The golden rules of PR

pharmafile | June 29, 2005 | Feature | Medical Communications |   

In light of the enormous potential brand benefits of pharma PR,  the question should not be 'Shall we invest in PR?', but 'How do we ensure our chosen campaign comes up to scratch?'. Is it really as simple as using a couple of golden rules or are there more complicated factors at work?

In trying to identify the elusive golden rules, the reasons behind the re-examination of PR programmes must be acknowledged. Has anything really changed?

If we consider the reputation of the industry overall, then the resounding answer is 'yes'. In the last year or so the pharma industry has been subject to an unprecedented number of detrimental stories, the most high profile of which leap immediately to mind, not only to industry insiders but also to the general public. More worryingly, it is difficult to think of a positive, high profile story about any aspect of the industry that has become a talking point for lay people of late. This is something that can, and should, be tackled.

As well as its relatively poor public perception, the industry is also facing pressure from those in power to tighten its regulations. The recent Health Select Committee (HSC) report into the influence of the industry may see the regulatory goalposts for healthcare PR programmes being rapidly re-adjusted.

The report made numerous, and at some points, radical recommendations, ranging from the extension of regulations regarding  promotional materials to cover quantity and quality available at launch (including pre-publication vetting by the MHRA) to the limiting of prescribing powers for new drugs.

The report also contained a critique of well-established pharma marketing practices, including ghostwriting, disease awareness programmes and interactions with key opinion leaders and patient groups, all of which were portrayed in a disappointingly similar light.

The attitude is exemplified by conclusions on disease awareness campaigns: "While disease awareness campaigns may be valuable, the presence of company logos and use of [certain] tactics…clearly suggests that these are not merely health promotion tools."

This damning comment failed to acknowledge the possibility of two concomitant outcomes (ie, patient and brand benefit) from such a project and highlights the uphill struggle the industry faces to reassure those in power, as well as the general public, of its integrity.

In response to the report, the ABPI released a statement partially defending the honour of the industry and refuting some of the important claims regarding the perceived prescription explosions post-launch, intensive marketing and the 'over-medicalisation' of society.

They also pointed out that the industry's own Code of Practice covering the promotion of medicines to health professionals was currently under review and insisted that the revised version would take into account the conclusions of the HSC.

So, what exactly are the implications of all this? One thing is clear – in the current climate the pharma industry cannot afford to take unnecessary risks with its reputation. In light of the ABPI's defence, possible funding problems and a sheer lack of administrative manpower, it is difficult to predict exactly which of the HSC's marketing recommendations will be implemented following the re-election of Labour in May.

It is likely, however, that there will be further restrictions on pharma marketing practices by both the industry self-regulator and the government. This does not mean that it is time for the industry to curl up and hide – quite the opposite, it needs to come out fighting, but fighting fair.

Are PR campaigns the most effective way for the pharma industry to communicate with their key stakeholders, and do their outcomes really justify the expenditure? Successful campaigns are often complex and far-reaching and at times can be difficult to evaluate, particularly in monetary terms. Aspects such as relationship-building, issue management and raising  awareness are all crucial to a profitable campaign and cannot be measured by a simple mathematical formula.

This has sometimes led to the perception of PR as potentially tricky to justify in comparison to other aspects of the marketing mix. That does not mean that PR effectiveness cannot be proven, but rather that the evaluation needs to take into account not only ROI to a certain degree, but also other agreed outcomes and targets (ie, PR proving its worth through tangible evidence). In fact, the main concern for a company should be maximisation of investment by ensuring a first-class campaign. This is highlighted by the fact that a strong, well-executed PR campaign that meets its objectives and targets can be of huge importance to the success of a brand – a poor campaign can, of course, damage it irreparably.

Two golden rules

When trying to pinpoint golden rules it is important to remember that healthcare PR is different to PR in other industries due to the nature of the products being promoted. The brands we support often have life-changing effects on their consumers and in this sense consumers are literally putting their lives in the hands of the products. This simple but pertinent fact is key to understanding the needs of the pharma industry and their customers and has implications in all areas of the promotional programmes undertaken in this field.

Keeping this unique aspect of the products in mind the first golden rule for a successful pharma PR programme is the identification of common ground. So, often, when the industry is accused of underhand practices and dubious motivations, it is because of the conflicting ideals of the stakeholders involved.

Everyone appears to be fighting from different corners, like a star-shaped tug of war where the centre of the star can be likened to the product environment.

With each stakeholder tugging in a different direction there can be little change in the product environment but a surprising amount of time and sweat involved in preventing the status quo from shifting too far in an undesirable direction. However, with a common goal and parties working to the same end, a large shift in the market can be achieved. The successful Narcolepsy and Herceptin case studies (see below), where all interested parties worked closely together, both focused on a common goal that, most importantly, was clearly aligned with patient benefit.

