AZ: Let's Put a Positive Spin on this "Cursed" Study

As reported in today's Wall Street Journal: "A document dated Feb. 12, 1997, describes internal company deliberations over how to report 'Study 15,' a study comparing Seroquel to Haldol, an older-generation psychiatric drug. In the document, an AstraZeneca employee named Richard Lawrence writes to his team that one of his colleagues had done a great 'smoke and mirrors job,' and another had suggested an approach that 'should minimise (and dare I venture to suggest) could put a positive spin (in terms of safety) on this cursed study.'" (See "AstraZeneca Papers Raise Seroquel Issues".)

This "raises further questions about whether AstraZeneca kept a lid on unflattering Seroquel studies," said the article. Duh!

This kind of thing is JUST what I was talking about in my previous post (see "Drug Fact Box: It All Depends on What You Mean by 'Fact'") about drug safety "facts" presented in consumer-friendly drug "Fact Boxes" proposed by Dartmouth researchers, who at this very moment are testifying before the FDA. Bob Ehrlich suggested that post-marketing data obtained by drug companies should be included in such boxes even if "less than perfect." Yes, after adding "positive spin" to the facts I suppose!

Drug Fact Box: It All Depends on What You Mean by "Fact"

Good morning, Pharma Marketing Blog fans! It's Friday and that means it's time for the Bob (Ehrlich) vs John (Mack) Friday Morning Smackdown! Every Friday, Ehrlich, who publishes the DTC Perspectives Magazine and Blog, sends me his opinion on a DTC (direct-to-consumer) advertising topic and I try to "smack down" his ideas. That's a bit of an exaggeration. What we have here is an attempt at communication in a point-counterpoint fashion. Hopefully, we all learn more and are entertained as well.

Today, Bob wrote about a Dartmouth Study that concludes a "Fact Box" on risk/benefit is good for consumers. Presumably, Fact Boxes would be included in all print DTC ads, on product web sites, and with the drug when it is picked up at the pharmacy.

The study included a mock up of a Fact Box for Lunesta (shown below; click on it for an enlarged view), a popular sleep aid drug that has been heavily advertised to consumers.


Bob cited a New York Times story about the study that coincidentally quoted him (see "A Push to Spell Out a Drug’s Risks and Benefits"). You can read about the study here.

The Fact Box proposed by the Dartmouth researchers includes only data from the FDA-approved package insert (PI), which is based solely on the clinical trial data submitted to the FDA as part of the approval process.

Bob says he supports "anything that gives consumers... numerical information." But he suggests other "facts" should be added. "Drug companies and FDA should also include all relevant information in a fact box," said Ehrlich, "including post marketing data, even if that is less perfect than controlled clinical studies."

I assume "less perfect" means nonfactual because facts are facts -- they are by definition perfect! Regardless of perfection, whenever you hear the word "marketing" as in "post-marketing data," you should be wary about the "facts" that are gleaned from the data. Bob admits it would take a "lot of work from the objective medical community" to include such post-marketing data in Fact Boxes.

While physicians can obtain such additional data through medical journals, consumers rarely have access to vetted post-marketing data about drugs. So, it makes sense that consumers should also have access to such data as long as it is accurate -- as perfect as possible.

Yet the "objectivity" of the medical community has come into question recently. Therefore I'm not sure what Bob proposes would work and it may just open up another door inviting DTC critics to enter and piss in the DTC tent.

BTW, there are some "facts" in the Lunesta Fact Box that I don't quite understand. The authors commented on these facts in a video (here). From their comments, I conclude that the authors are a tad biased against DTC advertising to begin with. For example, the Fact Box cited "facts" on drowsiness and indicated that "More had drowsiness (additional 6% due to drug)." I assume "More" means "More patients on the drug."

But why is drowsiness a side effect? Isn't drowsiness a benefit of a sleep aid drug? It turns out that this really refers to drowsiness after awakening the next day, "which is ironic" said one of the authors of the study, "because the whole the purpose of the drug is to treat your insomnia, let you sleep well, and feel rested the next day." Coincidentally, the new Lunesta ads emphasize how rested you feel when waking up the next day (see "New Lunesta Print Ad: 70% LESS Moth!").

The point is that this "fact" as presented in the Fact Box is not clear, IMHO. This is a case where more "data" is not always a good thing, especially when it's not clear how to interpret the data.

Another "fact" that appears in the Lunesta Fact Box is in the section "How long has the drug been in use?" Only one fact is presented there: "Lunesta was approved by the FDA in 2005." The rest is opinion on how you should interpret this fact: "As with all new drugs we simply don't know how its safety record will hold up over time. In general, if there are unforeseen, serious drug side effects, they emerge after the drug is on the market (when a large enough number of people have used the drug)."

According to the NY Times, "Dr. Woloshin and Dr. Lisa Schwartz, also of the Dartmouth institute, plan to present their case to the F.D.A. during a meeting of the agency’s advisory committee on 'risk communication.' That panel is examining how best to provide consumers with data about prescription drugs using printed matter like package inserts." Find more information on this meeting here. NOTE: If you plan to attend, you'll have to leave your shoes outside (see back story here and here).

New "New Media" Trick for Pharma Marketers

Pity the poor FDA! Despite its use of social and other "New" media, the FDA is not equipped to keep up with the new technology that allows unethical pharmaceutical marketers to get around FDA regulations relating to "fair balance," etc.

I have pointed out in the past certain "tricks" that pharmaceutical marketers can and ARE using to get around FDA regulations (see "Web 2.0 Pharma Marketing Tricks for Dummies").

Recently, the FDA DID manage to catch one of these tricksters (see "Death of the One-Click 'Rule' or 'Received Precedent' or Whatever!").

Today, thanks to ePharma Pioneer Club member Jonathan Richman, I learned a New "New Media" Trick: use of "QR Code" in mobile marketing (see "How to Avoid FDA Regulations Using Mobile Marketing").

Richman cites this wikipedia definition: “A QR Code is a matrix code (or two-dimensional bar code) created by Japanese corporation Denso-Wave in 1994. The “QR” is derived from “Quick Response”, as the creator intended the code to allow its contents to be decoded at high speed ... QR Codes are now used in a much broader context, including both commercial tracking applications and convenience-oriented applications aimed at mobile phone users (known as mobile tagging). QR Codes storing addresses and URLs may appear in magazines, on signs, buses, business cards or just about any object that users might need information about. Users with a camera phone equipped with the correct reader software can scan the image of the QR Code causing the phone’s browser to launch and redirect to the programmed URL.”

The image above/left is an example of a QR Code that points to Richman's blog.

Richman created a mock up mobile ad for Boniva using an image of Sally Field, who is quoted as saying "I use something once a month to keep my bones strong and healthy." No product is mentioned by name, but the ad also includes a QR Code that links to the boniva.com web site. All you need is a QR Code reader on your smart phone to bring up the product name and visit the Web site.

Richman says this is a way that pharma marketers can avoid including all the nasty "fair balance" that FDA requires in drug ads.

Of course, the ad itself is nothing new -- it's called a "reminder ad" and it is perfectly legal. [NOTE: There is no such Boniva reminder ad to my knowledge.] Of course, such an ad would violate the spirit of PhRMA's new guidelines for broadcast and print DTC ads. Those guidelines, however, do not apply to ads on the Internet or on mobile phones.

Richman was trying to make a point that "without effective guidelines for digital media from the FDA, this [sort of thing] is going to start happening." Maybe. But we may have to wait til hell freezes over for the FDA to develop guidelines. What we need to do is bring together stakeholders from the drug industry, consumer/patient groups, healthcare professionals, AND the government to develop ethical guidelines for use of new digital media for health advertising.

For me, this is deja vu all over again!

