Wooing Dems: Thank You Mr. Kindler!

According to the Financial Times (FT), the recent changing of the guard at several big drugmakers, including Pfizer, the world's largest, may make it easier for drug industry lobbyists to woo democrats.

"Democrats may be more willing to lend an ear to chief executive Jeffrey Kindler than former chief executive Hank McKinnell, who was a large donor to the Republican party," reported FT (see "Big Pharma on a mission to woo Democrats").

FT went on to report "Records collected by the Center for Responsive Politics show that Mr Kindler donated $10,200 in this election cycle. The beneficiaries were all Democrats."



That's about 0.2% of the $4.5 million Pharma donated to Democratic candidates (vs. $10 million lavished on Republicans). Some hedge bet!

Mr. Kindler's largesse notwithstanding, the drug industry is marshaling its forces to defend its gains. As I mentioned in yesterday's post (see "What's In Store from Congress?"), there are several proposed legislative changes that the industry is anticipating it must fight. What's your opinion?

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Pharma Marketing News is currently hosting an online survey to determine how likely these changes are according to pharmaceutical marketing experts. You can take the survey here. You will be able to see a de-identified summary of the current results after you complete the survey. I plan to also write up a summary of the results for the December issue of the newsletter. Your responses are held strictly confidential unless you give me permission to use your name.

What's In Store from Congress?

Now that the elections are over, the pharmaceutical industry is left to ponder what the new Congress has in store for it. There has already been a lot of speculation in the general press and trade media (see this compilation of articles) as well as some shots fired across the bow by Congress.

It's not just democrats itching to get at Pharma. For example, the Senate Committee on Health, Education, Labor, and Pensions (HELP) chaired by Sen. Michael B. Enzi (R-Wyoming), met in full session on November 16, 2006 ("Hearing on Building a 21st Century FDA: Proposals to Improve Drug Safety and Innovation;" access audio and testimony from this hearing here) and Senator Charles Grassley (R-Iowa) has put a hold on the nomination of Dr. Andrew C. von Eschenbach for commissioner of the FDA (see "Hold It!").

One bill currently before the HELP Committee is S. 3807: Enhancing Drug Safety and Innovation Act of 2006: A bill to amend the Public Health Service Act and the Federal Food, Drug, and Cosmetic Act to improve drug safety and oversight, and for other purposes. This bill is also known as the Enzi-Kennedy after the senators that sponsored it. These same senators head up the HELP Committee.

Here's a synopsis of the issues and changes experts have predicted that the drug industry will be subjected to in the next legislative session:

Drug Price Related

• Medicare reform -- allow government to directly negotiate prices with pharmaceutical companies
• Allow drug importation from Canada
• Patent Reform -- set limits on whether big pharmaceutical firms can make deals with generic drug makers

Marketing Related

• Enact a mandatory 6-month, one- or two-year moratorium on ads for new drugs
• Require FDA pre-clearance of all DTC ads
• Wipe out or limiting tax deductions for advertising expense
• Require a "black triangle" in ads and labels for new drugs
• Set standards for risk presentation that make broadcast ads infeasible

FDA/Drug Approval/Safety Related

• Hold up of Prescription Drug User Fee Act (PDUFA) reauthorization
• Make FDA more powerful -- eg, create office of drug safety within FDA, give the FDA the power to fine companies to force them to do safety studies or change the labels of drugs (Grassley-Dodd and Enzi-Kennedy bills)

Recommendations to the Congress by the Institute of Medicine (see "IOM Report Calls for DTC Moratorium") and the Enzi-Kennedy Bill are top of the list items under consideration as reflected in the testimony before the HELP Committee. See highlights of testimony below. Meanwhile, please consider what your own opinion is:

Take the Pharma Marketing News Online Survey
Pharma Marketing News is currently hosting an online survey to determine how likely these changes are according to pharmaceutical marketing experts. You can take the survey here. You will be able to see a de-identified summary of the current results after you complete the survey. I plan to also write up a summary of the results for the December issue of the newsletter. Your responses are held strictly confidential unless you give me permission to use your name.

