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!