An Avodart Print Ad that FDA Missed

Yesterday, I posted a notice about FDA sending GSK a warning letter citing a violative Avodart "Planetarium" TV commercial for exaggerating the benefit of the drug to shrink enlarged prostate glans (see "FDA Warns GSK About Enlarged Avodart Ad Imagery").

One piece of evidence cited by FDA was the imagery used in the ad. Looking back over previous posts I have made, I find a post I made back in January, 2008, about an Avodart PRINT ad, which, as it turns out, ALSO exaggerates the amount of prostate gland shrinkage attributed to Avodart. See the following images:


The top image shows the whole ad, while the bottom image shows an enlarged area of the ad plus an optical illusion I added (see a previous post for an explanation).

Note that the enlarged illustration suggests that Avodart shrinks the prostate whereas "Other Drugs" do not (the ad copy says so outright -- click the ad image to enlarge IT). The image also shows a shrinkage of 19% in the diameter of the prostate, whereas the FDA says clinical trials only show a decrease of 10%.

Seems that the FDA missed this ad. Why don't they read this blog? It would save them a lot of time!

Online Personal Health Records and Pharma Search Engine Marketing

At yesterday's 3rd Pharmaceutical Search Engine Marketing Strategies Conference hosted by ExL Pharma, I was able to ask a question about the convergence of online personal health records ("PHR"; eg, MSN's Health Vault) and search engines may help pharmaceutical marketers greatly increase their return on investment in search engine marketing (SEM).

I asked the question because of a presentation that Grad Conn, Senior Director, Microsoft Health Solution Group, made at the recent ePharma Summit. In that presentation, Conn described MSN's Health Vault as a Personal Health Information Service (PHIS) that could be an important customer relationship management system that also is a "cross-selling platform for partner products." The illustration above shows Conn's concept of the how Health Vault will be the centerpiece of an "open ecosystem" of personal health information.

How can pharmaceutical companies benefit from online PHRs? Suppose, for example, that a pharmaceutical company wishes to recruit patients for a multi-center clinical trial. The company could buy search terms that relate to the medical condition being tested and its ads would be served only to those people searching on those words. As I mentioned yesterday, you could use Geo targeting to focus on a subgroup or groups of people who live near research centers. However, the ads would also be served up to physicians and many other people who do not qualify for inclusion in the clinical trial.

What if the search engine used aggregate Health Vault data to serve the ads ONLY to those people whose medical data strongly suggest that they are qualified for inclusion in the trial? That would be much more efficient and not only lead to better conversion rates but also to better qualified applicants.

Health Vault's privacy policy states that the information you deposit in the "vault" may be used to display "content and advertising that are customized to your interests and preferences." I think it's obvious how the same technology could be used for a branded drug SEM strategy. Imagine how much more effective your ads would be if they reached only those people whose medical information indicated a need for your product? [I'm talking about ethical pharma marketing here, not the kind that wants to convince people that they have a medical condition requiring the drug that's being advertised.]

This is a new twist on behavioral targeting, which I have discussed before on this blog (see "Behavioral Targeting: RJ vs JP").

Of course, there's a few hurdles to overcome before PHP's can be used this way. The number 1 hurdle is scale. MSN and Google are going to need to convince many millions of us to upload our medical records to their "vaults." Interestingly, president Obama's revival of government support for electronic medical records may help push this along.

The second hurdle is privacy and HIPAA, which places limits on how "covered entities" can share "protected health information" with 3rd parties for marketing purposes. If these vaults contain ONLY your personal medical information that YOU supply, then HIPAA does not come into play -- the law does not limit what consumers and patients can reveal about themselves to 3rd parties. Of course, you may not feel comfortable sharing your personal health information with just any one. In fact, many consumers do just that on social networks all the time! Besides, what I am talking about does not involve sharing this information with marketers. Your data is merely part of an aggregated subset that defines a segment to target for relevant ads. And who would not want relevant ads?

The trick is getting permission to use the data for targeting purposes. The Federal Trade Commission urges companies to obtain affirmative express consent before collecting such data for behavioral advertising, but does not REQUIRE it.

So, it could happen.

If you want to know how the experts at the SEM conference answered my question, you'll have to wait for the March issue of Pharma Marketing News in which I will cover this topic in much more detail. Subscribe now to get it delivered to you free!

Meanwhile, you are welcome to respond to my survey on this topic (see "Use of Personal Health Record Data for Patient Recruitment and Marketing Purposes") or post your comments here if you'd like your opinion included in my review. As usual your comments are confidential (anonymous) unless you specifically provide your contact information at the end of the survey and allow us to attribute comments to you personally.

Not Your Father's SEM! YouTube Empowered and Geo Targeted, Just to Name a Few New Things to Consider

One of the unique things I do is attend several pharma industry conferences and write up highlights of selected presentations in Pharma Marketing News. Usually, that gets the information to my readers within a matter of weeks as opposed to months for other publications. For example, in the February 2009 issue -- scheduled to be published March 3 (see the Pharma Marketing News Editorial Calendar for a summary of the contents; sorry for the delay).

But a publishing turnaround of days or weeks are not fast enough these days, what with blogs, twitter, Facebook, etc. That's where this blog comes in handy. This morning I published some news I heard yesterday at the 21st Annual DIA Conference on Marketing Pharmaceuticals in a Time of Change conference. So far that story about a new FDA warning letter (see "FDA Warns GSK About Enlarged Avodart Ad Imagery") has not been picked up by any other blog or news source, which surprises me! But, still, you heard it here first, unless of course you were actually at the meeting!

Today I attended another conference -- ExL Pharma's 3rd Pharmaceutical Search Engine Marketing (SEM) Strategies Conference in Princeton, NJ. Pharma Marketing News was a Media Partner for this conference and way back in January I interviewed two conference speakers -- Laura Pfister, VP, Interactive Media & SEM, IGNITE HEALTH, Buddy Scalera, VP, Interactive Media, QI INTERACTIVE, A COMMONHEALTH COMPANY -- on my Pharma Marketing Talk LIVE podcast show, entitled "Emerging Search Engine Technology Drives Digital Integration Strategy."

I have to admit that I thought it would be just too technical for me, but I WAS WRONG! The presentations I sat in on were very informative without being dumbed down to a marketer's level. Jaimie Strovich, president of seoegghead.com, was pretty technical. I forgot to ask him why vBulletin was better than PHPbb and to get the correct syntax for rel=canonical. Oh, well! He did, however, give away his book entitled "Search Engine Optimization with ASP.NET," which I am sure has all the details! Of course, I was looking for something more like "Search Engine Marketing for Pharma Marketing Dummies!"

One piece of wisdom I did get from Jaimie was this: "It would be good if marketers knew more about SEM technology and if SEM geeks" -- of which Jaimie admits he is one -- "knew more about marketing." How true. How true.

Conferences like this one are a good way to advance that goal. Unfortunately, the economy is such that many pharmaceutical marketing people are simply either afraid to leave their offices or have had their conference budgets cut. After all, no one in pharma wants to appear to on a "junket" at a hotel on Route 1 in Princeton, NJ, feasting on a rubber chicken/mushy Spaetzle lunch! Not that it wasn't tasty!

This conference was more like a short course on search engine marketing. And it didn't include a lot of speakers who merely highlighted their wonderful case studies. They actually provided useful information that you could take back to your office and benefit from right away.

I won't get into details here -- you'll have to wait for the March issue of Pharma Marketing News for that. But I want to just mention a few takeaways, including:

Search Engine Marketing is evolving rapidly and it's no longer simply a matter of purchasing keywords on Google. These days you need to differentiate yourself through linking and social media in order to get top ranking in search engines. Perhaps two out of the top ten search results are social networking sites. Search google on "Pharma Marketing" and you'll find this blog in the #1 and #2 positions and the Web 1.0 Pharma Marketing Network site only #3!