Testimony Highlights
Several witnesses at the HELP Committee hearing framed the issues and specifically discussed S.3807 and the IOM report. I pick two from "opposite sides of the aisle"; that is, a pharmaceutical company representative and a consumer representative.

Highlights from testimony by Dr. Adrian Thomas, Vice President, Benefit-Risk Management, Johnson & Johnson Pharmaceutical Group (see complete statement here).

On S.3807: "We support the use of Risk Evaluation and Mitigation Strategies proposed in S. 3807 to enhance safety, where these strategies are most needed. We believe the proposed Reagan-Udall Institute could be a valuable impetus to spur scientific innovation if consistent and adequate appropriations are provided. We support the provisions of S. 3807 and the IOM report regarding the registration and disclosure of results of confirmatory clinical trials. We support efforts to manage conflicts of interest in FDA Advisory Committees and to enhance transparency while retaining FDA’s access to expertise. Finally, we believe that Congress should adequately fund the Food and Drug Administration in the interest of all Americans."

On DTC Moratorium: "Another remedy that should be reconsidered is the proposed ability of FDA, under the legislation, to impose a moratorium on direct-to-consumer (DTC) advertising for up to two years. This restraint on advertising represents a troubling change. Many members of the industry, including Johnson & Johnson, have voluntarily agreed to exercise restraint with respect to DTC advertising, especially during the period of time after approval. But appropriate DTC advertising plays a valuable role in educating patients about diseases and treatments. The value of this education to patients, as well as the important First Amendment issues that arise from banning truthful speech, even for a period of time, must be carefully considered before legislating in this area. At a minimum, the standard for imposing DTC advertising restraints should be much higher than is currently articulated in the legislation, to ensure appropriate application of this new authority."

Highlights from testimony by Mr. Jim Guest, President & CEO, Consumers Union (see complete statement here).

On DTC Moratorium: "In light of the promotional nature of DTC advertising and the long history of abuses in DTC advertising, and given that such advertising strongly influences consumers, Consumers Union recommends a requirement that ALL advertisements be pre-cleared by the FDA for accuracy and honesty, including the growing use of ads in the Internet and other non-traditional sites. In addition, the FDA may impose a two (2) year moratorium on DTC advertising for drugs showing more serious safety concerns. Given the amount of influence this type of advertising has on consumers, and given the potential serious ADRs that may occur years after approval, Consumers Union recommends a moratorium on DTC advertising of three or more years for all new drugs. The history of ADRs and withdrawals shows that drugs cannot be assumed safe after just two years. Adding possible third year to the moratorium authorities in S. 3807 would be prudent and constitutional."

On Off-Label Use of Drugs: "S. 3807 is silent on the issue of off-label use. Given the potential for off-label uses to create serious safety problems, Consumers Union recommends that the FDA develop a program to scientifically study drugs widely used in off-label settings. We are not advocating a ban on such use. We are simply asking that some scientific study be brought to this area, so that the labels on these drugs may be expanded and improved in the cases where the scientific evidence is supportive."

What Do You Think: Take the Pharma Marketing News online survey.

Not Your Father's eDetail

The recent eyeforpharma eCommunications and eMarketing conference held in Philadelphia included an international mix of speakers and attendees. I met pharma people from China, Peru, Germany, UK, and Mexico as well as the US. Of course, all were proponents of "e" for marketing and the two most discussed topics were social marketing on the consumer side and eDetailing on the physician side. I covered the social marketing discussion in a previous post (see "The Girl from Google"). Here, I cover eDetailing.

Mark Bard of Manhattan Research moderated a panel discussion entitled "Using the Internet to Support and Evolve Sales." Panel members included Craig DeLarge, Associate Director of eMarketing at Novo Nordisk, and Clay Butterworth, eMarketing Manager at Shire.

