Merck's KOL Hit List: "Seek them out and destroy them where they live."

At first, when I read this Tweet from pharmalot (aka Ed Silverman):

"We may need to seek them out and destroy them where they live" http://tinyurl.com/cdg3c6

I thought it was something president Obama said about Osama bin Laden and Al-Qaeda terrorists.

Publish Post

Actually, it was something a Merck employee wrote in an email regarding a "hit list" of doctors who had to be "neutralised" or discredited because they criticized Vioxx. This according to the Federal Court in Melbourne, Australia where Merck & Co and its Australian subsidiary, Merck, Sharpe and Dohme, are being sued for compensation by more than 1000 Australians, who claim they suffered heart attacks or strokes as a result of Vioxx (see "Vioxx maker Merck and Co drew up doctor hit list").

Here's some more:

The Federal Court was told yesterday that Merck wanted to gain the backing of researchers and doctors - or "opinion leaders" - in the fields of arthritis to help promote the drug to medical professionals when it was launched in 1999.

Mr Burnside said internal emails in April 1999 from Merck staff showed the company was not happy with what some researchers and doctors were saying about the drug.

"It gives you the dark side of the use of key opinion leaders and thought leaders ... if (they) say things you don't like to hear, you have to neutralise them," he said. "It does suggest a certain culture within the organisation about how to deal with your opponents and those who disagree with you."

The court was told that James Fries, professor of medicine at Stanford University, wrote to the then Merck head Ray Gilmartin in October 2000 to complain about the treatment of some of his researchers who had criticised the drug.

"Even worse were allegations of Merck damage control by intimidation," he wrote, according to Mr Burnside.

"This has happened to at least eight (clinical) investigators ... I suppose I was mildly threatened myself but I never have spoken or written on these issues."

Mr Burnside told the court Dr Fries went on to describe instances of intimidation, including one colleague who thought his academic appointment had been jeopardised and another who received phone calls alleging "anti-Merck" bias.

Funny. I just finished reading the MM&M "Antidote" opinion column written by Marc Siegel, MD, in which he said that "Merck has been hit over the head the past few years with attacks, several of which were unfair or overblown." I wonder what category of attack this falls under?

Faux Social Marketing: Have Your Cake and Eat It Too!

Pharmaceutical marketers want their cake and eat it too when it comes to social media marketing. That is, they want to engage in patient communities but they don't want to hear what some patients have to say about their products -- it might be an adverse event that they will have to report to the FDA.

Now, thanks to The CementWorks -- UCB's agency of record for its Crohn's disease drug Cimzia -- pharma companies have a way to build a "community" online and NOT worry about pesky comments from patients.

What CementWorks did was to create an unbranded disease awareness campaign called Crohn's and Me. Its digital agency partner Heatbeat Digital created a website (www.crohnsandme.com) that it calls a "faux community," which "gives visitors a feeling of community without the risks of open-ended social networking" (I'm quoting from an article in the March 2009 issue of MedAdNews).

Click on the image for an enlarged view.

The sense of "community" is heightened by using the phrase "community" as often as possible and inviting site visitors to "join the community" rather than saying "register." And you MUST join in order to view most of the videos of "community" members who tell their stories.

It's a very nice faux community. I joined it and asked to receive everything they wanted to send me about "products." I can't wait until I receive my "welcome to the community" e-mail!

MedAdNews should have added "without the benefits of open-ended social networking" in its description of this faux community. Because there are definite benefits of "real" online communities, one of which is ENGAGEMENT. And that's exactly the word MedAdNews uses in the headline describing the community: "And engaged Crohn's community."

However, when you read down you'll find that Heartbeat Digital defines "engagement" by the "average length of visit." Since the site is chock full of videos, the average length of visit is much higher than would be the case with text. Hence, increased "engagement."

However, I don't think this is what most people mean by "engagement" when they talk about social networks. Engagement means to me allowing users to engage YOU in conversation by submitting comments and getting comments back from YOU and from other site visitors. Maybe that does not increase the average length of visit, but it will increase the number of visits and the number of times you can get YOUR message in front of the same visitor. Isn't that MORE important than how long someone stays on your site ignoring your message while watching shiny moving objects?

The drug industry more than any other should understand that risks always accompany benefits and just as they advise their customers about balancing drug risks with benefits, drug marketers need to learn how to balance social media risks with benefits.

But just like dumb Rx drug consumers, drug marketers want all the benefits and NONE of the risks!

Oh well. I can't have MY cake and eat it too!

----------------
Further Thoughts
On further thinking about this site I must take back the "shiny objects" criticism. The message that Crohnsandme.com wants to convey is precisely what's in the videos. So it was unfair of me to suggest that the message was not getting across while users were watching the videos. This might not be the case, however, with other sites that try to emulate this faux community.

Still, I don't think like the concept of "faux" communities when perfectly "real" communities could be created. Of course, agencies must work under the constraints imposed upon them by their clients and good luck to them convincing pharma people to accept the risks of doing that. Maybe faux is the best we can hope for.

Docs at ACC Meeting Treated to "PolyPill" Trial Results

Reuters reports on a 2,053-patient, Indian clinical trial that evaluated a "polypill" containing low doses of three blood-pressure drugs from different classes -- thiazide, atenolol and ramipril -- as well as the statin cholesterol-lowering drug Zocor and aspirin.

The trial tested whether the pill (an artist's conception of the pill is shown on the left) leads to meaningful changes in heart risk factors. Results of the study were presented at the American College of Cardiology scientific meeting in Orlando.

Way back in 2006 I suggested another type of poly pill for the treatment of cardiovascular disease. My proposed poly pill would combine Norvasc (for hypertension), Lipitor (for cholesterol), and Viagra (for ED caused by high cholesterol) (see "Caduet, Smaduet! Add some wood to the fire!"). You could easily throw in 81 mg of aspirin too!

The advantage of my pill combination is simple: Much better compliance, at least among male patients!

Did I Miss the Fair Balance in Last Night's Omnaris Nasal Spray TV Commercial?

Last night at about 6:47 PM Eastern US time during the ABC Evening News, I saw for the first time a short ad -- maybe a 30-second spot -- for Omnaris, which is Sepracor's new nasal spray for seasonal allergies. I may be mistaken, but I don't recall hearing about any side effect information during this commercial. At least NOT in the voice over. I'm usually pretty alert to what's being said in TV drug ads, so I find it hard to believe I missed it.

I also find it hard to believe that a company like Sepracor, which has a lot of experience with DTC advertising (it spent over $243 million on DTC advertising for Lunesta in 2007 -- even allowing for Bob Erhlich's 40% discount from reported ad spend; see here) could neglect to include fair balance information.

Therefore, if anyone out there also saw the commercial and can verify that the "fair balance" information was there, please let me know.

UPDATE: 3/30/2009. Tonight I was able to watch the ad again by flipping back and forth between ABC, CBS, and NBC news at around 6:50 PM. I just caught the "fair balance" statement when I flipped to NBC. It consisted on one sentence, about 5 seconds in length -- basically, "side effects include headache, sore throat, and nosebleed." No wonder I missed it the first time!

Although the ad may have mentioned all the major side effects and probably complies with the letter of the law, the "new" FDA may want to flex its muscles and cite this ad because there is quite a lot of time spent on the benefits and so little spent on side effect information.

The commercial explains that Omnaris works differently by easing inflammation in the nasal passageways. In it animated uniformed men with helmets -- who look like Orkin pest control men -- shove an Omnaris spray nozzle up some one's nose. You then see the yukky inflammation recede. Something like that.

Obviously, this is not the first time the ad was run. On 24 March 2009, a Sepracor sales rep posted this to CafePharma:

I do not know who has seen the new Omnaris commercial, but It is BEYOND ridiculous! Where is the stick and stay messaging... won't run down the back of your throat? Does not have a smell? No burning? Method of action?

NOTHING!

It was beyond horrible. It basically looked like a commercial for Charlie and the Chocolate Factory with a bottle of Omnaris instead of a Wonka Bar.

Oh, and the $11 copay was written at the bottom of the last screen in tiny font! Don't rely on that for an increase in Rx's!

This rep saw Charlie Wonka, I saw the Orkin Man.

Of course, another sales rep was quick to pick up on the "stick and stay" reference and turn into a sexual joke too gross to repeat here. You can find the entire CafePharma thread here.