Did you know, for example, that Youtube is the second biggest search engine by volume? What's your Video Search Engine Marketing strategy? Laura Pfister suggested that video syndication via Youtube -- ie, placing your video on YouTube -- is much more effective than putting it on your branded web site. Why? Simply because more people will find it and view it on YouTube! You'll have to know how to get it ranked high up on YouTube searches, but I'm not going to give that secret away here (subscribe to Pharma Marketing News and you'll get the details in the March issue).

Laura also went into some detail about Geo targeted search engine marketing and how it is a great tool for recruiting patients for clinical trials or for sales force support in reaching "white areas" where you have no sales reps. She also mentioned that SEM will NOT help you reach "no-see" physicians. Anyone out there know why not? Another point Laura mentioned about Geo search was to be sure that your legal/regulatory people know what additional text Google automatically adds to Geo-enabled pay-per-click (PPC) ads. Hint: Google will add the location at the bottom of the ad. Not sure why legal/regulatory need to know this, but, as Laura said, they may get upset if they didn't know about it.

OK. That's enough for now. Time for dinner.

FDA Warns GSK About Enlarged Avodart Ad Imagery

Yesterday I attended the 21st Annual DIA Conference on Marketing Pharmaceuticals in a Time of Change conference in New York City and heard FDA updates on direct-to-consumer (DTC) advertising. The meeting was well attended by pharmaceutical company representatives, who have a clear need to hear what's up at the FDA from the horses' mouths -- not that the FDA officials were equestrian in any way, although Marci Kiester, PharmD, DDMAC Group leader, did sport an attractive PHS service uniform like the one shown here.

At the end of her presentation, Dr. Kiester summarized recent FDA untitled and warning letters (let's ignore the difference for now) regarding DTC ads shown on TV and the Internet. Among the products that won the honor of receiving such a letter were Viagra (see "Violative Viva Viagra Video - Still There!"), Aderall XR (see "Vyvanse Warning Letter: Too Late! Shire Got Rid of Ty Pennington Long Ago!"), and Yaz (see "YAZ Commercial Yanked from TV, But Not from YouTube"). She showed videos of the ads and then discussed why they violated FDA laws and regulations.

These were all old news to me. Kiester, however, did talk about a NEW warning letter that the FDA sent to GSK just last week. The offending ad was the Avodart "Planetarium" TV commercial, which you may have seen (see YouTube video below). This is so new that the FDA has not yet published the letter on its web site!



BTW, this is ANOTHER FDA swift action that occurred months after the ad has run its course. Too bad the conference organizers or panel moderator did not allow questions until the end of the conference! Sorry, but I can't afford to go back to NYC and ask Kiester the embarrassing question "Why did it take FDA so long to send the letter?" I already know the answer any way. Kiester showed a flow diagram detailing how warning letters get created at FDA. There's about 4 hierarchical layers it must get kicked up through before it reaches the FDA's chief counsel office where it probably languishes under politico-legal review for a month or two (see "FDA DTC Review: The House that Troy Built").

Back to Avodart. The commercial had a number of regulatory faux pas. First, the ad claims that Avodart is the only drug that shrinks enlarged prostates, which cause BPH. Not true, said Kiester, who cited Proscar as another drug that shrinks the prostate gland. Second, the commercial claimed that Avodart works better than other drugs. Not supported by clinical trials, said Kiester.

But the last and to me the most interesting violation cited by the FDA was that the ad's imagery overstates the efficacy of Avodart in shrinking the prostate. The following image shows two frames from the video representing how the ad depicts a shrinking prostate by way of analogy to a shrinking model of a planet.

Looks like an ostrich egg shrunk to the size of a chicken egg!

Kiester said that Avodart clinical trials show a 20-25% reduction in prostate VOLUME, which corresponds to about a 10% reduction in diameter, whereas the ad imagery shows a much greater reduction in diameter.

To check her math, I actually measured the diameters of the planets in the ad before and after Avodart and found that there was a 57% reduction in diameter between the two images (a decrease in diameter from 4.7 cm to 2.0 cm as measured in a printout of video frames). That reduction in diameter corresponds to an amazing 92% reduction in VOLUME, which is MUCH more than the 20-25% supported by clinical evidence.

If the Avodart ad accurately represented the shrinkage, the difference would have looked much less dramatic as in this illustration:

Looks like a large chicken egg shrunk to the size of a regular chicken egg! Is it worth an extra 20 cents per dozen?

UPDATE: On 2-29-2009, a day after this post, FDA uploaded the Avodart letter (see here for pdf version) and the storyboard that was submitted to the FDA on March 3, 2008 (see here). To find this letter on the FDA web site you have to do a search because it's not yet listed in the "Warning Letters" page under "Regulatory Actions." I guess they are not listing this letter there because the letter is not strictly a "warning letter" addressed to the company's CEO. This letter is addressed only to the regulatory affairs person at GSK.

BTW, as in previous cases, this letter was sent almost 1 year AFTER the FDA had the storyboard in its possession.

Ethical Pharma Marketing

As reported in FDAnews Drug Daily Bulletin, I recently had a discussion with Fabio Gratton, chief innovation officer of Ignite Health [and member of the ePharma Pioneer Club], who said pharma marketers should find ways to use social media without fear of regulatory hardships.

"The industry is afraid to learn of new adverse events through comments on social media sites and the need to investigate each consumer complaint," noted FDAnews. "Gratton says there should be guidelines to encourage pharma to focus more of its time on the general well-being of patients. If pharma companies do this, regulatory agencies should cut them some slack with regard to the use of social media, according to Gratton."

[See my original post on this topic here, which includes access to the audio recording of my interview with Gratton.]

Over on the ePharma Pioneer Club's discussion board, I suggested that this idea could also help pharma improve its public image (see "Start the discussion on improving pharma's rep and utilizing social media to improve health").

You can help get this discussion started by participating in my survey: "What Can the Drug Industry do to Earn Back the Public's Trust?" which you can find here: http://tinyurl.com/d6dzse. Included is a question about Fabio's idea and a box for your comments.

Meanwhile, ePharma Pioneer Club member, RJ Lewis (President & CEO or e-Healthcare Solutions) responded with this call for pharma to trust their "ethic" and "do the right thing":

It's really quite simple, and it's been forever a timeless principle. Individuals and companies need to DO THE RIGHT THING. Regulation is only a mechanism to ensure people do the right thing, because left to their own devices, occasionally they stray.

We are living through one of the most interesting economic eras in a century... a time when "straying" from this principle has become common place. Pharma has always had a strong ethic - and they need to trust it.

David Patterson, Governor of NY today on CNBC said it beautifully. When asked about a decision he made that was seemingly unpopular politically, he said, (and I paraphrase) "That's why I don't look at my decisions through a political lens - I look at them through the lens of doing the right thing. I believe if I always do that, then when election time comes, even the decisions I made against mass opposition, I believe in time, they will be judged to be politically correct, because they were ethically correct."

If there are consequences - regardless of their cause or bias - you can always face them proudly when you did the right thing.

To which I responded:

The pharmaceutical industry was once called the "ethical drug" industry. I am not sure, but that phrase may have come into being when drug companies (eg, Merck?) transitioned from selling "snake oil" patent medicine remedies to products that actually delivered on promised results.

The loop has somewhat closed when we are bombarded with drugs to treat "syndromes" that are ill-defined and sometimes ludicrous -- what I will now call "snake oil marketing" tactics using actors pretending to be patients suffering from these syndromes, etc.

Now, in the era of social media, there is the possibility of "snake oil marketers" greatly amplifying the effect of patient testimonials -- by recruiting people through social media. Perhaps the latest use of YouTube videos produced by consumers and submitted to drug company YouTube pages is an example of that.

I note that everything done this way is above board, but is it "ethical?" It is very difficult to determine what is and what is not ethical and maybe that is what we should focus on.