Bard, as usual, opened with some numbers regarding physician use of the Internet and adoption of eDetailing. He summed up the current eDetailing situation succinctly by stating "Half our clients think eDetailing will be dead in 2 years, the other half says it will take off." He pointed out that for eDetailing to take off it has got to change and get more in sync with what physicians who use the Internet want, which is something Bard knows a lot about (see, for example, the report that Manhattan Research was handing out at its booth: "Trends Impacting Consumer and Physician eMarketing).

Bard presented some data showing that the percentage of physicians using eDetail programs in the past year has leveled off at around 40% -- no longer growing, in other words. However, only 20% of docs say they have absolutely no use for eDetailing. That leaves 20% who might have use for it if it offered them what they want. Unfortunately, a lot of them want money or cash equivalents. Although pharmaceutical companies have gotten away from a "pay for view" regime, which is frowned upon by the watchdogs, some have worked around this issue by paying physicians to take a short survey after the eDetail. Some doctors have their children press the forward button to get through the eDetail so that they can get to the money at the end.

To entice doctors to participate in eDetails without monetary rewards, some vendors have come up with hooky ways of engaging docs such as pretending that the eDetail is a soccer match. One presenter admitted that this wouldn't work in the soccer-challenged US market. It might just be as boring as the game itself! Maybe the doc's children will enjoy it though. (OK, have at me in the comments.)

The core problem with eDetailing remains: it's still a sales activity rather than an information sharing or communication activity that physicians prefer. It's worse than a live sales rep. A savvy physician can manipulate a rep to just deliver the goods -- essential prescribing information and samples. I suspect that manipulating computerized eDetails is not as easy -- and you don't get the samples at the end!

DeLarge agreed -- and I am paraphrasing him here -- that eDetails are too sales focused vs. customer insight focused. There is an opportunity, DeLarge said, through the eChannel, to get a better idea what physicians want vs. being another sales channel. "Companies that do this well will have a tremendous competitive advantage in the next 2-5 years," he said.

I also heard from pharmaceutical people at the meeting that eDetails "still cost too much" although they agree that the ROI is good.

A new vendor in the space asked what pharmaceutical companies wanted from eDetail vendors. What the best vendors offered were eyeballs (access to physicians) and analytics. Pharma companies actually want to own the physicians and are not content to "rent" lists from vendors. Some vendors have pushed back and refused to deal. That may be the Achilles heal of eDetailing.

One of the highlights of the conference was my live podcast during the lunch break on the second day.

Joining me for my podcast was Mark Bard, President, Manhattan Research, Harry Sweeney, CEO of Dorland Global Health Communications, Svetlana Toun, SVP, International Strategic Alliances, Alansis Media, Steven Krein, CEO of OrganizedWisdom, and Unity Stoakes, CMO at OrganizedWisdom. Fard Johnmar, Founder of Envision Solutions, L.L.C. and fellow blogger over at Healthcare Vox also joined in by phone.

Listen to what these experts have to say about social networking and how pharmaceutical marketers should get involved. Click here to listen to an archive of this podcast. You will need Microsoft Media player. Go to the Pharma Marketing Talk Host Page for other options and to listen to previous podcasts.

The "Girl from Google"

"I could strangle that girl from Google," said a friend of mine after a presentation by a Google operations specialist at the recent eyeforpharma eCommunications and Online Marketing conference held in Philadelphia. Of course, this was not a literal terroristic threat, just an expression of frustration by a long-time industry advocate.

What did the "Girl from Google" (GfG) say that upset this person so much? 

The "Girl from Google" (GfG) was up just before my presentation and the title of her talk was "The Importance of Interactivity: How multimedia technologies will change the way you Connect with Consumers & Physicians."

It was actually a nice presentation but it could have benefited from a little legal/regulatory review beforehand. GfG was one of those presenters who have little or no experience working within or for the pharmaceutical industry. Her bio in the conference brochure says only that she has worked with Google for three years (congrats on the stock options!) and graduated with a Masters Degree form the University of Southern California (party on!). I estimate that GfG joined Google straight from school.