Ah, the wonderful world of DTC advertising! Is there anything else that can make the drug industry as easy target? Even it's own people use the ads to skewer their marketing people!

UPDATE: Here's the commercial courtesy of AdPharam, the Pharmaceutical Advertising Gallery: Click here.

Peter Pitts in a Pickle with Journalists and Catholics

I read with amusement Jim Edwards account of the brouhaha over conflict of interest disclosures relating to Peter Pitts, the star blogger over at Drug Wonks. You can read it on Pharma BNet: "NPR Producer Gets Apology Over Goodwin Affair; Says Peter Pitts Not Upfront About Ties to Eli Lilly."

What I find amusing is that a "seasoned journalist, a Columbia Journalism graduate" would take at face value Pitts' PR agency's pitch, which simply states "Peter Pitts, former associate commissioner for the FDA, and co-founder of the Center for Medicine in the Public Interest (CMPI)."

The "seasoned journalist" in question, a producer of the NPR show that had Pitts as a guest, "swears [Pitts] did not disclose to her that he was a PR person for pharma; if he did, alarm bells certainly would have gone off..." Sure, sure.

Pitts claims he DID tell her. He said, she said...

I have to agree with Jim, a "seasoned" journalist should have known all about Pitts, pharma's pit-dog. Pitts has been outed as a shill for pharma many times in the Pharma Blogosphere (see, for example, "CMPI, aka DrugWonks, is a 'breeding ground for industry moles'").

If us lowly, non-journalist bloggers know all about Pitts' ties to the drug industry, why didn't a "seasoned journalist" know?

But, I don't mind that Pitts has ties to the pharmaceutical industry although a little more transparency on his part would help.

What I DO mind, however, is how Pitts attacked Bill Lichtenstein, the lead NPR producer who defended his co-producer quoted above. Pitts asked if Lichtenstein had given "up crow for Lent" because he wouldn't admit that Pitts revealed his drug industry ties to him.

I don't like that Pitts brings up Lent in his attack on Lictenstein. Does Pitt know something I don't know? Is Lictenstein Catholic? Is Pitts anti-Catholic?

This is the second time I've heard giving up something for Lent as part of a joke within a pharmaceutical context. I don't happen to think it's funny, not to us Catholics.

Let's leave religion out of our attacks, please.

Dis RealAge All You Want NY Times, But Consumers Want those E-mails from Pharma Companies!

According to an article ("Online Age Quiz Is a Window for Drug Makers") in today's New York Times, "Pharmaceutical companies pay RealAge to compile test results of RealAge members and send them marketing messages by e-mail. The drug companies can even use RealAge answers to find people who show symptoms of a disease — and begin sending them messages about it even before the people have received a diagnosis from their doctors.

"While few people would fill out a detailed questionnaire about their health and hand it over to a drug company looking for suggestions for new medications, that is essentially what RealAge is doing."

Really? Are you sure "few" people would fill out a detailed questionnaire about their health and hand it over to a drug company?

It just so happens that a recent study by Epsilon concludes that 38% of patients they surveyed prefer to learn about pharmaceutical products via e-mail from a brand or a pharmaceutical company (see chart below and this excellent Dose of Digital Blog review by ePharma Pioneer Club member Jonathan Richman). That beats out offline (ie, TV) advertising.

Click on chart for an enlarged view.
Although Pharmaceutical companies like to maintain physician email databases, they do NOT want to own databases of patient information. Not after Lilly got its you-know-what in an FTC wringer several years ago for sending out email to 600 or so patients with all their e-mail addresses visible in the BBC line. Let sites like RealAge assume the risk.

There is, however, one catch. RealAge may know how to collect patient e-mail addresses, but do they know how to protect those addresses and other personally-identifiable health information?

I've worked with several agencies and web sites that collect consumer data on behalf of pharmaceutical companies and found that their internal policies and procedures often do not match the promises they make in their public privacy policies. That's how the FTC got Lilly to sign a 20-year settlement that requires the company to have ALL their agencies that handle consumer data on its behalf go through a rigorous privacy/security self-assessment. For more on this see "Good Privacy Practices."

Update on that YAZ YouTube Video

More than a month ago, I noted that "Goodbye to You" YAZ commercial, which the FDA found violated the law, was still available on the YouTube site maintained by Desiree Hall, one of the actresses in the commercial (see "YAZ Commercial Yanked from TV, But Not from YouTube").

I didn't think that Bayer was responsible for uploading and maintaining the video on YouTube, but I thought that Bayer should have compelled Desiree to "pull" the video from YouTube. You know, out of obeying the spirit as well as the letter of FDA law. After all, I doubt that Desiree's use of the video was allowed under the "fair use" provision of copyright law. Bayer could have compelled her to remove the video just on the basis of copyright and trademark infringement, if it wanted to.

Today, I notice that the video is no longer available on Desiree's site. I just love it when stuff like that happens! Of course, it may have have had nothing to do with my post. Desiree may have just decided she didn't like the video any more. Yeah, right!

Was PhRMA Fiddling While We Burned?

"While just about all retirees are covered, and nearly 90 percent of children have health insurance, workers now are at significantly higher risk of being uninsured than in the 1990s, the last time lawmakers attempted a healthcare overhaul, according to a study to be released today," reported AP (see "Health insurance woes hit workers. Premiums rising 6 to 8 times faster than wages have").

"The study for the Robert Wood Johnson Foundation found that nearly 1 in 5 workers is uninsured, a statistically significant increase from fewer than 1 in 7 during the mid-1990s."

I came across this bit of information just as I hung up the phone with Billy Tauzin, president of PhRMA. Mr. Tauzin led a "roundtable" discussion on health reform. I, and several other bloggers, were invited to participate.

Towards the end of the conversation, we all got to talking about Hilary Clinton and the 1990s, which was the last time healthcare reform was a national issue. At that time, if my memory serves me, PhRMA and the drug industry were against the reforms proposed by the Clinton administration. Now, PhRMA and practically everyone else is in favor of "reform," as long as it is the kind of reform they want.

Leaving aside for a second what PhRMA wants, what I want to know is this: what was PhRMA doing between the time Hilary was rebuffed and Obama was elected to reform healthcare? Why didn't the industry push the Bush administration to get healthcare reform back on the agenda?

While more and more workers are unable to afford private insurance, Billy Tauzin still enjoys his government health insurance plan that he was allowed to keep after he left Congress to work for PhRMA. Mr. Tauzin, however, does not want all Americans to have access to government insurance but prefers government handouts that allow people to afford private insurance.

Sorry to make this personal, but that was exactly what one blogger participant was worried about -- how to deal with all the personalities that are "at the table" in this current round of negotiations about health reform. As Mr. Tauzin said, it's different this time because everyone has been invited into the tent. Mr. Tauzin closed the call with the hope that Republicans will not continue to stand outside the tent pissing but would come in and talk.

Hey, it could happen.

At least Mr. Tauzin invited bloggers into his tent, for which I have to give him credit. Hopefully, he'll invite me again.

For tweets made during PhRMA's Tauzin call with bloggers see: http://tinyurl.com/dzp9rq

Wolfe Defanged at FDA Advisory Committee Meeting on J&J's rivaroxaban

Some see the glass half full -- eg, the In Vivo Blog's post "Fighting Like a Wolfe Against Johnson & Johnson" (image on left) -- while others see it half empty -- as in this post (image on right).

"During the March 19 Cardiovascular-Renal Drugs Advisory Committee review of Johnson & Johnson’s anticoagulant rivaroxaban, Wolfe, the acting consumer representative, took the unusual step of calling out to an FDA drug safety reviewer—Office of Surveillance & Epidemiology associate director for science John Senior, who was sitting in the audience—to ask him point-blank the very question the committee was being asked to deliberate: whether rivaroxaban should be approved based on the available data," reported In Vivo. "Sidney Wolfe isn’t one to stand on protocol."

Would a real wolf call upon a sheep to be its ally?

I don't know much about John Senior except a comment I found on Pharmalot: "John Senior the reviewer who let Lotronex on the market" once said the public has to "realize that drugs aren’t safe and that we have to wait until post marketing" (see comments to "FDA To Post List Of Drugs With Safety Issues").