I think RJ and I are on the same side here. We worked together in the distant past (1997) to try and apply ethical principles to publishing health information on the Internet. In that process I learned a lot about "doing the right thing." Again, a loop is being closed! Just as then, today we need to bring into the discussion various stakeholders.

You can join this discussion by:

1. Taking the "How to Earn Back the Public's Trust" survey (click here), or
2. Joining the ePharma Pioneer Club on Facebook and participating in the discussion (click here)

Amgen's Bike Jersey Tchotchke Available

The pharmaceutical tchotchke business is NOT dead! Take, for example, this AMGEN bike jersey that's for sale on eBay -- starting bid $9.99. If you want one, you'd better hurry. The sale ends Feb-20-09 15:16:19 PST.

Mike Huckman of CNBC's Pharma's Market Blog says a colleague of his who lives near AMGEN headquarters in Thousand Oaks, California says "pedal-pushing company employees wearing jerseys like this one ... are a constant (she says sometimes annoying) presence on the streets around those parts. The red dots that look like rose petals or throat lozenges are supposed to be blood platelets."

Sorry, Mike. But those are DEFINITELY red blood cells, not platelets. Who among us would know what a platelet looks like? No-one, that's who. So, while it's not technically correct to show red blood cells representing a product that acts on platelets, it's a necessary "dumbing down" of science for the sake of creativity and saleability. Platelets, after all, don't look like pretty rose petals. The ugly yellowish blobs surrounding the red blood cells in the image on the left are platelets.

NOTE: Mike and I may BOTH be wrong! Christiane Truelove wrote in Pharma Blog Review: "Amgen shouldn’t have put red blood cells on the shirt in the first place, as Neulasta stimulates white blood cells, which look like this" (you'll have to go here to see the white blood cells. But I think the purplish fuzz ball in the image shown here is a white blood cell.)

Who'd want a bike jersey emblazoned with yellow blobs? Come to think of it, who'd want a bike jersey with "AMGEN" and "Neulasta" written on it in big black block letters? I bet there are quiet a few nerdy, bicyclist hematologists/oncologists out there who would like one! Too bad that Amgen is a signatory to PhRMA's PhRMA Code on Interactions with Healthcare Professionals, which prohibits Amgen from giving these away to physicians, unless of course they are among the Tour spectators. I suppose Amgen is free to give away the jerseys to them at the event.

Huckman also points out the irony of a "biotech company that makes EPO, what is by nearly all accounts the most popular performance-enhancing drug among cyclists, is the major sponsor of a bike race [Amgen Tour of California] featuring one defrocked, steroid-using racer and another one who has long been rumored to juice up." He was referring to superstar cyclists Lance Armstrong and Floyd Landis.

Marketing Budgets Take a Nose Dive!

According to a new survey from the ANA (Association of National Advertisers), the recession had a more profound effect on the marketing industry than predicted just six months ago.

Budgets were already reduced more than six months ago and now more cost-cutting measures are being put into place, says ANA.

Here's more from the press release:

Following up on a survey conducted in August, the second survey conducted on this topic reveals that more companies are identifying cost savings and reductions (93 percent as opposed to 87 percent six months ago) and that 37 percent of respondents today plan to reduce budgets by more than 20 percent, up substantially from the 21 percent of respondents in the first survey.

The top five areas where marketers plan to reduce costs or expenditures in marketing and advertising efforts are as follows:

1. Departmental travel and expense restrictions (87 percent, versus 63 percent in the previous survey)

2. Reducing advertising campaign media budgets (77 percent, versus 69 percent in the previous survey)

3. Reducing advertising campaign production budgets (72 percent, versus 63 percent in the previous survey)

4. Challenging agencies to reduce internal expenses and/or identify cost reductions (68 percent, versus 63 percent in the previous survey)

5. Eliminating or delaying new projects (58 percent versus 61 percent in the previous survey)

Other tactics gaining greater consideration by marketers today, as compared to six months ago include:

* Departmental salary or hiring freezes jumped to 57 percent from 45 percent six months ago
* Forty-eight percent of marketers are looking at reducing agency compensation today, versus 32 percent six months ago

In the first survey, the ANA asked if marketers thought their budgets would increase, decrease or remain the same in the next six months. In the recent survey, the ANA asked what actually happened.

* In July/August, 53 percent of marketers thought their advertising budgets would be reduced in the next six months, when in fact, 71 percent experienced a budget decrease.
* Thirty-eight percent thought their budgets would remain the same, but only 23 percent had their budgets untouched.
* Nine percent thought they would see a budget increase, when only six percent did.

"In the current economic environment, there's a need for brand building that's right for the times - that acknowledges consumers' financial circumstances, and offers them products, services and solutions that meet their needs," said Bob Liodice, ANA President and CEO. "For some marketers, that will mean skewing their media mix towards promotional spending and direct marketing. For others it will mean framing a new, relevant and timely brand message."

When asked about their predictions for what will happen in another six months from now, 49 percent of respondents felt that their advertising budgets would be reduced, while 43 percent think that they will stay the same and only eight percent have hope that their budgets will increase.

In both surveys, conducted online, marketers working in a range of industries were surveyed including pharmaceutical, financial services, consumer packaged goods, computers and technology, retail and others.

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I'm trying to get pharma-specific data from ANA and will update this post if and when I get it.

Nightly News Trigger Bad Memories of the Great 2008 Depression? Try propranolol!

A widely used heart drug may be able to stop frightening images or experiences from lodging in the memory and repeatedly resurfacing to cause fear and anxiety, researchers from the Netherlands reported (see story here).

"A team at the University of Amsterdam gave the medication propranolol to test subjects in a complex experiment that measured how people reacted when they were shown pictures of spiders they’d been taught to fear," Bloomberg reports. "Propranolol is a so-called beta-blocker used to treat heart rhythm disturbances and high blood pressure."

Here's the study protiocol as reported by Bloomberg: The researchers first conditioned their test subjects to fear a particular kind of spider by showing them pictures of the spider, followed by an electrical shock to the wrist.

One day later, the subjects came back. By then, the experience had been consolidated and stored in their memory. This time, some were given propranolol and others were given placebos (control group) before being shown spider pictures again -- with no electric shock. All the patients, including those who had taken propranolol, showed some fear of the pictures.

On the third day, when the placebo subjects were shown the spiders and given no shock, their fear response was high, while the propranalol users no longer showed fear. Then, just when they thought they were safe -- zap, they get shocked again. The people in the placebo group were thrown back into a state of fear and anxiety but there was no return of fear in the group that took the drug.

The following image is my interpretation of how the researchers may have summarized the results of their experiment so that it can be easily understood by the general public:


Obviously, if the results of this study can be generalized to include all fears and not just the fear of spiders, then propranolol may be useful in the treatment of post-traumatic stress disorder, which is something thousands of combat soldiers suffer from.

For many millions more of us, propranolol may help watch the nightly news again!

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A Tithe on Pharmaceutical Marketing for Promoting Health

Yesterday, Fabio Gratton -- Co-founder, Chief Innovation Officer, Ignite Health, and ePharma Pioneer Club™ member -- was a guest on my LIVE Pharma Marketing Talk streaming audio show.

The first 30 minutes of the show was on the topic of social media marketing and specifically on new ways to measure social media communications success. The last 12 minutes or so, which did not stream live but is available in the podcast archive (here), was a segue into the social responsibility of pharmaceutical companies and how the pharmaceutical industry can engage in social media forums to improve the health of US citizens.

The transparency and authenticity demonstrated by the Obama administration "may be ... the way organizations should be thinking about how to deal with customers, how to engage, and how to communicate," said Gratton.