Narcolepsy

In 2003, a Cephalon-sponsored programme aimed to raise awareness of the condition of narcolepsy. Prior to the campaign the condition was little known by the public and poorly understood in primary care.

The PR agency secured two major broadcast documentaries, Nap Attack on BBC1 and Living Nightmare, on BBC2's flagship science programme Horizon. Case studies, patient groups and clinicians in the area participated in the programmes and narcolepsy factsheets were produced and disseminated to facilitate spin-off coverage. The audiences for the documentaries exceeded 11 million and over 114 pieces of print coverage directly resulted from the broadcasts including several case study-led features. Coverage was also secured on several other television and radio programmes.

The campaign successfully placed the public spotlight on narcolepsy, raising awareness of the issues that face sufferers in their day to day lives and led to a remarkable change in public perceptions. Clinicians reported an immediate increase in both patient and GP referrals and therefore a dramatic reduction in the time to diagnosis. Nap Attack was so seminal that it was celebrated as 'one of the most important factual moments' in Jonathan Ross' review of TV moments of the year. Other PR campaigns have had mixed success.

Becoming whiter than white

With the responsibility of patients' health in the hands of the industry and the increase in regulations that are likely, the second golden rule is clear: communication programmes must be honest, ethical and beyond reproach in every aspect of the planning and implementation stages.  

Recent problems encountered by some of the world's biggest selling medicines have been confounded by allegations of suppressed negative data and the damaging publicity it attracts upon its release to the public. If there is anything the industry can take from these experiences it is that they must learn to bite the bullet when it comes to potentially damaging data.  

There is no point putting the problem on the bottom of the 'to do list' and letting it fester. The public want the pharma industry, on which they rely, to treat them with some respect. When data is withheld it can only be expected that the media will jump on the story and represent it in an incredibly negative light. By being honest and upfront, damage limitation strategies can be set in motion and dialogue established with key stakeholders explaining data implications.

With the industry reputation under scrutiny it's not just bad data that needs to be approached in an honest and pragmatic manner but all aspects of a PR programme. There must be no question of unethical practices – all aspects of a campaign must appear whiter than white to ensure the authenticity of the messages and there is no room for clouding the picture.

Can pharma PR campaigns achieve success purely on the back of those two golden rules? Of course not. There are still the standard PR 'rules' that apply across the board: including careful research and planning, creative thinking, realistic objectives, well-organised implementation and thorough evaluation – but a PR person from any industry could have told you that.

What the pharma industry really needs to do before launching a new communications programme is to stop and think. These two rules may not seem like rocket science, but too often PR programmes run away with themselves. By keeping things simple, learning from the success and failures of others and playing by the pharma golden rules, PR can meet the needs of the pharma client without compromising its reputation.

CASE STUDIES – 3G Technology

The launch of 3G handsets by 3, into the UK market was a campaign covered by PR Week. The campaign was devised and implemented over two and half years, to 'manage expectations' for the new product after the flop of WAP technology. Following an extensive advertising campaign and product demonstrations the technology was launched to the public on 3 March 2003 (03/03/03) amidst much confusion.

Three shops were opened for consumers to experience the new technology, but they were unable to buy the product. In fact, there was an expected wait of four to six weeks for each handset and the network coverage was limited to southern England.

Consequently, the launch received a very high proportion of negative media coverage. Though it was a memorable date and relevant to the brand it is without  question imprudent to launch a brand when the technology is lacking.

The programme lacked the ability to meet objectives through a combination of public miscommunication and logistical problems.

Upon realisation of the potential damage to the company and brand's image, those involved in managing the programme should have been brave enough to reassess the communications plan. It is imperative for a successful programme that problems are dealt with effectively so promises can be delivered upon.

Herceptin – Breast cancer postcode prescribing

A programme implemented in 2003, on behalf of Roche, with the support of CancerBACUP, focused on the problem of postcode prescribing.

Market research had highlighted that uptake of the drug Herceptin varied considerably from region to region with only 14% of women having access to the treatment in the Midlands, rising to up to 61% in the South West.

An audit of Herceptin use prior to, and after, the NICE approval, validated by the Department of Health cancer tsar, was funded and used as a basis for a tiered media outreach programme that had the support of all the key stakeholders. The media coverage included broadcast print and online articles, reaching an audience of 123 million and CancerBACUP recorded a 19% increase in breast cancer calls to their helpline. The campaign successfully highlighted access variations to Herceptin to the public, political and clinical audiences and  produced positive action on the issue. The results led to a report (published December 2004) recommending the introduction of deadlines on the implementation of NICE guidelines.