I have no idea if Senior is a sheep or fellow wolf(e). In the end it didn't matter. Wolfe's breach of protocol had little effect on convincing the committee to see things his way. Wolfe was effectively defanged.

FDA Lacks Credibility, Says Judge in Ruling to Allow Access to Plan B by 17-year-old Women

BREAKING NEWS FROM "THE TAN SHEET"
See also OverTheCounter Today Blog.

A federal judge today ordered FDA to allow distribution of the Plan B emergency contraceptive without a prescription to 17-year-old women.

Judge Edward R. Korman ordered the agency to rescind its restriction on nonprescription access to Plan B to women 18 years old and over because "no useful purpose would be served by continuing" to require that 17 year olds have prescriptions for the drug.

FDA must comply with the order within 30 days. In the U.S. District Court for the Eastern District of New York, Korman also directed FDA to reconsider whether to make the drug available to women of all ages without a prescription.

Korman said the requirement that the product be distributed only by pharmacists can continue.

The judge ruled on a complaint filed by the authors of a citizen petition asking FDA to make Plan B available without a prescription to 17-year-old women. The agency did not act on the 2001 petition.

Korman said "FDA is free ... to exercise its expertise and discretion regarding" disposition of the petition, but the record of the Plan B switch application "shows that FDA officials and staff both agreed that 17 year olds can use Plan B safely without a prescription."

He added that FDA's "justification for this age restriction, that pharmacists would be unable to enforce the prescription requirement if the cutoff were age 17, rather than 18, lacks all credibility."

Will Margaret Hamburg, who was named FDA Commissioner just last week, and who -- while NYC Health Commissioner -- opposed a "morality oath" demanded by the NYC Board of Education in 1992 while the city was debating abstinence-focused sex education in schools, act swiftly on the disposition of THIS petition? Or is she not yet seated on the throne?

Pharma Reps' Worst Fear Is Near: Outsourced to the Internet!

When eDetailing was relatively new in 2003 -- before the dawn of Web 2.0 -- there were about 90,000 pharmaceutical sales reps. In 2007, just when the hype about Web 2.0 began and the physician social networking site Sermo was launched, the number of sales reps peaked at 102,000. Today, there are about 92,000. In 2012, ZS Associates predicts the number will be 75,000 -- the lowest since 1996 when the sales rep expansion was just starting.

About 45,000 doctors meet with detailers using online video, and 300,000 physicians say they are open to doing so, said a September 2008 study from Manhattan Research. This trend is worldwide. Tomorrow, in an exclusive interview with Mark Bard, President Manhattan Research, we will talk about technology adoption and integration trends in physician practices across Asia (see "Taking the Pulse™ Asia: Asian Physicians and Emerging Information Technologies").

There seems to be a correlation going on here -- one that sales reps have long feared: as pharma adopts the Internet for reaching physicians, they will start getting rid of sales reps. Those that supported the adoption of eDetailing by the industry used to allay these fears by saying things like "the best eDetailing programs work hand-in-hand with the sales force" and "eDetailing should complement the sales force" (for more on the history of eDetailing, you can order the eDetailing Supplement to Pharma Marketing News. Use the discount code 'EDET64297N' and save $7).

You may no longer hear concerns from pharma people -- except from sales reps -- about eDetailing replacing sales reps. And developing programs that "complement" the sales force may now have less appeal. "Drugmakers are responding to hard times with layoffs and a shift toward online marketing," proclaims an article in today's American Medical News ("Doctors increasingly close doors to drug reps, while pharma cuts ranks").

The current recession offers pharma (and other industries) a great opportunity to adopt new technology! You can lay off people and replace them with off-shore resources (see "Pfizer Pfires Thousands of Americans, Outsources Tasks to India") and/or with new technology (eg, social media).

To be sure, visits by drug reps will not disappear entirely. The hope is that the sales force that survives the layoffs will be "better trained and have a greater depth of clinical and scientific knowledge," according to experts cited in the American Medical News article.

Do Fat People Like Wynonna Judd's Music? GSK and alli May Think They Do.

"Consumers purchasing GlaxoSmithKline's weight loss drug Alli will receive a free copy of Wynonna Judd's new album Sing," reports MM&M (see "GSK pairs Wynonna Judd album with Alli").

This assumes that:

1. Many Wynonna Judd fans need alli, or
2. Fat people like Wynonna Judd's music, or
3. alli needs Wynonna Judd, or
4. Wynonna Judd needs alli, or
   
5. None of the above, or
   
6. All of the above
   

Which do you think is true?

"I hope that I can inspire people to be better... that they can see themselves in me and say, 'If she can do it, I can do it,'" said Judd.

I don't know if Judd has "done it" (lost weight with alli) or not. But if you juxtapose her image on the Sing album cover to the image GSK uses in its promotion of alli, one of two things are possible:

1. If the album photo of Judd was taken after the alli photo, then alli worked, or
2. One of these images have been "photoshopped."

Protracted Decline in US Rx Sales Growth Portends Dire Future for Industry, Unless...

"We ration care in the US today using one of the most capricious and inequitable means possible -- ability to pay," says Kim Slocum, former Director, Strategic Planning & Business Development at AstraZeneca, in an article to be published in the March 2009 issue of Pharma Marketing News. "As cost shifting to consumers has accelerated over the past decade, we've seen the effects of this as year-on-year sales growth for prescription products has dropped on more or less a straight line since 2000."

To support his thesis, Slocum sent me the chart above, which shows the percent change in dollar sales for US prescription products from 1990 through 2008. The original source of this data is the IMS National Sales Perspective, January 2006, 2007, 2008, 2009.

"There's plenty of evidence to show that the average consumer is a very inferior decision-maker when it comes to health care," says Slocum. "Consumers tend to cut back on all sorts of care, both necessary and unnecessary, in equal proportions."

Unless something changes, Slocum envisions dire consequences for the drug industry: "Extend the trend out just a bit further and you’re faced with a world in which sixty or seventy million people are completely uninsured with many of the remainder living with very skimpy coverage. Generic utilization rates in this situation probably exceed 80% and perhaps 30%-40% of all prescriptions go unfilled."

This describes a future scenario Slocum calls "Consumer Chaos." He spoke about this and alternative scenarios in a recent Pharma Marketing Talk podcast entitled "Will Healthcare be Rationed or Rational?" In that podcast he made a case for the industry to support Comparative Effectiveness Research or CER.

CER gathers real-world evidence on what medical therapies and technologies work best and is often cited as a fix for the nation's rising health costs. "[CER] is much discussed these days in the face of the $1 billion-plus appropriation contained in the American Recovery and Reinvestment Act (ARRA) to set up such a function here in the US," said Slocum.

The U.S. Department of Health and Human Services (HHS) yesterday announced (here) the members of the Federal Coordinating Council for Comparative Effectiveness Research. Authorized by the American Recovery and Reinvestment Act (ARRA), the new council will help coordinate research and guide investments in comparative effectiveness research funded by the Recovery Act.

"Comparative effectiveness research can improve care for all Americans and is an important element of President Obama's health reform plan," said HHS Spokeswoman Jenny Backus. "President Obama is committed to openness and transparency and the Coordinating Council will host open meetings and a listening session as it begins its important work."

It's obvious that the pharmaceutical industry needs to get involved in the discussion since the stakes are very high. "The only real threat of CER is to have it done badly, by people whose only interest is in reducing costs," said Slocum. PhRMA -- the trade association representing the interests of US pharmaceutical companies -- agrees. Yesterday, PhRMA Senior Vice President Ken Johnson issued the following statement:

"The economic stimulus law made an important footprint in the health care debate by providing significant funds for government-sponsored comparative effectiveness research (CER). PhRMA has long supported well-designed CER because when used correctly, it can serve as a tool to help improve patient outcomes and medical decision-making.

"To help ensure that CER is used to promote patient health and improve the quality of health care in the U.S., it is critical that the new Federal Coordinating Council listen carefully to input from all stakeholders throughout the process, particularly physician and patient input because, ultimately, they will be ones most impacted by the Council's recommendations.

"As the Administration continues to implement this initiative, we expect it will be done with transparency, openness, accountability and public input in how research priorities are set and how studies are ultimately communicated and conducted.

"We look forward to working with members of Congress and the Administration as a long-term framework for comparative clinical effectiveness research is established."