"I would love to have representatives of the CDC, the FDA, DDMAC, regulatory [people] within the pharmaceutical industry, key marketers, key patients, key doctors ... sit down and discuss what this industry should be doing," said Gratton. He was talking about establishing guidelines for using social media for disease awareness education (and product education) without the risk of being penalized from regulatory agencies.

He cited the fear and burden, for example, that pharmaceutical companies have of reporting adverse events that they may learn about via social media interactions. It's not just the reporting, but the requirement of tracking down every mention of an adverse event to do the reporting.

Even on this blog with a relatively small targeted readership, I get about one self-reported adverse event comment per week or so. I don't have to report these nor publish them, whereas it's not clear what a pharmaceutical company would need to do in a similar situation. It can be a huge problem for them considering the scale and type of audience that the pharma industry can reach.

"How do we generate guidelines -- not laws -- that help the industry navigate [the social media terrain] and do the right thing without fear of penalty?" asks Gratton. "I would love to see a guideline that says 10% of a company's efforts should be focused on general well being [education/information] surrounding a disease state," said Gratton.

I think Gratton was saying that pharmaceutical marketers have an accountability to the US population and a responsibility to devote some money and effort for health communications that promote general health and well being without being focused primarily on generating new scripts for drugs. If pharma companies do this, regulatory agencies should cut them some slack with regard to the use of social media, according to Gratton.

I guess it would be like a user fee pharmaceutical companies pay in exchange for preferential treatment by the FDA. I'm not sure how that can work from a legal perspective. FDA is free to offer guidelines and regulations that describe how they will enforce the law. So there is some leeway there.

Anyway, Fabio calls for a forum or roundtable discussion of these issues. I think that is a worthwhile project for the members of the ePharma Pioneer Club to take on and I will be working with Fabio to start the discussion going there. You are all welcome to join -- first tell me something about your self here.

You can hear Gratton's pitch here (WAV audio file).

Where's Da Wabbit (Abe and Beaver too)?

I have often commented on the critters used in direct-to-consumer (DTC) ads and have had a lot of fun at their expense. It seems that now I will have fewer of these critters to kick around.

As reported in AdWeek, Pfizer is shifting creative duties on smoking-cessation drug Chantix to mcgarrybowen from McCann HumanCare. It seems that the rabbit was also pfired by Pfizer. The rabbit is missing in the most recent version of the Chantix home page (see image below; click for an enlarged view).


The top panel shows the page as it was on September 27, 2007, when I first noted that the web site featured a cute cuddly rabbit instead of the scrawny, reddish -- devilish, may one say? -- hare seen in the TV and print ads (see "A Pill, a Plan, a Profit? -- Chantix!").

Another DTC critter that we may never see again is Rozerem's beaver, which I must take credit for making "infamous," which is how PharmExec described it (see here). See the old vs. new Rozerem web site home page in the image below (click on the image for an enlarged view).


I just could not resist the urge to add some dialog balloons to these images, especially to the new Rozerem web site, of which a friend of mine observed "New ad agency, and they couldn’t get the eraser out fast enough, apparently." Of course, I urged Takeda to fire their Abe and beaver ad agency a long, long time ago (see "Takeda - Fire These Guys!").

Maybe Abe was jettisoned because we've just celebrated the bicentennial of Lincoln's birthday and having ads depict America's most beloved president playing chess and jump rope with a beaver was a bit too disrespectful, which was something I pointed out from the very beginning (see the now classic blog post I made way back in July 2006 when the Rozerem ads first aired: "Rozerem Ads Dis Lincoln, Show Beaver)".

[To commemorate the demise of Abe and the Beaver, I will be publishing a special tribute to the duo in an upcoming issue of Pharma Marketing News.]

Only a few DTC critters remain. Come to think of it, I haven't seen the Enablex balloon people lately. Some balloon people are known to explode due to overactive bladders and others just have sexual fun while their parents are completely oblivious (see "The Secret Lives of DTC Critters" for a hilarious video).

These ads are truly offensive because they depict potential consumers of the product as mere overactive bladders rather than real people with a real problem. Shame on Novartis for running these ads! Maybe they have seen my criticism and have fired their agency too!

Now for a little fun:

My 2009 DTC Ad Spending Prediction is Now Conventional Wisdom

If you do a Google Image search on "dtc ad spend" you'll find the chart I created and published back on November 14, 2008 (see the chart on the left -- click on it for an enlarged view -- and the original post here).

On a Google web search, my post and chart is the first result listed -- ahead of Pharmalot (now defunct) and any other publication or research organization!

Maybe that's why some people have been co-opting the chart and using it in their presentations! Unfortunately, they are not citing me as the source.

Robert Palmer, EVP, Managing Partner, SUDLER & HENNESSEY DIGITAL, for example, redrew my chart in a presentation he made at the recent ePharma Summit conference. His presentation -- "Creating a Three-Way Dialogue with the Patient, the Physician and the Brand: Imagining the Solutions, Dealing with the Realities" -- included this version of the now famous chart ( I reproduce the whole slide -- it includes some other useful information about DTC ROI):


The $4.2 billion estimate, which was represented by the black bar on my original chart, was a number I pulled out of my you-know-what! Why do I think DTC spending will decrease by 11% year-over-year in 2009? Simple:

• We're in a world-wide recession that economists predict will last longer than any recession in recent history ...
  
• I don't see any new DTC-worthy blockbuster drugs on the horizon that will boost DTC ad spending in 2009 ...
  
• Even if there were new drugs approved soon, it is likely that the industry -- under pressure from Congress -- will impose a 1-year moratorium on DTC advertising for any new drugs brought to market in 2009 (see my post: "An Experiment: Ban All DTC Broadcast Advertising for One Year") ...
  
• There will be increasing pressure on pharmaceutical marketers to prove to managed care organizations, insurers, and Medicare (which may be given the power to negotiate drug prices) that brand name drugs are effective.

I am not the only person who predicts DTC spending will decrease in 2009. Check out this post: "DTC Spending Will Be Decimated in 2009, Experts Say."

Are FDA Penalties No Longer a "Slap on the Wrist?"

It's Friday and welcome again to the "Bob and John Blog Dialog" -- an ongoing series of informal back and forth jousting between DTC true believer Bob Ehrlich (DTC Prespectives) and me, DTC agnostic John Mack (Pharma Marketing News).

If you are new to this more or less weekly dialog, see here, here, and here.

This week we focus on YAZ, Bayer's contraceptive drug that seems to cure all young womens' monthly problems and acne as well. No, wait, the FDA said that Bayer overstated these benefits of YAZ and must run "corrective ads."

Bob says, "The settlement with the states and FDA should help convince DTC critics that drug companies do not get away with over stating benefits. FDA has been called complicit and lax in allowing drug companies to keep deceptive ads on too long and with no real penalties."

Drug companies do not get away with overstating benefits? Really?!

Seems to me that Bayer did just that in its YAZ commercials.

Bob frequently refers to me as "DTC critic." Who else can he be referring to when he says "FDA has been called complicit..." knowing full well that I said as much in my post entitled "FDA and YAZ: Is FDA Helping Marketers Work Around Regulations?"

But "critic?" Really?

I'm really agnostic when it comes to the benefits of DTC advertising. I can take it or leave it. It's not DTC in and of itself that I am critical of -- it's the often blatant and sometimes accidental disregard of FDA legal guidelines and the industry's own standards that I am critical of.

In the case of YAZ, it took the FDA several months to get a letter out to Bayer about "overstating the benefits" and that was AFTER the FDA saw the storyboards BEFORE the ad was even on the air! That's the complicity part.

Bob says "For drug marketers seeing another DTC drug get slapped with corrective ads, the effect can be chilling."

Chilling? Really?

Why's that? Because Bayer will have to spend $20 million over 6 years making "corrective" ads? Bruce L. Lambert, a professor of pharmacy administration at the University of Illinois at Chicago, referred to the corrective $20 million ad campaign for YAZ as "chump change" and "just the cost of doing business."

