that suggests statins such as Pravachol -- the drug used in the study -- help prevent heart attacks for at least a decade after people stop taking them.

This caught my attention because I recently stopped taking Pravachol, a Bristol-Myers Squibb (BMS) product, after about 12 years because I started getting leg cramps at night. Since I stopped, no cramps. I wondered if my risk for heart attack would increase because I stopped taking the drug, so I was pleasantly surprised to read this story, especially because it was about Pravachol. [BTW, I will discuss this with my cardiologist on Tuesday.]

The problem is, if I had just read the headlines and skimmed Ed's summary, I may have missed an important fact, which was pointed out in a comment to Ed's post; namely,
"...there was a statistically significant increase in prostate cancer which went up as the years progressed... Prostate cancer developed in 89 on pravastatin versus 59 on placebo, a 51% increase, which is much greater than the 25% decrease in heart attacks. The authors stated that the increase was 'probably due to chance and not causally related.' A similar ruse was given for the finding from PROSPER of a 25% increase in cancer, where the authors said that it was due to 'the play of chance'..."
The commenter was Doug Bremner, MD, a physician and researcher at Emory University and author of the book Before You Take That Pill: Why the Drug Industry May be Bad for Your Health.

Clearly, Bremner has a bias against the drug industry. He does, however, make a good point that "somehow" got lost in the original AP story and probably wasn't mentioned in the NEJM editorial about the results.

It turns out that BMS provided at least some of the funding for the study and as ed points out "All but one of the researchers reported receiving consulting fees, lecture fees or research grants from a total of five other drugmakers, four of which sell statins."
NOTE: Pravachol is off-patent and generic versions are available. Therefore, BMS may not benefit so much from this study as would other drug companies marketing statins.
It appears that the authors of the study went out of their way to play up the good news and play down the bad news.

According to Dr. Bremner, "I think it is time for these researchers to start playing by the rules of statistics, i.e. don't use statistics only when it goes in your favor."

I would have to agree with the doctor. Now, I am interested in his book and also may invite him as a guest to one of my Pharma Marketing Talk podcasts. If you read this, Dr. Bremner, give me a shout.

Wednesday, October 10, 2007

Medical Transcript Advertising: A Unique Form of "Non-Personal" Marketing

A few weeks ago, I got a call from Manuel Prado, the CEO of datumRx, a California-based company that specializes in aggregating clinical data and medical records.

DatumRx offers a unique service to pharmaceutical companies that allows them to reach physicians with targeted brand messages via medical transcripts.

I will be interviewing Mr. Prado in an upcoming LIVE Pharma Marketing Talk podcast on Monday, October 22, at 2 PM Eastern time (see details here). In preparation for that podcast, I'd like to get some input from readers regarding datumRx's service.

Here's how it works as far as I understand it right now: datumRX partners with medical transcription companies across the United States to place drug product logos on patient medical transcripts containing key words relevant to the product. Every time the physician views, faxes, or prints the transcript, he or she sees the logo and is reminded about the product.

"This is the last promotion a doctor will see before writing a prescription," says Prado.

Transcript advertising appears to be a better idea and more cost-effective than logoed chatckes like pens, refrigerator magnets and Rx pads because it is targeted to a patient's specific medical condition. Also, the physician gets a little discount on transcription fees for opting in to have the ads on transcript pages.

Mr. Prado will discuss the details in the upcoming podcast. Meanwhile, I have two questions for which I invite reader input:
  1. Is this legal and/or HIPAA compliant?
  2. Would physicians worry that datumRx has access the Personal Health Information of patients that are included in transcripts?
When I discussed this with a couple of pharma compliance officers, they did not dismiss it out of hand, but reserved their opinions on the HIPAA issues. Of course, HIPAA compliance is in the physician's court.

Non-Personal Physician Marketing
With roughly 100,000 pharmaceutical sales representatives knocking on doctors’ office doors every day and states imposing restrictions on their activity, it is harder and harder to reach prescribers. There is also the expense of using "live" sales reps (see discussion thread "What Is Average Cost of Sales Call?" over at the Pharma Marketing Network Forums).

There is an ever-increasing need to reach physicians with brand messages and reminders through "non-personal" marketing techniques that do not directly involve sales reps. Transcript advertising is just one physician/patient marketing technique at the patient-physician interface.

I plan to host a discussion of this topic in an upcoming Pharma Marketing Roundtable Forum. For more information about participating in this "members-only" Forum, read the announcement here.

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