Will CER be a part of our future healthcare system? How will it be implemented? CER is just part of ONE of the possible future scenarios that Slocum envisions. For more details and to provide your input on this issue, see "Future Health Care Scenarios. Which is Best for Pharma?"

Pharma Companies Anticipate My Survey Results and Expand Prescription Savings Program to Cover More Americans in Time of Crisis

According to a Pfizer press release, Pfizer Inc announced today that Together Rx Access™, a prescription savings program sponsored by Pfizer along with several other leading pharmaceutical companies, has expanded the program’s eligibility income levels to help even more uninsured individuals and families save on the medicines they need to stay healthy and to manage chronic conditions. Under the new income levels, nearly 90 percent of uninsured Americans will now be eligible for the Together Rx Access Program (see " Pfizer-Sponsored Prescription Savings Program - Together Rx Access™ - Expands Eligibility Criteria in Response to Challenging Economic Times").

This is one of the options I included in the "How to Earn Back the Public's Trust Survey" that Pharma Marketing News hosted online between February 4 and March 14.

One question in that survey asked. "Regarding solutions for improving the industry's reputation, please indicate you level of agreement or disagreement with the following suggestions:"

• The drug industry should freeze or lower prescription drug prices for everyone. The drug industry should freeze or lower prescription drug prices for everyone.
• It should not lower prices across the board, but it should help by re-imbursing all or part of co-payments made by people with prescription drug coverage. It should not lower prices across the board, but it should help by re-imbursing all or part of co-payments made by people with prescription drug coverage.
• It should greatly expand its patient assistance programs to cover more people (eg, the unemployed). It should greatly expand its patient assistance programs to cover more people (eg, the unemployed).
• It should be much more transparent in reporting clinical trial results. It should be much more transparent in reporting clinical trial results.
• It should do more to promote comparative studies to prove the efficacy of prescription drugs. It should do more to promote comparative studies to prove the efficacy of prescription drugs.
• It should support Medicare's right to negotiate prices under Part D. It should support Medicare's right to negotiate prices under Part D.
• It should ramp up its PR effort (eg, pay much more attention to the media by "engaging" and "educating" them). It should ramp up its PR effort (eg, pay much more attention to the media by "engaging" and "educating" them).

The third option on the list was one of the most popular options selected by respondents and was one of the options that consumer and pharma respondents were in agreement on (see chart).

Future Health Care Scenarios. Which is Best for Pharma?

I think everyone should listen to my podcast interview of Kim Slocum, former Director, Strategic Planning & Business Development at AstraZeneca, who suggested that the pharmaceutical industry faces at least three likely future health care scenarios in the US that will have an impact on its business and profits:

1. "The Triumph of Reason" -- Supported by evidence-based medicine, widespread use of health information technology to support real-time comparative effectiveness review, and value-based reimbursement for innovative biopharmaceuticals.
2. "Big Brother Arrives" -- Gov't "fixes" the health cost problem (ie, single payer system) and determines who has access to health care.
3. "Consumer Chaos" -- Involves the acceleration of trends shifting the costs of health care and decision-making authority to consumers.

Two other scenarios include:

4. "Safety Net" -- Government run, price-controlled system that covers primary care, generic medications, basic chronic disease care and catastrophic hospitalizations. People with more money could "trade up" with their own money to better standards of care. This is much like the healthcare system we see in Australia.
5. "PhRMA's Platform" -- A scenario endorsed by PhRMA, the US drug industry trade association (see Platform for a Healthy America). It emphasizes affordable health insurance and choice for all Americans rather than a government-run insurance plan. The plan depends upon "expanding private health insurance coverage through new refundable tax credits targeted at low-wage, small businesses and providing individual subsidies for low- and moderate income families to purchase coverage on their own or through new pooling arrangements" and upon Medicaid and SCHIP as safety nets.

In the podcast Slocum talks about several of these alternatives in more detail and argues for the biopharmaceutical industry to support the rational approach based on comparative-effectiveness review. A more comprehensive presentation of Slocum's argument, including an analysis of the impact on pharmaceutical sales and marketing, will be published in the March issue of Pharma Marketing News. Subscribe NOW and receive this issue FREE.

TAKE THE SURVEY
Meanwhile, I invite readers to take the "Which Future US Health Care Scenario is Best for Pharma?" online survey, where you can vote on which scenario is likely to unfold in the next 10 years and which one would benefit the pharmaceutical industry the most.

[You might argue that what's best for consumers is also best for pharma. That's fine. But I am specifically interested in your opinion on what's best for pharma. You should then back up your choice with why you also think it's best for patients. There's plenty of room in the survey for open-ended comments.]

Results of this survey will be summarized in Pharma Marketing News. After you complete the survey, you will be able to see the summary yourself. No comments or other identifying information is included in the summary.

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.

Take the survey here.

Big Pharma: Going Global or Going Postal?

Is it just me or is the guy on the cover of this month's PharmaVoice magazine a little bit scary looking?

He has that look in his eyes that warns us he might "go postal" any second!

Meanwhile, Big Pharma is "going postal" viz-a-viz mega mergers!

CNTO411: We'll Meet Again, Don't Know Where, Don't Know When

Remember Centocor's corporate/disease awareness blog, CNTO411? A few weeks ago I predicted that this blog would soon be taken down because Centocor cannot find anyone to take the place of Michael Parks, Centocor's former Vice President of Corporate Communication, who was the heart and soul of the blog (see "CNTO411 Blog to Go Dark").

Well, I was wrong. Something MUCH WORSE is going on: Centocor is playing footsie with loyal followers of CNTO411 -- if there are any loyal readers left!

Yesterday, Kassy McGourty, VP, Communication & Public Affairs at Centocor, posted an "Update" in which she said "some of you may have noticed recently that we've been on well... a bit of a break.. and I thought it high time to let you know what's up with CNTO411."

She blamed the "break," which began October 8, 2008, on internal consolidation of business units. Yawn! Who among your readers really cares about that?

Surprisingly, McCourty condensed and possibly restated the mission of CNTO411 this way: "to offer perspective about our business and the biotechnology industry."

Melissa Katz, who worked with Parks at the time, posted these objectives in her "Inaugural [CNTO411] Blog Posting":

• Give Centocor a voice in the blogosphere – to have a point of view in the conversations already taking place.
• Be a credible blogger by speaking the plain truth and providing my personal opinion about news, events, and situations relevant to the business.
• Be a responsible steward of my industry by communicating in a balanced way, sharing my point of view on the innovations, and putting a balance on things that impact what we do.

Melissa also mentioned "engaging in a dialogue with John Mack" and others in the Pharma Blogosphere. McCourty does not mention dialogue with outsiders -- ie, bloggers and journalists.

McCourty pointed out that in "our inaugural post we said that '...we like to think of ourselves as pioneers.' We still do as pioneering new treatments is engrained (sic) in the fabric of our culture. And we will continue to provide patients and physicians with innovative medicines, the latest treatment information, support services and quality care."

She closed with this less than hopeful statement: "We’re taking a break but not exiting indefinitely, so we hope to have the opportunity to chat with you again the near future."

I can forgive the spelling errors, but not this slow, painful death of a blog! Are you blogging or not? Hard to tell. Should I bother to come back tomorrow, next week, next month, next year to "chat?"

"We'll meet again. Don't know where, don't know when. But I know we'll meet again some sunny day."

Pharma Dreams of Dipping Its Toe Into Social Networking Waters

Before YOU dip your toe into social media marketing, shouldn't you understand your company's unique regulatory environment, corporate culture, and knowledge, all of which need to be taken into consideration before you develop your marketing plan?

In order to help pharmaceutical companies, their vendor partners, and other companies determine how ready they are to engage in social media marketing, Pharma Marketing News has created the online "Rate Your Social Media Marketing Readiness" survey or tool. To date, over 330 companies have used this self-assessment.

Please take a few minutes to complete the survey and find out how you score compared to your peers.

Your participation is confidential (anonymous) unless you specifically provide your contact information at the end of the survey and ask to be contacted for more information.

Take the survey here: http://tinyurl.com/caghnm

Botox v. Reloxin: Market Share Battle May Revive DTC Spending Late in 2009

If you thought the DTC advertising sleep aid (Lunesta v. AmbienCR v. Rozerem) advertising war was excessive, wait until Reloxin is approved for marketing by the FDA, which may happen during the second half of this year according to Bloomberg.com (see "Medicis's Reloxin May Vie With Botox in U.S. to Clear Wrinkles").