I would have to agree. If sales of YAZ in the United States is $616 million or more per year, I would expect Bayer to spend at least $60-$90 million PER YEAR on "non-corrective" DTC advertising. That's about 20 times what it pledged to spend on "corrective advertising." Consider that a 5% levy -- cost of doing business -- on its DTC ad spend.

Bob ends with this: "...it shows regulation does work. The public and Congress should be somewhat reassured that the state and federal regulatory authorities are monitoring DTC ads. Although we will not avoid additional hearings and regulation on drug marketing, the critics can no longer say penalties are a slap on the wrist."

Regulation works? Really?!

If regulation is like a barn door, it only works when it is closed and PREVENTS the cow (ie, ad) from getting out of the barn (ie, regulatory level playing field). It's not working when you punish the cow by taking away 5% of its food as a punishment for leaving the barn!

And I can still say that FDA penalties are a "slap on the wrist" because -- besides the fact that the penalty is actually small compared to the benefits reaped by running the ads -- corrective ads are RARELY required by the FDA. Now, if they were ALWAYS required, then I would agree with Bob that the penalties are no longer a slap on the wrist.

BMS's "Oh, Yes I Can!" Ad is Reminescent of Obama's "Yes We Can!" Slogan

In an ironic twist of advertising art imitating life, I noticed that Bristol-Meyers Squibb (BMS), marketer of the anti-arthritis drug Orencia, has trademarked the phrase "Oh, yes I can!"

The trademarked phrase, which I discovered in an Orencia print ad in this month's Prevention magazine (see image left), is as close as you can get to president Obama's "Yes We Can" slogan and speech he made on January 8, 2008 in New Hampshire.

The twist is that BMS trademarked its phrase back in March, 2007, well before Obama's speech and the music video that followed in February, 2008 (see YouTube video at the end of this post).

I probably have seen this ad and phrase many times before, but it never made an impression on me until now. You might say that the ad's effectiveness has increased due to Obama becoming president, which is ironic because BMS was a big pharma supporter of Republican party candidates in 2008 (see "Top Pharma Contributors to Federal Candidates and Parties")!

Now what was McCain's slogan again?

YAZ Commercial Yanked from TV, But Not from YouTube

Some time ago I pointed out that Bayer Healthcare Pharmaceuticals pulled its 60-second "Goodbye to You" ad for birth-control pill Yaz after the FDA "expressed concerns" that the ad went too far in suggesting the drug could help overcome PMS and acne. I criticized the FDA for closing the barn door after the cow have left (see "FDA and YAZ: Is FDA Helping Marketers Work Around Regulations?").

My criticism, which was published way back in the beginning of October, 2008, may have helped goose the FDA to do something it rarely does: require Bayer to run new ads to correct previous Yaz marketing. The new $20 million advertising campaign points out the errors in previous ads and warns that nobody should take Yaz hoping that it will also cure pimples or premenstrual syndrome (see this NY Times story: "A Birth Control Pill That Promised Too Much").

According to the NY Times, "Under a settlement with the states, Bayer agreed last Friday to spend at least $20 million on the campaign and for the next six years to submit all Yaz ads for federal screening before they appear." $20 million over 6 years pales in comparison to a typical DTC campaign and is mere "chump change," said Bruce L. Lambert, a professor of pharmacy administration at the University of Illinois at Chicago.

While I have seen the new ad on TV, I haven't seen it on YouTube.

BTW, the original "Goodbye to You" is still available on YouTube (see below) where it has received nearly 15,000 views since it was uploaded on 21 May 2008 by "desireegrae," who apparently is one of the actresses in the commercial (ie, Desiree Hall, see photo here). Play the video at the end of this post and see if you can spot her in the ad.

OK, so here we have an ad currently running on YouTube that is in violation of FDA regulations. Shouldn't Bayer use its power to have Desiree "pull" this video from YouTube just as it was pulled from TV? I mean, it didn't take me long to discover the ad on Youtube (search for "YAZ Commercial") and who uploaded it (look at the stats and sites that link to the video and you will immediately see desireehall.com, which is obviously connected to "desireegrae.")

Is there any legal obligation for Bayer to do this? Did the FDA mention YouTube when it asked to have the ad pulled? Or is Desiree's reproduction of the ENTIRE ad considered "fair use" under copyright law? Inquiring minds want to know.

P.S. Desiree really got pissed when YouTube commenters were dissing the ads and suggesting that the song implied that women wanted to say "goodbye' to babies:

"PEOPLE," responded Desiree. "Pay attention to the commercial if you are going to critique it so harshly. The good bye to you song is good bye to cramps, fatigue, bloating, which is precisely why the balloons, that float upwards (which signify these horrible monthly problems leaving), say "CRAMPS", "FATIGUE" and "BLOATING", etc. It has nothing to do with good bye to babies. Birth control pills has other benefits than just preventing pregnancy. Educate yourselves."

From the comments I read, it appears that "overstating the drug’s benefits" had the desired effect on many viewers, including Desiree!

10 Things I Hated (and Loved) about the ePharma Summit

I did not attend the ePharma Summit today -- I just had too much work to do here in the office taking care of business. Besides, one day was enough for me to meet old and new friends, which is what I love about ePharma Summit and other industry conferences. Unfortunately, there are some things that I hate. Let me elaborate in no particular order.

#1: Yesterday, before driving down to Philly, I ranted how much I loved how the folks who are running this conference promoted it and are keeping us informed about the conference and ePharma marketing issues in general (see "ePharma Summit: Practicing What's Being Preached!").

#2: The number one thing I hated was how panel "moderator" Robert Goldberg -- co-founder, Vice President and Director of Programs for Center for Medicine in the Public Interest and blogger at DrugWonks -- attempted to hijack the panel discussion on "Driving Policy/Guidelines Around the Use of Social Media in Pharma."

By way of introducing the panel, Goldberg started by saying we should excuse his craziness because he hadn't had his coffee that morning. He then went on a conservative rant that had many attendees scratching their heads and wondering if, in lieu of coffee, he imbibed or smoked something more powerful on his Accela train ride up from Washington, DC (or wherever).

Goldberg ranted on about Congress approving $1.1 billion for comparative effectiveness studies and other such anti-government issues that had absolutely NOTHING to do with what the panel was going to discuss! He had the bully pulpit and he used it to HIS advantage, not ours. Bob is like that. For example, he used Ted Kennedy's illness to attack the "liberal healthcare agenda" (see "HOW 'LIBERAL' CARE WOULD KILL TED"). Not once in that article did he have any kind words of comfort for Kennedy or his family!

#3: The number one thing I loved about this conference was the network of people I met there. Unfortunately, there were few pharma people in attendance, although I did meet a couple of J&J people, including Peter Justason, Director, Global Marketing Group, and Marc Monseau, Director, Media Relations and JNJBTW blogger (Marc -- why is your facebook image a photo of a mouse?). If it wasn't for J&J, Pharma's presence in social media would be practically nil!

Speaking of J&J's use of social media, Peter introduced me to Bill Sickles, Head of Healthcare at Google. Bill was the person responsible for spearheading J&J's Youtube launch. I hope to have him -- and maybe Peter as well -- as a guest on my Pharma Marketing Talk show as part of the ePharma Pioneer series of interviews.

I also met Bill Evans, Senior VP, Digital, at Fleishman Hillard, who is interested in working with me to delve into case studies of successful ePharma programs -- something that his colleague, Mark Senak, has been doing on his blog (Eye on FDA).

I finally met Wendy Blackburn, blogger at ePharma Rx and contributing author to Pharma Marketing News (see "Measuring & Communicating eSuccess," PMN Reprint #79-03).

