Whatever happened to e-marketing?

pharmafile | March 17, 2006 | Feature | Sales and Marketing |   

Is e-marketing dropping off pharma marketing's radar, or are opportunities going begging? Three or four years ago, it was the great white hope of marketing; using a couple of proxies, Google, and the Communique Awards, for the current popularity of a marketing technique can illustrate how high a priority it has. Today, if you do a search on Google, you will find a few reports from 2000 and 2001 gathering cyber-dust, but very little evidence of new activity.

You can also search in vain among the categories of the Communique for any mention of e-marketing. The categories cover all the old warhorses: Best Professional Education Project, Best Use of Surveys or Data, Best Opinion Leader/Advocacy Development, Best Use of UK Meetings… the list is long. No sign of e-marketing, though. Does that mean it has become part of the wallpaper, like, say, direct mail (which does have its own award), or has it gone away?

What is e-marketing, anyway? Well, in its broadest sense, it means exploiting the electronic channel by any means available. It doesnt just mean static information-only websites, but includes targeted opt-in emails, database-driven websites, which allow much more personalisation, and web services.

Some of the new developments in the web also offer opportunities. Known collectively now as Web 2.0, these include blogs, various forms of many-to-many publishing, social software, online web services, and others.

According to Wikipedia, "Proponents of the Web 2.0 concept say that it differs from early web development, retroactively labelled Web 1.0, in that it is a move away from static websites, the use of search engines, and surfing from one website to the next, to a more dynamic and interactive World Wide Web.

Industry consultant, Erik Jan Scholten, until recently managing director of medeConnect, thinks pharma is missing some major opportunities, even in Web 1.0: "E-marketing lacks momentum in the industry. Amazon developed and gained momentum, and through its Grow Big Fast strategy, it developed a new market space.

"E-marketing in pharma has not been able to generate a momentum, and adoption is still piecemeal. This does not mean it is not the right way forward, it means it has not been adopted as a tool, yet.

"However, this creates a value gap in the doctor's mind. Doctors are on the web, and they get information and education through that medium. The fact that pharma is not there means they are not providing doctors with added value.

"Instead, pharma is still forcing doctors to do things their way- seeing reps, attending meetings- instead of providing doctors with an integrated communication where they can choose to be educated online or at meetings, find out about a product online or from a rep, or both.

"Pharma is still too product-focused, not customer-focused and the communication, in terms of content and methodology, is still what pharma wants to say, rather than what the doctor wants to hear."

Before e-marketing could get to its current position it more or less followed a dotcom style boom, then bust, then levelling out. Steven Bauer, general manager of DXS explains: "After a bullish start in the late 90's when pharma invested heavily in e-channels- primarily e-detailing, initially unrealistic expectations preceded disappointing results. However, a more cautious and well thought through approach is now well underway."

Although pharma companies have varying levels of in-house expertise to deal with

e-marketing, Bauer says they are recognising the important place that e-channels occupy in the promotional mix, and are upskilling appropriately.

Doctors, the internet and e-detailing

Perhaps the most prominent and certainly the most heavily hyped element of pharmaceutical e-marketing, is e-detailing. The idea is, or was, that e-detailing, or putting product details on a website so that doctors could use them in their own time, would reach those doctors who wouldn't see reps, as well as encouraging doctors to prescribe the detailed product more frequently.

The lack of clarity over the impact of e-marketing extended also to e-detailing. Marketing director at OnMedica Steve Doyle says: "When e-detailing was first introduced as a promotional channel, there was no clear consensus as to the impact it would have on pharmaceutical marketing. Initial assessments of the channel ranged from the wildly optimistic 'this is going to make all representatives redundant' to 'it's a waste of time – doctors will never view details over the internet.'

"The truth, as usual, lies somewhere between the extremes, but it is a very versatile marketing tool."

Research by Datamonitor in 2003, in The eHealth Market in the UK: Understanding Physician and Consumer Needs, offers some pointers on the challenges pharma companies faced, and still face, with e-marketing.

According to Datamonitor's 2004 Consumer Insight Survey, 96% of UK consumers can access the internet, at home, at work, through a friend or family member, or through a public access point such as a library.

However, says the report's author, O'Malley, relatively few frequently use online sources like search engines, general health websites, and online support groups as a source of health information.

"The primary reason for this is that UK consumers do not trust online sources of health information as fully as they trust offline sources such as books, magazines, and family and healthcare professionals," she says.

"Pharmaceutical companies must focus their advertising campaigns on raising disease awareness. Ideally, by providing the general public with information on disease signs and symptoms, pharmaceutical companies will succeed in encouraging consumers to seek treatment from their physician. The more individuals seek treatment, the more prospective prescriptions written for a particular product. This approach, when combined with targeted product-specific messages to physicians, can successfully increase market share of an individual product."

O'Malley thinks the most significant problem the industry faces is successfully winning  and keeping- consumers' trust.