“The results of the study [published in the March/April issue of Archives of Facial Plastic Surgery] show that it’s as good as Botox," Ronald Moy, the lead author of the study and a professor in the medical school at the University of California, Los Angeles, in a March 13 telephone interview. "The side effects are the same as Botox."

So...how's Medicis going to capture 25 percent to 30 percent of market share from Botox as one analyst claims it will? And how will Allergan, which markets Botox respond?

Advertising of course!

"It's important that people just recognize that these are different products," said a spokeswoman for Allergan.

And to make people "recognize" the difference you'll need lots and lots of advertising! And I don't mean the reminder DTC ad crap that Allergan has been getting away with for years (see "Botox BS Piled Higher and Deeper" and "Allergan Doesn't Comply with PhRMA Guidelines, Wins Kudos Anyway").

But there's going to be those nasty side effects to deal with and include in any "above-the-board" DTC ad. "The researchers found that 804 of the 2,838 adverse events reported by patients were probably or possibly related to the treatment."

According to Moy "Many of our patients liked it [Reloxin] even better." Maybe Medicis can stick with reminder ads and use "You'll like it even better!™" as a tag line? I think I'll trademark that!

P.S. As pointed out in a comment to this post, Johnson & Johnson has agreed to acquire breast-implant maker Mentor for $1.07 billion. The deal could also give Allergan a big rival in the wrinkle-fighting space, as Mentor awaits FDA approval for a Botox competitor. So there could be THREE anti-wrinkle meds out there soon vying for market share!

FDA's Answer to ePharma Marketing Guidelines: "circles and arrows and a paragraph on the back"

Today, Mark Senak (Eye For FDA) posted a podcast interview with Dr. Jean Ah Kang, Special Assistant to Tom Abrams at DDMAC in charge of Web 2.0 policy development (see "A Conversation with FDA/DDMAC About Pharma, Social Media and Web 2.0").

This was the second time in one week that the FDA had the "bully pulpit" and the ears of ePharma marketers. The first was at CBI's eMarketing conference in Princeton, NJ, where Sanjay Koyani, Director of FDA Web Communications, gave a keynote presentation, which will be summarized in the March issue of Pharma Marketing News.

On both occasions pharma eMarketers had their ears perked up to hear what the agency had to say about regulation of pharmaceutical marketing on the Web and especially on social networking sites.

On both occasions, we were disappointed.

Regarding the keynote presentation, ePharma Pioneer Club member Jonathan Richman had this to say: "It was the FDA showing all the great things that social media can do (which everyone in attendance knew already), but completely ignored the elephant in the room, which was the question: How can we do it and not get into trouble?"

Mark Senak also was rebuffed in his attempts to get some actionable information out of Dr. Ah Kang. "There was no expectation, of course, that the FDA was going to issue a guidance in the context of a podcast," said Senak, "but it did seem important to start getting some definition to the environment where there has largely been only speculation."

Mark posed a scenario to Dr. Ah Kang that I thought was odd. It addressed what Mark said was "the real fear among many companies that if they generate and post original materials that they may later be changed by others." I've never heard that one before and it's a trivial concern compared to pharma's fear of adverse reporting obligations.

Dr. Ah Kang spent the last 4-5 minutes going over the details for submission of ALL promotions -- including Web ones -- produced by pharma for so-called "pre-approval" -- actually, "advisory comments" -- by the FDA. She said: Go to the FDA website, look over the org chart, find the right division, the right "docket," the reviewer responsible for the docket, click on the submission information link, and make sure to put together the package as indicated. Be sure to include a cover letter, all your promotional materials, annotate the materials (ie, with "circles and arrows and a paragraph on the back of each one"), include references. highlight and annotate those references (more circles and arrows and paragraphs), include a PI, etc. Got a problem? Call the FDA's main number!

But whatever you do, don't leave your name on an envelope in the bottom of that half-ton pile!

FDA Widgets: How About One for Adverse Event Reporting?

Fabio Gratton is at it again! He has started a poll, which asks "To all pharma marketers: A universal FDA Adverse Event widget required by all pharma websites (brand, disease, social) would be effective?"

I assume he is following up on the "Tit-for-Tat Tithe" idea and that the widget he is proposing would allow visitors to pharma websites to easily report adverse events DIRECTLY to the FDA. This would lift the burden from pharmaceutical companies to track, investigate and report the adverse events themselves and free them up to focus on using social media sites for marketing purposes.

Sounds like a good idea. What do you think? Take Fabio's poll here.

Meanwhile, here are a few widgets developed by third parties that push out FDA information on drug safety topics. They are not interactive in the sense that you can enter information into them.

Tit-for-Tat Tithe on Pharma Marketing. How It Can Work.

A few weeks ago, Fabio Gratton, Co-founder nd Chief Innovation Officer at Ignite Health and ePharma Pioneer Club™ member, was a guest on my Pharma Marketing Talk live streaming audio/chat show where he enlightened us about "How To Measure Social Network Communications Success" (see PMT Show #69).

During that interview, Fabio threw out a half-baked idea idea intended to help pharmaceutical companies effectively use social media networks by limiting the regulatory risks in exchange for setting aside 10% of their resources (online ad spend? total marketing? profits?) to promote general health and well being.

The regulatory risk most often cited by the drug company regualtory people is the uncertainty about investigating and reporting adverse events (AEs) their companies receive through comments on social media sites (see "Report from CBI's eMarketing Forum: Taking on the AE Boogey Man").

Gratton says there should be guidelines to encourage pharma to focus more of its time on the general well-being of patients without worrying about AEs. "If pharma companies do this (focus more of its time on the general well-being of patients), regulatory agencies should cut them some slack with regard to the use of social media, according to Gratton." What the nature of this "slack" should be remains an open question (see my idea at the end of this post).

To get a discussion going on this, I asked respondents to the recent "How to Earn Back the Public's Trust Survey" if they thought this was a good idea. I also asked them to submit comments. I will report the full results in the upcoming March 2009 issue of Pharma Marketing News. If you are not already a subscriber, you may want to subscribe now and get this issue delivered free as soon as it's published.

Here's a preview of what I learned. As the pie chart below demonstrates, the idea has some traction, although most people understandably wanted to learn more about the details.


None of the healthcare professionals HCPs) and consumers who responded to the survey thought this was a great idea. About 40% of HCPs thought it was a terrible idea. Keep in mind that there are not enough data to expand these results to the general population. Look upon this as an ad-hoc focus group.

Some comments, however, were of interest:

'Without fear of penalty' is the equivalence of how do we hear about adverse events without being held responsible for doing nothing. The bottom line is that 'doing the right thing' may result in lower profits and that is unpalatable. Regulatory agencies cut too much slack as it is.
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Patients are the center of this industry and we should want to open channels of communication wherever possible. Some of the benefits of this communication include better informed patients, patients more eager to enter therapy, more awareness around clinical trials (and other non-prescribed therapies), and patients who are pre-qualified seeking treatment options. This list can go on!
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Given the industry's history of marketing and the consequences of DTC, CME, etc., I am skeptical. However, anything that improves patient management and promotes compliance and better outcomes is to be encouraged.
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What is meant by "focus more time on the general well-being of patients"? The industry spends hundreds of millions of dollars each year to discover new and more effective therapies, fund extensive disease state awareness efforts, donate charitable contributions to therapeutic co-pay foundations, support of patient advocacy programs and patient assistance programs, and so on. A lack of transparency and bad marketing practices by some has been the detriment to all... not just a lack of good will to patients. Additionally, regulatory agencies always regulate a few steps behind technology. General web advertising guidance came years after the advent of web advertising. "Good will" will not change regulatory opinion. A responsible approach to using new technology will. We sit back and wait for the guidance, when in reality we should be (in a sense) writing the guidance by demonstrating a responsible approach to educating our customers using new technology.
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Post marketing Pharmacosurvalience (sic) could be enhanced by the use of social media. It is in the industry’s best interest to open up the channels and see and hear what is really happening in the marketplace. It could prevent drug recalls by getting out in front of problems that were not encountered during the clinical trials prior to launch.