Those were some of the "new" (to me) people I met. Of course, I also met a number of "old" friends including James Chase, Editor, MM&M (we dissed our competition), RJ Lewis, CEO, eHeathcare Solutions (who told me all about go-carting at 60 mph in south New Jersey -- the closest he or I may come to Le Mans), Mark Bard, President, Manhattan Research (we talked how to keep ahead of dopplegangers in Google searches on our names, something he seems fond of doing), Mark Gleason, Sr. Vice President, Aptilon Holdings, who admitted to not having a facebook page (!), Jack Barrette, CEO, WEGO Health, who will be my guest this Thursday on Pharma Marketing Talk.

#4: I hate how at these conferences we always talk about the same thing -- why pharma doesn't pay more attention to (and spend more money) on "e" and how far behind other industries it is in this regard. There's a divergence of opinion on this topic. Some want to see the glass half full -- or at least more full than the naysayers see it. Paul Ivans, conference co-chair, thinks the "e" slice of the pharma marketing pie is "much greater" than the 3%, which is based on measured media spends (even that low number is often misquoted higher than it actually is; see here). He cited search as one of the unmeasured media spends and the fact that some brands devote MUCH MORE to "e" than other brands. All true, but when compared to other industries, we are comparing apples to apples -- ie, measured media spends, and pharma is still lagging (see here for more on that).

If the ROI of "e" promotion is about 4-5 (ie, $4-5 dollars returned on every dollar spent) compared to 1-2 for broadcast TV DTC advertising, why are we even having these conferences? That was a question posed to John Mangano, Senior Director, Comscore after his presented his ROI analysis of a de-identified case study. I have to wonder at the veracity of those ROI numbers. As much as I like Comscore, I've seen the exact same dog and pony show before, which is another thing I hate about these "e" conferences.

#5: As I just said, I hate the "dog and pony" presentations that are meant primarily to promote your business. Aside from the fact that this is like preaching to the choir, it really contributes nothing to the conversation. Maybe it's something we can use to entice more "e" marketing bucks out of pharma product managers, but it doesn't get to the core of the problem. What would have been more exciting would have been a discussion about how to measure the effectiveness of social network marketing, which everyone wants pharma to engage in. This was the gist of a question from the audience. ComScore, unfortunately, does not measure that. I'll be addressing that problem in my Pharma Marketing Talk discussion with Fabio Gratton (see "How To Measure Social Network Communications Success").

#6: [Left intentionally blank for you to fill in -- see comments.]

#7: [Left intentionally blank for you to fill in -- see comments.]

#8: I hate that coffee was very hard to get at lunch and impossible during the afternoon break. I tweeted (twittered?) about that during the conference after James Chase and I wandered around searching for caffeine. If it wasn't for Grad Conn, Snr Director, Product Marketing, Microsoft Health, who cracked us up with his humor, I would have fallen asleep near the end -- if fact I DID fall asleep. Hope I wasn't snoring!

#9: Speaking of Twitter, I love that a lot of us were posting messages from our cell phones during the conference. I was wondering if any of the panel members picked up my tweet about Goldberg ranting while they were sitting there nervously waiting for him to turn the mike over to them? My tweet about the coffee issue may have been unwarranted -- Allison noted that "We've already had a great coffee hour and got a chance to meet a few of our fellow attendees--great coffee, too!" Obviously, I missed that. My bad.

#10: Summarizing Microsoft's efforts to build a personal health data repository, I loved it when Grad Conn simply said, "It's really hard and it's going to take a long time!" That about sums up pharma's path to mastering social media marketing.

ePharma Summit: Practicing What's Being Preached!

After 4 days of R&R down in Miami, FL, I am back tending to my flock (of social networks, blogs, clients, subscribers) and trying to get back in the groove. Unfortunately, I lost my glasses on a Miami Metrobus and I have to put my face against the screen to write this!

But I am happy to see that the folks who have organized the ePharma Summit,which is being held today and tomorrow in Philadelphia, are practicing what they preach by using social media tools to keep me informed about the conference. That's good because I may not be able to attend today's session -- I will be busy catching up and getting new specs! But I hope to attend tomorrow.

NOTE: Pharma Marketing News -- the e-newsletter I publish -- is a Media Partner for this event and has been paid to promote the event. This post, however, is not a paid ad.

This morning the "ePharma Summit Team" (aka Allison Rigels and Amy Xu, Institute for International Research) sent me an e-mail update summarizing who will be presenting. That in itself is more than I have seen many other industry conference organizers do. But the ePharma Summit people are and have been doing much more.

"We’re excited to be kicking of this year’s conference with new features; combining live blogging and Twittering for you to track the event live!" said the Team. "We’ll also be posting several interviews taken throughout the day introducing you to some of the industry leaders and companies who are hear today. If you aren’t in Philadelphia, stay tuned to the ePharma Summit Blog and ePharma Summit Twitter to follow details about the latest presentation at the event. On the ePharma Summit webpage, you can check for the latest video and photos of today’s presentations and exclusive interviews with the speakers."

Even before the conference, Allison et al have employed various social media networks to keep us informed not only about the conference, but about ePharma marketing in general. They've done that through the blog as well as a Facebook Group and LinkedIn Group that you can join.

As a Media Partner, I helped Allison and the ePharma Summit Team by posting their Blog's RSS feed to a special Pharma Marketing Network Forum dedicated to that feed. The summary of and link to each post made to the ePharma Summit Blog is a separate discussion thread (post) within this forum. These summaries have been very popular with the 4,000 or so daily visitors to the Pharma Marketing Forums site. As of February 1, 2009, there were 97 posts made to that forum and a total of 9,869 views!

I think every pharma industry conference organizer and marketer should follow the ePharma Summit strategy of getting involved with social media marketing to promote their conferences and keep their attendees informed during and AFTER the conference. It may not be appropriate for ALL conferences, but it especially useful for recurring conferences like the ePharma Summit, which has good brand recognition.

It's hard work keeping your social marketing efforts going and the ePharma Summit people have now become so experienced with new media marketing that I would not be surprised to learn that some smart pharmaceutical company asked their advice on how to do it.

I wonder how many agencies that promote social media marketing to their pharmaceutical clients have actually practiced what THEY preach?

Your Fortune: "Marketer Without Network Like Beached Whale"

Another Friday and another installment of the "Bob & John" show; ie, Bob Ehrlich (DTC Perspectives) and me, John Mack (Pharma Marketing News) debate another issue, blogo-a-blogo!

Today, however, I am in total agreement with Bob's post about "The Disappearing Corporate Career Path." I addressed this also in the January issue of Pharma Marketing News (see "Is There Life After Pharma?").

"Today, no marketer should expect to be rewarded with a steady one company career," said Ehrlich (see here). "The days of your company taking care of your future have been on the decline for more than a decade. After this economic meltdown, they are now officially over. Contacts are now king. Get out of your office and develop them before the grim reaper finds you at your desk. A marketer laid off without a network is going to face a long time collecting unemployment."

I agree with Bob 100% on the value of networking, which has always been an important part of my business plan. In 1997 I started with the PHRMA-MKTING listserv. That e-mail listserv has now been replaced by the web-based Pharma Marketing Forums.

Like Ehrlich, I urge pharma marketers to get out there and network. You can also write articles for trade publications -- including Pharma Marketing News (see Author Guidelines) -- and attend conferences.

As the editor of Pharma Marketing News, I get complimentary press passes to practically every industry conference. If you can write and wish to attend one of these conferences (see a Conference Calendar here), contact me (johnmack@pharmamarketingblog.com) or download the PMN Stringer Agreement.

There are over 1,000 Pharma Marketing Forum members and hundreds of posts. As a pharmaceutical marketer you should respond to or start conversations in one of the many forums there that match your area of interest. Demonstrate your knowledge, develop a public profile and a reputation on this site, which gets over 3,500 unique visitors every day. In fact, right now, there are over 140 people visiting the site. One of them might be a future partner or employer or someone who can help you get off the beach!