I had only one little problem with her presentation.

Influencing the Dialogue: Marketers Suck at It!

My post to this Blog back in July, 2006 entitled "Rozerem Ads Dis Lincoln, Show Beaver" has generated the most comment and is top-rated on Google searches for "rozerem ad" or "rozerem commercial."

Interestingly, the Rozerem marketers or their "buzz" agency lackeys -- maybe even the folks at Abelson-Taylor, the lead Rozerem ad agency -- are attempting to hijack the conversation by submitting commercial messages (ie, ads) disguised as genuine comments from ordinary citizens. One example is the following anonymous comment:

"I found this page because I googled 'rozerem commercial' to find more information about the ad because I find it to be compelling and curious. I am just your average 44 year old woman and I can't get this ad out of my mind. The imagery is intriguing and each time I see the advertisement I try to catch things I may have missed before: the beaver is eating eggs and sausage, so it must be a morning after insomnia. The beaver's speaking voice is particularly attention getting and I don't see it as a sexual image. I think the ad is funny, thought provoking, and cute and represents the random nature of our dreams. The advertisement has worked for me..I take Ambien and have been considering switching to rozerem. I guess that says it all."

I don't for a minute believe this is a genuine comment from an "average 44 year old woman," do you?

Is this a genuine comment from a consumer?

Yes No

I have mentioned before that when marketers try to influence consumer or user generated content (UGC) on blogs and on bulletin boards they really, really suck at it (see, for example, "Question Everything").

Here's how I know the above comment is fake:

• What self-respecting, average 44 year old woman would bother searching Google for "rozerem commercial"? Only a self-absorbed ad agency guy who was involved with creating the commercial would ever do that!
• "compeling and curious" are two buzz words that a "creative" ad agency would use. Other ad agency buzz words used here include "imagery", "intriguing", "attention getting", and thought provoking". An ad agency measures its success by how "compelling" and "thought provoking" its ads are, not by how much product it sells. In the case of Rozerem, sales are definitely not compelling (see "Rozerem Ads Innovatively Ineffectual").
• Finally, the last sentence was the dead giveaway -- the call to action! It's what every ad should include. Obviously, it's just a bit of wishful thinking in this case.
  

In other words, this is an ad disguised as a genuine comment!

The Rozerem marketing folks have done a poor "impact vs. risk" analysis of this doomed attempt to slip in an ad as a genuine UGC comment. First, the impact on sales of Rozerem is pretty minimal, especially when the effort is wasted on submitting comments to this blog. Second, the risk is high because the marketer is not in control of this channel, I am! Did you guys think I would just roll over and allow the comment through? But it was even more risky because now I am "outing" you and exposing you to ridicule. All of which could have been avoided if you were just honest with me and my readers!

Pharma Marketing Blog perhaps is not as democratic as are some patient blogs or online discussion boards. Maybe many of these are not moderated and allow all comments through. Yet, my experience with such UGC venues -- I used to host a diabetes online discussion board -- is that they are much less forgiving than I of attempts to hijack their discussions by marketers or shills of marketers.

I suggest, therefore, that marketers engage in honest dialogue with consumers if they are going to insert themselves into the conversation. Here are a few simple rules:

1. Identify yourself. Don't try to hide behind anonymity. It doesn't work.
2. Acknowledge your true motive, which is to help sell more of product you believe in. You do believe in it, don't you?
3. Encourage dialogue. You might learn something you can use. Just think of it as a free focus group.
4. If things go wrong, don't argue. Change course or retreat to fight another day.

In other words, be transparent!

Unfortunately, this can never happen in the real world where pharmaceutical marketers engage outside agencies to do their bidding. The agency cannot be transparent; it's contrary to their very nature. Also, too much money and too many careers are at stake.