I have refrained from identifying who made these comments and whether or not they were pharma respondents. I will provide more comments and details in the upcoming Pharma Marketing News article.

Several people doubted that the FDA would ever publish guidance for pharmaceutical use of the Internet 1.0 let alone the 2.0, social networking version of the Internet. "Regulatory agencies always regulate a few steps behind technology," said one survey respondent.

But the answer lies within the pharmaceutical industry itself. If it has an interest in getting clearer guidelines for social media marketing, it should petition the FDA to respond. The industry has brought pressure on the FDA before -- ie, to publish guidelines on the distribution of off-label information to physicians.

The FDA could take a small step and define the industry's responsibility to report adverse events (AEs) they come across on web sites -- including social media sites -- under their control. It's not really a technology issue. That guidance could simply be something like "No self-reported AEs on social media sites need to be reported by pharma on Form 2253 under the following conditions..." Under a "tit-for-tat tithe" program, the conditions define a "safe harbor" available to pharma companies who commit to spending 10% of their marketing budgets to non-branded disease awareness programs approved by an independent 3rd party.

I'm interested in other ideas, if you have any.

Rooster and Friends Win Pharm Exec Ad Stars Award

Forgive me, but I just could NOT pass this up!

In the March 2009 issue of Pharmaceutical Executive (PE) magazine, I found this image -- sans my added text -- showing the Saatchi & Saatchi Consumer Health + Wellness ad team that won a prestigious (I guess) 2009 "ad stars" award given them by the Pharm Exec staff.

PE identifies the two guys in the photo as (from left) Andrew Curtis, copywriter and Jay Marrotte, art director. The rooster, aka "cock," was not identified, although PE did claim that the rooster was "specially trained to stay up at night."

When the "Silence Your Rooster" ad first appeared on TV, I noted that most of the rooster vignettes used in the commercial were "politically incorrect": men worried about sports, cars, and creative outlets whereas women worried about vacuum cleaners and hair dryers (see "Introducing the Politically Incorrect AmbienCR Rooster"). I suspected that there were more male than female masterminds responsible for these creative vignettes. Now that I see these two guys, my hunch has been verified!

P.S. Come on guys... Tell me that I am not the only one who thought "Two guys, one cock" when shown this photo!

What's the Cause of the Drug Industry's Bad Reputation?

Thanks to everyone who responded to the "How to Earn Back the Public's Trust Survey" that Pharma Marketing News hosted online between February 4 and March 14.

I've gotten some great insights from respondents and will report the full results in the upcoming March 2009 issue in a few days. If you are not already a subscriber, you may want to subscribe now and get this issue delivered free as soon as it's published.

Meanwhile, I'll whet your appetite by presenting a few highlights from the survey here. Specifically, I'll focus on why respondents believe the industry's reputation is so bad.

This all started when I quoted Ray Kerins, Pfizer's global PR chief, who said "How in the hell do we have such a bad reputation?"

His answer: The media is the main culprit because it reports mostly bad news about the industry and not the good that it does. His solution: Engage the media more pro-actively and tell them the good the industry does. I've heard a lot of pharma executives say the same thing. In fact, the common belief among pharma PR people is that it takes 6 positive stories to counteract 1 negative story.

The "Media as culprit" argument seems to be more popular among pharma respondents and their agency allies than among healthcare professionals (HCPs) and the general public. Pharma respondents also believe the the industry has not done enough to educate the public about the benefits it provides.

However, the two most-often cited reasons among all respondents were the high cost of drugs and the lack of transparency when it comes to reporting negative clinical data.

I was a bit surprised that "profits" were not cited more often as the cause of the industry's bad reputation.

All in all, the survey indicates a bit of a disconnect between the industry and its customers -- HCPs and patients. I suppose this is to be expected.

The next question is, how can the industry improve it's reputation and earn back the trust of its customers? The survey included several suggestions, including the following:

1. The drug industry should freeze or lower prescription drug prices for everyone.
   
2. It should not lower prices across the board, but it should help by re-imbursing all or part of co-payments made by people with prescription drug coverage.
   
3. It should greatly expand its patient assistance programs to cover more people (eg, the unemployed).
4. It should be much more transparent in reporting clinical trial results.
   
5. It should do more to promote comparative studies to prove the efficacy of prescription drugs.
   
6. It should support Medicare's right to negotiate prices under Part D.
   
7. It should ramp up its PR effort (eg, pay much more attention to the media by "engaging" and "educating" them).

Unfortunately, the survey is now closed, but if you have any suggestions that you wish to contribute and to be cited in the article, please post them as comments to this post. You can remain anonymous or identify yourself -- your choice (I wouldn't want anyone to be fired because they made an honest comment to a blog!).

Follow Who's Following Me on Twitter. But NOT Phishy "pfizer" Please!

Lately I've been doing some research on who's "following" me on Twitter and I've discovered same really interesting things, including a phishy (ie, phony) "pfizer" Twitter account. More on that later.

If you don't know what Twitter is, shame on you! From Wikipedia, the free encyclopedia:

"Twitter is a social networking and micro-blogging service that enables its users to send and read other users' updates known as tweets. Tweets are text-based posts of up to 140 characters in length. Updates are displayed on the user's profile page and delivered to other users who have signed up to receive them. Senders can restrict delivery to those in their circle of friends (delivery to everyone being the default). Users can send and receive updates via the Twitter website, SMS, RSS (receive only), or through applications such as Tweetie, Twitterrific, Twitterfon and Feedalizr. The service is free to use over the web, but using SMS may incur phone services provider fees."

I first discovered Twitter almost exactly one year ago (see "I'm All a Twitter Over Twitter! Viral Social Marketing at Its Best?").

Twitter is used by many people like Shwen Gwee, part of the Business Solutions group at Vertex Pharmaceuticals and mastermind behind med 2.0 blog. I follow Shwen on Twitter (find him here: http://twitter.com/shwen) even though he violates one of my conditions for following someone on Twitter: I'm not that interested in tweets like "I'm at the barbers waiting for a haircut. There's like 7 ppl ahead of me n I need to be home in 1.5hrs for a call - hope they cut quickly!", which was one of Shwen's recent tweets.

Shwen, however, makes up for mundane personal tweets by posting a lot of information that interests me. Not only does he often speak at conferences such as the recent ePharma Summit (see "ePharma Summit: Practicing What's Being Preached!"), he "live tweets" from them. Shwen's Twitter stats are impressive: he follows 797 people, 952 people follow him (including me), and he has posted 3,504 tweets.

Compare that to my stats: I follows 45 people, 517 people follow me (including Shwen), and I have posted 359 tweets. You can find me at http://twitter.com/pharmaguy

At first I thought I'd end up "following" more people than followed me, but it was soon apparent that I could not keep up with the hundreds of people who follow me. Lately, however, I've been thinking that the people who follow me on Twitter constitute a group of "readers" I should learn more about. So every time someone new signs up to follow me -- I get an e-mail notice when this happens -- I visit his or her Twitter page to learn more. Not only am I interested in who these people are, I am also interested in who their Twitter friends (followers) are. Based upon my review, I decide then and there whether or not I should follow them. I figure that by following the most interesting people with the most friends, that will help me attract many new followers of my tweets!

Why don't I just follow everyone who follows me? The main reason is that I would need to scroll down a long list of tweets from the people I am following to find the ones that really interest me. What I need is a way to automatically filter these tweets to display only the ones that are most relevant. I'm sure there is an app for that - right?

Of course, like everyone else, I am interested in the personal lives of people and I am amazed how much personal information people post to Twitter and other social network applications. Here, for example, are some things I've learned about a few of the people who follow me on Twitter (click on their names to visit their Twitter home page):

Anu Acharya - the founder and CEO of a global genomics outsourcing company called Ocimum Biosolutions. Anu makes some interesting observations such as "Am wondering why the cosmetic industry isnt doing much genomics work. My 'make up' should be mine right?" but she also seems to have a curious hobby: "Its time to let go of Lego and shift our attention to Siftables. They are the coolest little blocks esp the music ones." What are "Siftables"? A Google search reveals: Independent, cookie-sized devices with sensing, graphical display, and wireless communication. I learned something from that, but what do I do with it?