Good luck!

Pharma: Earn Back Your Trust Before Hell Freezes Over

Yesterday, I posted comments made by Pfizer's global PR chief, Ray Kerins, who asked "How in the hell do we [the pharmaceutical industry] have such a bad reputation?" (see here).

His "core strategy" for improving Pfizer's reputation and model for other pharmaceutical companies is to "engage and educate" more journalists more often.

It's not Kerins' fault that he sees better PR as the solution to Pharma's image problem -- he is, after all, "PR chief" (AdAge's moniker, not mine). Hell may well freeze over, however, before the PR-only strategy works.

The industry, like the economy, needs more than cheerleading PR to regain the trust of consumers and physicians. I included some suggestions for real actions pharmaceutical companies can take to improve their image and I received other suggestions from commenters to my post and from S&R Blog, which I just discovered.

Kim D. Slocum, who has worked in the biopharma industry for over three decades and now is “retired” but doing consulting work for the industry, said this:

"The industry's problem is equal parts 'image' and 'business practices.' Both are going to have to be addressed and the latter probably has to precede the former. Sales & marketing models (with the ongoing set of fairly ugly revelations that appear in the press on a regular basis) have to change dramatically. It's hard to have a good image when many of the major firms in the business are or recently have been operating under Federal Corporate Compliance Agreements.

"The industry's salvation probably lies at least partly in the one thing folks are running away from as fast as possible--comparative effectiveness review. That process done well (with industry help on how to analyze data properly) could at one stroke reduce patient co-pays, thereby eliminating the out-of-pocket optics problem. It would also cut the need to spend 20%-30% of revenues on promotion by a significant amount as well, thereby ameliorating another big image issue. That might actually offer up the possibility of improving profitability while also improving the public perception of the industry.

"Finally, industry needs to be paying a good deal more attention to the bigger environmental & policy issues that can have such a large effect on business conditions. In part, industry got into this mess because it largely ignored things like multi-tier co-pay models (which simultaneously raised patients' out of pocket spending on pharmaceuticals and their ire at the industry) until the process was well advanced. This game is now about to get replayed in the specialty Rx arena and the fallout will be considerable.

"Industry can't simply invent its way out of these problems, as much as it might like to. However, by understanding its channel partners (such as employers, CMS, and health plans) and working with them more collaboratively, it can probably get to an equitable solution for all concerned. That would do more to enhance the image of the research-based firms than just about anything else."

Kim, I believe, was on the R&D side of the business before he retired, which may explain his views on the commercial side of the business. “Sales & marketing is the single biggest budget block on any firm's income statement," he told me. "DTC [direct-to-consumer advertising] is now a big line item, the ROI is questionable and it draws a lot of political fire," he added (see "The Future of DTC Advertising," Pharma Marketing News, REPRINT#81-01).

Don Schindler, another commenter and a digital marketing strategist, also mentioned promotion as a problem:

"Drug companies (to me) are a lot like the oil companies. Even though they are doing tons and tons of research, people and media focus on their profit. You profit in good times and bad times by having a necessity with a healthy margin.

"They also spend a ton on push DTC TV marketing. The constant 'screaming' about the population's disease problems is really, really depressing. ED, depression, anxiety. Just because you have the money doesn't mean you need to burn it openly and ignoring my actual needs.

"I'm working with my first pharma client and I'm surprised by the regulations that keep pharma companies from connecting with their consumers (FDA regs). Pharma companies (health in general) is so open until it comes to drugs. Then everything is behind iron curtains. The FDA seriously needs to reconsider this. It is effecting the drug company's reputation the most.

"Stop beating me up with interruptive advertising (calling it awareness) and start engaging me when I need you - with online education and my doctor's CME."

I am not sure what Don meant about "iron curtains," but it could have something to do with hiding negative clinical trial data from the public and from physicians. His comment on "interruption" vs engagement "when needed" is interesting and is good advice for Pharma PR people as well.

Speaking of interruption and physicians, I found this post ("It’s Time To Earn Back The Trust – Part 1 — The Sales Representative") on the S&R Blog:

"After 37 years in the pharmaceutical business I can finally say that I am embarrassed by the industry that once gave me great pride, confidence and a feeling of really contributing to the good of society. Yes, the pharmaceutical industry has contributed to our overall well being with amazing innovation, life-saving therapies, improvement in our lives, longer life and immense cost savings. But a great deal of formerly well-deserved respect for this industry has evaporated as it has lost the trust of its most important customer – the physician. How do I come to that conclusion? I listen, I read, and I watch.

"Our industry has lost much of its clout by marginalizing its greatest asset: its sales force. The pharmaceutical detail rep was once regarded as a valuable, credible source of information. Physicians looked to the “detail man” for information about new and existing products, insights into how these products were most effectively used, and the presentation of clinical data that supported the efficacy and safety of any given product.

"Yet over the course of 15-20 years, the 'detail man/woman' has lost the shine and presence that once existed. Fewer and fewer physicians will now see pharmaceutical representatives. Yes, that is often because of increased demands upon their time, but also because many physicians now find the representatives less informative, less trustworthy, and less engaging. Many physicians look at sales reps as mere 'lunch delivery' people. How did this happen?

"It happened for a number of reasons. A recent conversation with a group of physicians indicated that the sales reps no longer brought anything of value to the discussion. And this is something I have heard, read, and watched for the last 5 years. According to this group of physicians, reps typically had watered-down sales presentations, used poorly designed sales materials, and spouted 'robot-like' information that centered only on what the company wanted the physician to know.

"Another reason often mentioned is that today’s sales representatives are not very knowledgeable about the products they sell, much less the diseases that these products are supposed to treat. Many physicians have stated that it is hard to believe a sales presentation when the rep simply does not understand the disease, its processes and the pharmacology of how a given product acts.

"Adding further fuel to the discussion is a continuing suspicion that the pharma companies are not totally coming clean with their data. Reps are simply repeating the 'good' data but will not discuss the fair balance and sometimes negative data that often comes years after the product has been released. This nagging suspicion has brought many physicians to the level where they simply don’t trust anything that the company says, be it the sales representative, promotional materials, even educational presentations.

"So, amongst all this skepticism, how might the industry proceed to reinstall the trust, confidence and relationships that were once so welcome?

"First, retool the sales force. Make reps knowledgeable by providing high quality levels of training on disease state, pharmacology, and the products that these reps are asked to sell. This also means that reps need to understand their competition as well as they do their own product to be able to effectively differentiate their product where possible.

"Second, provide sales reps with effective and efficient sales presentation skills. It’s not just about the presentation of product information. It’s also about listening, hearing, and understanding the physicians’ concerns and recognizing that your product can’t be everything to every patient. Understand the product’s limits and speak about them honestly.

"Third, stop scrubbing data. Present the real data, the real truth and make sure that the physician truly understands the appropriate types of patients and conditions that best suit the use of your product. This is a critical factor in bringing back the trust and credibility.

"Finally, help the sales reps build relationships with their physicians. Provide them not only with the real product and disease information that they can share, but also provide them with the tools and services that make the physician’s office life easier – e.g. reliable, unbiased patient information; real and balanced educational opportunities; a sales rep with personality and common sense.

"The industry will only regain a presence and place at the table by providing highly qualified and knowledgeable sales reps. That is the first piece of the trust puzzle. More to come later!"

I don't know who the poster is, but he/she also makes a point about transparency (ie, "not totally coming clean with their data"). I can't wait to read Part II!

So, we've discussed Pharma's image as it relates to both consumers and physicians and some ideas on how the industry must CHANGE -- not just TALK -- to address the problem. I welcome your comments and suggestions.

You can respond to the online
How to Earn Back the Public's Trust Before Hell Freezes Over Survey!