"The internet is a pull rather than a push-medium, so users need to independently seek the information a company is providing. The first challenge is to reassure potential users that pharmaceutical sites provide trustworthy and reliable content. One way to do this is by collaborating with third parties that accredit health content on the web, such as the HONcode.

"Next, pharmaceutical companies have to protect the trust that they have earned by openly committing themselves to protecting the privacy and security of any information that consumers provide them.

"Finally, the pharmaceutical industry has to provide consumers with information and services that they find valuable. While it is tempting to invest a significantly greater portion of a marketing team's time and money targeting physicians, it is important to remember that the internet is not just building a better healthcare system, it is also building a more knowledgeable healthcare consumer."

It is not just the pharmaceutical industry that faces online challenges. O'Malley thinks there are also structural issues to overcome both at a UK and European level, but notably with the NHS's proposed new infrastructure.

This includes the NHS's IT project, encompassing initiatives such as Choose and Book, which processes patients choice of hospital, connecting up all NHS Trusts and electronic patient records

O'Malley says: "The NHS has been widely criticised both for its failure to include enough doctors and other healthcare workers in project planning and for far over-running its budget. Original estimates to upgrade the information technology infrastructure of the healthcare system hovered around 6.2 billion over 10 years. Recently, the Department of Health has raised that estimate, announcing that the programme will likely cost between 15 and 30 billion. At the same time, clinicians are expressing frustration that they are receiving neither the information nor the training they need to adopt the new systems."

This situation provides pharma with a unique opportunity, she thinks.

"While individual companies cannot force co-operation between doctors and the government, they can ease the transition as healthcare workers begin to adopt what will ultimately become mandated standards of technology. To the government, pharma can provide research on physician technology adoption. To doctors, the pharmaceutical industry can provide support and training on how to get the most out of their experience with the new IT system. While these are not considered traditional sales and marketing campaigns, they will allow pharmaceutical companies to work closely with physicians as they work to adopt new technology at the point of care."

For pharmaceutical companies to achieve this is still a big ask. Chief executive of online market research consultancy Medix, Dr Rino Coladangelo says: "The e channel is a busy one for doctors, and getting marketing information or messages through in the midst of all the other uses for it remains a challenge.

"There is a steady trend for doctors to increase their use of the internet for a whole range of activities. This is already the preferred source of medical information for many but simple marketing via this channel is unlikely to be any more effective than traditional advertising.

"The opportunity for pharma now and for the next few years is in using the e-medium to produce marketing packages customised for the doctor and relevant to his/her specific practices, with stimulating and informative content.

The online EU

There is also a European dimension. To develop an internet-enabled society, the EU developed an eEurope 2005 Action Plan to guide and support Member Nations. This Action Plan has enabled Member Nations to move quickly towards the goal of developing a fully wired EU through widening the availability of both broadband access and a secure information infrastructure.

The eEurope 2005 Action plan is a strategy to modernise the European economy and to build a knowledge based economy in Europe. The Commission proposes fifteen actions to achieve the specific objectives of the Action Plan and to expedite the progress of technology integration and adoption.

All eEurope objectives, including eHealth initiatives, will be realised in two phases. In the first phase, each of the 25 EU Member States work independently to achieve minimum standards of technology adoption and interoperability within their own country.

In the second phase, Member States work together in order to voluntarily and multilaterally establish pan European e-enabled systems. Member States often vary widely in their ability or willingness to adopt individual initiatives. As such, it is common for individual Member States to be working concurrently on both phases of adoption.

The main aim of the eHealth initiative will be to promote the sharing of best practices and measurement of progress. Fostering an environment of openness is critical, as creating a common standard of practice between 25 distinct healthcare systems is an inherently problematic task  not least of all because individuals health data is particularly sensitive.

At a micro level, there are some crumbs of comfort in the research. Obgyn.net runs polls on its website. Clearly these are skewed towards users of the web by definition, but still show some interesting trends, bearing out the points that both Erik Jan Scholten and O'Malley have identified.

In early February 2005, 310 women healthcare physicians had answered one of its polls. Over 80% were men, 74% were aged 30-49, and all were based in Europe, with 50% coming from Spain, Italy, the UK and the Netherlands. Exactly half had either taken an e-detail or were interested in doing so, with the highest number visiting Schering or Organon sites.

But it is the behaviour triggered by these e-details that is of most interest. About 47% said they spent about the same amount of time speaking to pharma reps, 21% said they found themselves speaking more to reps, and only 28% said they spent less time with reps. About 4% never saw reps.

Asked: 'How would you most prefer to get drug and product information?' 50% answered, 'On the internet with the option to request a face-to-face visit or samples,' 19% said 'By face-to-face visit only,' and 18% replied 'On the internet only.'

When asked: 'What would you find to be the best enticement to take an online drug detail?' 64% favoured free access to a full-text Cochrane database. Clear, objective information is still key.