Julia Bigpharma - (I doubt that's her real last name!) I was interested in Julia because of her Twitter handle (bigpharma) and the interesting photo she uses as her Twitter avatar icon. She's into "Pharma gossip, drug wars, and meaningful meaninglessness." I really appreciate that she tweets about my tweets that refer to my blog posts and found this among her tweets: "I'M A DUDE PLAYING A DUDE DISGUISED AS ANOTHER DUDE. This is my life, Jack!" and "My childhood hero is now a gay icon. Discuss." I'll pass on that discussion but I note how Twitter can work to my benefit: a follower tweeted about my tweet and now HER followers know about me -- maybe some of them now follow me directly! I'd like to follow "bigpharma" because I admire big women with radical views who are into 'meaningful meaninglessness." But she only has 23 followers. Sorry, bigpharma.

Marc Monseau - who works at Johnson & Johnson, and "will Tweet about topics that I'm familiar with and that I write about on our blog, JNJBTW." Of course, I also know Marc because he writes the JNJBTW blog. I follow him because of that and also because he has 381 followers and follows 304 people. That's impressive since he just got started with Twitter about a month ago! Marc also tweets about me: "Colleague Tricia corrects blog discussion: http://tinyurl.com/byralc", which demonstrates how pharmaceutical companies SHOULD be using Twitter.

Pfizer Poser on Twitter
"pfizer" may appear to be Pfizer's entry into Twitter, but I suspect this is a "phishy" account; ie, a Phony Pfizer or Pfizer Poser. What tips me off to this? Tweets like "St. Clair County woman filed suit against Pfizer & one of its employees alleging she was injured after the employee collided w/ her vehicle." Why would the REAL Pfizer post something like that, without a link to more info? Also, take a look at this one: http://tinyurl.com/apts9t -- that's the entire post! Nevertheless, the ploy worked! With only 47 tweets made, "pfizer" has attracted 347 followers and follows 346 people -- I suspect whatever bot is running this automatically follows everyone that follows it! Which proves my point about how to leverage Twitter.

It occurs to me that the REAL Pfizer should go after this phony "pfizer" and shut it down. But that's NOT my yob. What I should do is BLOCK "pfizer" from following me. But then I would not benefit from all the dupes who follow it in the belief that it is the REAL Pfizer.

Ah! You've got to love social media marketing!

P.S. Other (Possibly) Phishy Pharma Twitter accounts:

http://twitter.com/merck
http://twitter.com/bms
http://twitter.com/jnj
http://twitter.com/amgen

Pfizer Pfires Thousands of Americans, Outsources Tasks to India

"Now is the time for all good men to come to the aid of their country."
-- Typewriting exercise.

"Typewriting" has been replaced by "keyboarding," but should American jobs be replaced by "slumdog" jobs in India?

Take Pfizer. It's buying up other US companies, pfiring thousands of American employees and outsourcing "tasks" to Indian companies who hire cheap "slumdog" laborers to work on these tasks while Pfizer managers sleep!

According to BusinessWeek Magazine, "Pfizer now lets [David Cain, an executive director for global engineering] punt .. tedious and time-consuming tasks [creating PowerPoint slides and riffling through spreadsheets] to India with the click of a button. PfizerWorks, launched early last year, permits some 4,000 employees to pass off parts of their job to outsiders. You might call it personal outsourcing." (See "Outsourcing Tasks Instead of Jobs").

Some might call it "shameful!"

"Pfizer itself announced some 8,000 job cuts in January," reported the same BusinessWeek article. I'll bet some of those people that Pfizer has "laid off" or will lay off know how to do "web searches, number crunching, and other tasks" that Pfizer is now farming out to India. I am sure some of them who are in-between jobs and off unemployment insurance will be happy to work the night shift on these projects even if it means getting paid only a fraction of what they used to get paid while employed.

I've seen at least one story on the Nightly News of a former executive who had a salary of $75,000 now working as a janitor for near minimum wage! Maybe -- just maybe -- he gets health and other benefits as a perk. But those benefits are rapidly disappearing.

Kerry Ramsey said in a comment to the BusinessWeek story, "Rather than outsource this work to India why doesn't Pfizer outsource that work here in the U.S., to help this economy?"

Good question Mr. Ramsey.

Any answers Pfizer?

DTC Ad Spending Decreased 18% in 2008. Worse Than Expected!

As reported in DTC Insights published by DTC Perspectives, "According to preliminary data issued by The Nielsen Company today, the spending for DTC ads fell dramatically in Q4, which led to an 18.4% decline for full-year 2008 results. The "reported" dollar total for 2008 is $4.344 billion, compared with $5.325 billion in 2007. The 2008 total for DTC ads is comparable to the level of DTC spending in 2004."

The source of these data is the Nielsen Company: "U.S. Ad Spending Fell 2.6% in 2008, Nielsen Reports". The Pharmaceutical sector's decrease was even greater percentage-wise than the Automotive sector, which experienced a 15.5% drop in ad spending in 2008. Data does not include Internet or B-2-B spending.

New Media Ad Spending Decreased for All Industries
According to Nielsen: "New media was also hit by the tough economic climate. Internet ad spends dropped 6.4% and Network TV took a 3.5% hit. Nevertheless, television continued to be the dominant medium for advertisers, with 60% of all ad dollars spent on Network, Cable, Hispanic, or Spot TV."

It appears than when times get tough, advertisers tend to stick to "tried and true" media, or at least the media they are most comfortable with. Many pharmaceutical marketers, therefore, may feel it's a bad time for them to experiment with new media like social networks.

I have revised my now infamous DTC Spend Trend chart shown below to include this revised 2008 number:


The black bar represents my estimate of what DTC spending will be in 2009 based on a recent survey (see "DTC Spending Will Be Decimated in 2009, Experts Say" and "The Future of DTC Advertising").

I'll keep my estimated 11% decrease for 2009 DTC spending for now, but if the general economy in 2009 is worse than in 2008, we can expect to see an even greater decrease.

Who Are the "Anti-DTC" Bloggers? This Blogger Wants to Know

It's Friday and you know what that means! The John v. Bob show, where I respond to Bob Ehrlich's weekly DTC Perspective's blog post. When I started doing this, I thought it would be a win-win scenario: I'd mention Bob's blog and he'd mention mine. We would both gain interested readers from each others loyal following.

Lately, however, it's all been one-way: Bob has not mentioned Pharma Marketing Blog at all in his posts, let alone linking to my blog. I continue to mention his blog, but have dropped the link -- you can find that over on my other blog that tracks pharma-related blogs (Pharma Blogosphere).

Today Bob takes on -- and mentions frequently -- Jim Edwards, the author of BNET Pharma, in his post entitled "The DTC Myth?" It's all about an Ad Age story about sleep aid drug sales rising despite a drop in DTC ad spending in that category. Edwards claimed that "this data strongly suggests that patient demand is most sharply triggered by drug efficacy, not by pretty pictures flickering in a fluorescent tube."

Bob takes exception to that conclusion. Turns out I agree with Bob and refuted Jim Edwards last week in my post "Economy Down, Insomnia & Depression Up. Result: Less Ads Needed to Sell More Drugs?" in which I said: "I don't believe these numbers can be interpreted to mean that DTC advertising does not lead to increased sales of brand name drugs." More importantly, I also questioned the "data" that AdAge cited and concluded that not much decrease in DTC spending occurred at all.

But that's not what I really want to talk about.

I want to discuss what Bob means when he says "I am sure the anti-DTC bloggers will try to make the sleep aid story a big deal but DTC will be evaluated objectively at big pharma." Specifically, I want to know who Bob is talking about when he says "anti-DTC" blogger, which he often does.

Being paranoid and an "it's-all-about-me" kind of guy, I immediately think Bob is talking about me. But he could also be talking about the Wall Street Journal Health Blog or BNET Pharma (Jim Edward's blog).

It's too bad we have to sully the discussion of issues with labels like "pro" and "anti." At times, I am as guilty as the next person, putting people into categories. For example, I categorize some blogs as being "anti" industry or "pro" industry and have even surveyed blog readers to see who THEY think are biased for or against the drug industry (see this summary of the first Pharma Blogosphere Survey).

Am I an "anti-DTC blogger?" You can vote below, but first let me say this: First of all, I did not use the AdAge article to rant against DTC and did not make a "big deal" out of it.