In response to the question 'What features do you think are most important in an online drug detail?' (ticking all that apply), 76% ticked 'Ability to find out about new treatment options,' 60% said 'Ability to get the information at my convenience,' 50% ticked 'Ability to get supporting opinion leader advice and opinions about the product,' 48% wanted to get feedback and questions answered by the manufacturer, and a smaller, but still significant number, 27%, listed the ability to request a face-to-face sales rep visit.

The research also indicates potential changes in marketing techniques. Replying to the question: 'Do you want to get more product information delivered to you via the internet in the future?' 55% agreed that it was the trend of the future, 36% thought the online detail should support rep meetings, and only 8% said 'I would rather just have the salesforce drop by my office.'

One of the trickiest issues for any website is promoting it, and email and cross marketing on related sites are the most preferred options. Asked 'What do you believe is the most effective way for pharmaceutical companies to let you know about an online detail?' 35%, perhaps unsurprisingly, said 'By promoting it on OBGYN.net and in its email newsletter,' 28% suggested an email notification sent by the company, 23% said 'Being told about it by a rep, 7% opted for advertising in medical magazines, and just 5% would be persuaded by direct mail.

And what about the perennial bugbear of e-marketing -ROI?  Erik Jan Scholten has a robust answer: 'Andy Grove, the former chairman of Intel, when tackled about his return on investment for his new internet ventures replied: "Are you crazy? This is Columbus in the New World…What was his ROI?"'

Making a return on e-marketing investments

What does e-business now mean to pharma, and to its suppliers? Erik Jan Scholten thinks that: "Current players in the e space have not been able so far to convince pharma that e-marketing should be part of the communication strategy and it provides a powerful way to add value to doctors.

"Partly because e-marketing providers sell e-detailing, a product rather than a doctor/customer approach, and partly because there is no common approach by the players, they are vying for market share rather than establishing a market, demonstrating the power of online as part of the entire marketing mix. There is little development of the market space in the first place."

Understandably, Steve Doyle at OnMedica, one of the current e-detailing providers, disagrees. He says: "E-detailing can be effectively integrated with ongoing salesforce activity or can used as a stand alone promotional activity, and we have ongoing projects of both types.

"The approach used depends largely on understanding the objectives of the client company and developing a campaign that meets those objectives."

There is no 'one-size-fits-all,' and pharma should expect e-detailing companies to be able to prove the effectiveness of their e-detail activity. Doyle says this means demonstrating and clearly understanding the marketing objectives of the client company, and being flexible enough to adapt their e-detailing offering to meet the clients needs.

"In return pharma needs to better understand the nature of online marketing. What works in the face-to-face rep call is not necessarily what will succeed with a doctor working at home in his own time. A copy of the rep detail online is not usually the answer.

The requirement to make e-Detailing a standard and growing part of the mix, will also require the reallocation of spend from other less effective channels.

The next five years for e-marketing

So, finally, in what direction is e-marketing likely to go? Erik Jan Scholten says: "Progress will be made as soon as e-marketers and pharma start to integrate the electronic medium in their marketing  call it a holistic approach to doctors, instead of a piecemeal approach or an approach solely centred on the rep. It should be centred on the doctor, with the rep having a major role to play in that approach."

E-marketing has certainly come along in leaps and bounds since the dotcom days of the late 1990's. Indeed, the enthusiasm, uncertainty, breakthroughs, and breakdowns of the early e-marketing initiatives seem quite quaint now that the medium is maturing. It is some way from being a fully adult member of the marketing mix, but perhaps its edgy status allows it to work more innovatively than older, more set in their ways, marketing disciplines.

It has already evolved to a point where the term e-marketing covers a broad range of channels to the target audience, varying from Point-of-Prescription promotion delivering high visibility messages to influence prescribing habits to more educational channels, to e-detailing, which combines education and sales approaches.

"Clearly the approach needs to be specific for the individual channel to achieve the best results, and pharma has recognised this," says DXS' Bauer.

"The impact of e-channel can often be measured more accurately than traditional marketing channels, resulting in rigorous demands being placed on the e-channels to demonstrate ROI, which is an excellent approach to establish e-marketing channels firmly in the accepted promotional mix.  Looking to other industries, where e-Marketing is well established in the mix, the similarly rigorous measures are in place across all channels – thereby levelling the playing field.

"Over the next five years we will see more precise segmentation of the target market and e-channels will continue to deliver more personalised and better focused messages.

"E-marketing will also be able to develop pharma's understanding of their audience through the development of a more intimate relationship. Technology is increasingly becoming a part of our everyday lives which opens new channels that reach audiences at different and more appropriate times."

John Hosken is principal consultant at Information Advisers, and also a qualified business coach. For more information visit: www.john-hosken.com or e-mail: jhosken@hotmail.com