If anything, I am anti broadcast DTC advertising because it soaks up too much of the DTC marketing budget, wastes money, is not educational, and opens the door for ridicule of the industry and contributes to its bad reputation. So, if that makes me an "anti-DTC" blogger, so be it. I'll have to live with that label.

Is John Mack an "Anti-DTC" Blogger?
	Yes, he obviously is against all forms of DTC advertising.
	Maybe, since he admits he is against broadcast (TV) DTC.
	I'd say no. But he definitely is a DTC critic, which is not the same as anti DTC.
	Come on! The guy is DEFINITELY anti-DTC all the way!
	This is not important to me and it's a waste of my time to even reply!

Why It's Important to Monitor & Engage in Social Media

This morning I posted about Debbie Phelps being "purged" from McNeil Pediatrics ADHD Moms™ Facebook page (see "Debbie Phelps Purged from McNeil's ADHD Moms Facebook Group. How Cruel!").

That blog post was picked up by Jim Edwards on BNET Pharma in his story, "McNeil Axes Michael Phelps' Mom From ADHD Facebook Page."

Now, both Jim and I have egg on our faces! McNeil's Tricia Geoghegan wrote the following comment to my blog post:

Debbie Phelps' departure from our ADHD Moms(TM) community was scheduled to occur in January 2009 and to prepare for it, we shared this news with fans in a few ways that month. Starting on January 7, 2009, we sent a notice to our Facebook community fans about Debbie's departure; it was sent to the "Updates" section of fans' personal Facebook pages. It read:

"New Year, New Start!
Wednesday, January 7, 2009
New Year, New Start! ADHD Moms will unveil new features and new faces in 2009. This month, Debbie Phelps passes the torch of advocacy to ADHD Moms fans and shares a note of thanks for the memories and support in 2008. Be sure to visit ADHD Moms frequently as we introduce new resources to the community in the coming weeks."

Additionally, from Jan. 7 through Jan. 30, 2009 we posted Debbie's good-bye letter along with a farewell letter to her from our community on our Facebook website homepage.

I should have contacted the company before I made my post to avoid this embarrassment and bad press generated because of my post. I regret not doing that. The only thing I can say in my defense is that whenever I have called the PR people at pharmaceutical companies in the past, I have never received a reply.

Shift Happens!

It appears that pharmaceutical companies are paying more attention to bloggers and other "consumer-generated content" and are willing to engage in the conversation, especially if they feel a need to correct a mistake.

Just today, Jeff Trewhitt, Senior Director, PhRMA Communications & Public Affairs, made a comment to another post ("As Innovation Shifts to Small Companies, How Will Big Pharma Defend High Drug Costs?"). He was interested in my survey on how pharmaceutical companies can improve their public image.

"This is one time when it is better for me to sit back and read and learn rather than respond, though on other occasions, I may weigh in if you don't mind," said Jeff.

I don't mind at all! I invite ALL my pharma friends to sit back, read, enjoy, and by all means weigh in whenever you feel like it!

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P.S. Who is Tricia Geoghegan any way?

It occurred to me that I did not verify that Tricia Geoghegan is employed by McNeil Pediatrics and has the authority to speak for that company. I guess I could call the company switchboard, but I haven't got time for that!

So, I searched for her on Twitter and found out she has a Twitter page (http://twitter.com/triciageoghegan) and follows Marc Monseau, communications director at J&J, who also has a Twitter page. But I can't see Tricia's tweets unless she wants me to -- so, I sent her a request for permission to follow her on Twitter.

I also found her on Facebook where she says "My goal in life is to be the person my dogs think I am..." Her Facebook friends are Marc Monseau and Peter Justason, also of J&J. Both Marc and Peter are friends of mine on Facebook (in real life too!). Tricia plans to attend the 2009 National Walk for Epilepsy and attended Obama's inauguration on CNN, just as I did! Sounds like a person I'd like to know better, so I made her my friend on Facebook!

Debbie Phelps Purged from McNeil's ADHD Moms™ Facebook Group. How Cruel!

[SEE CORRECTION AT END OF THIS POST.]

Back in August, 2008, I asked Debbie Phelps to be my Facebook friend but I never did hear from her, which prompted me to write a post about the ADHD Moms™ Facebook group sponsored by McNeil Pediatrics™, Division of Ortho-McNeil-Janssen Pharmaceuticals, Inc., a J&J company (see "J&J, Debbie Phelps, You, Me, Facebook: Is This Social Networking?").

At that time, Mrs. Phelps was a "Leader" of the ADHD Moms™ Group. Today, however, she has been purged from is longer part of the site. No longer is she a leader of the group and the article she wrote -- "Back to School: Help Your Child with ADHD Succeed In and Out of the Classroom" -- is not to be found on the site.

How cruel!

I'm not saying that this is punishing the parent for the "sins" of the child, but it's cruel because what Mrs. Phelps is dealing with may be what many parents of children -- even adult children -- with ADHD must deal with! I, for one, would have loved to hear what Debbie's thoughts were on her son's bad bong behavior at a party.

[I admit that I do not know the real reason why Debbie Phelps was "purged" from ADHD Moms™ It may be that she requested that her name and article be removed, but I doubt it [SEE BELOW]. In any case, friends of ADHD Moms™ -- of which I am one -- have not been notified about this. Instead, McNeil Pediatrics posted this notice on the Group page: "ADHD Moms™ has a new look! Facebook has changed its Page design in an effort to improve the user experience. Stay tuned for new features in the coming weeks." Put the blame on Facebook!]

Just so you know: Debbie Phelps still has a Facebook page and the following are typical of messages from other ADHD moms (real moms of kids with ADHD, not ADHD Moms™ Facebook Group members) posted to Debbie's Wall:

"We still love you and Michael too. Just remind him that he is a role model and a beacon for all kids with ADHD. We need for him to take care of himself and to do all that it takes to be in good health." -- Caren W. Madsen, Washington, DC (shown here hugging president Obama who's loving it!).

"I just wanted to show you a little motherly support for what is going on right now. My kids love your son. I am sorry his life is in the spotlight all the time. While I do think he is a role model, it is my job to explain to my children that role models are still human. Humans make mistakes. Best wishes." -- Ann Mitchell Caren, Atlanta, GA

HURRAY for REAL ADHD moms! As opposed to the virtual ADHD Moms™

Too bad McNeil Pediatrics missed an opportunity to REALLY support a real ADHD mom by supporting Debbie Phelps and keeping her involved in the ADHD Moms™ Facebook Group.

"The rise in botched endorsement deals with the likes of Michael Phelps and Chris Brown has marketers rethinking recruiting young, megawatt stars as brand ambassadors, celeb watchers said today at a gathering of top advertisers," claims an article in today's AdvertisingAge ("At Least Elvis Can't Get Caught Smoking Pot").

"One way to hedge your bets: Make a deceased celebrity the face of your brand. They are (for obvious reasons) far less likely to ignite media firestorms with callous behavior."

In the case of McNeil Pediatrics and ADHD Moms™, I think the media "firestorm" over Michael Phelps' pot smoking incident could have been a great opportunity to raise more awareness about ADHD issues.

Now, don't get me wrong. I am no fan of celebrity endorsements of Rx drugs. However, in the case of ADHD Moms™, we're talking about using celebrities for disease awareness promotion, which I don't have too much problem with as long as the celebrity actually has the disease or is related to someone who has the disease or is a caretaker of one. Whatever. You get my point.

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RESPONSE FROM MCNEIL PEDIATRICS:

Debbie Phelps' departure from our ADHD Moms(TM) community was scheduled to occur in January 2009 and to prepare for it, we shared this news with fans in a few ways that month. Starting on January 7, 2009, we sent a notice to our Facebook community fans about Debbie's departure; it was sent to the "Updates" section of fans' personal Facebook pages. It read:

"New Year, New Start!
Wednesday, January 7, 2009
New Year, New Start! ADHD Moms will unveil new features and new faces in 2009. This month, Debbie Phelps passes the torch of advocacy to ADHD Moms fans and shares a note of thanks for the memories and support in 2008. Be sure to visit ADHD Moms frequently as we introduce new resources to the community in the coming weeks."

Additionally, from Jan. 7 through Jan. 30, 2009 we posted Debbie's good-bye letter along with a farewell letter to her from our community on our Facebook website homepage.
Thanks, Tricia Geoghegan
McNeil Pediatrics