E-marketing has arrived…but not everyone has noticed

pharmafile | March 19, 2007 | Feature | Medical Communications, Sales and Marketing |  e-marketing, marketing, new media 

Pharmaceutical marketing has traditionally been a sales rather than a customer-led activity. In this internet-driven age, our customers – doctors and other healthcare professionals – spend vastly more time online than they do with pharmaceutical industry reps. Research has shown that more than 90 per cent of doctors regard the internet as essential for their medical practice and use it every day. Across Europe, doctors spend, on average, up to 16 hours a month searching online for medical information, news, education, and opinion – eight times longer than they spend in traditional face-to-face contact with reps.

Yet the focus of most pharmaceutical marketing spend is still around the traditional mix, with electronic-based activities often regarded as an add-on. According to Kay Wesley, global director of e-marketing at AstraZeneca:"At the moment, we are all jostling to spend face-to-face rep time with doctors and not considering how to spend more online time with them.

"Other industries analyse every possible touchpoint with their customers and aim to maximise all the opportunities for interaction with them. They place their messages, branded and unbranded, where the eyes, ears, hearts and minds of their customers are."

Speaking at a recent half-day conference organised by the PM Society, Kay Wesley was also adamant that e-marketing does not just mean e-detailing. "It is no use just automating the reps detail aids. We need to use the strengths of this new channel to actually interact with doctors."

Closing the loop

Of course, it is not just doctors that search online for information. Consumers are increasingly turning to the internet for healthcare advice before they go to the doctor, with as many as a third actually self-diagnosing, yet the pharmaceutical industry generally fails to provide any service to these internet-savvy patients.

In embracing e-marketing, any industry has to travel through a maturity curve. First, brands and brand messages need to be made visible. The next step is to introduce interactivity, typically with or without online selling.

Then comes customising the online experience: for example, Amazon allows customers to store a wish list, and online shoppers with Tesco can store their regular grocery list. The ultimate stage is personalised shopping (i.e. the online store gains insight as to what the customer likes and suggests similar products). In this way, every interaction becomes part of a continuous relationship with the customer – true multi-channel or closed-loop marketing.

A push-pull strategy

In the 1990s, when the web consisted mostly of corporate content, interaction with the user was one-way only and it was difficult for an individual to publish content online without understanding the intricacies of html or Javascript. This model is often referred to as web 1.0. Over the past couple of years, the publishing of web content has been de-skilled, with the emergence of technologies such as YouTube and Wikipedia, forums and weblogs. This new read-write web (referred to as web 2.0) allows anybody to publish content online and share it with other users. The balance has shifted and now large numbers of people (including medical specialists and healthcare professionals) are publishing their own content and creating a two-way flow of information.

Paul Hartigan, managing director of Pharmiweb Solutions, suggests that a corporate weblog is a useful way for pharma to engage with customers (and patients). He explains: "A corporate blog allows low-cost and rapid engagement with your target audience, and is a great way of disseminating information."

This also creates the opportunity for individual, motivated patients to become opinion leaders within the online community. Pharma tends to be frightened of blogs, however: "It is impossible to control and moderate content," concedes Paul. "You have to rely on the intelligence of the audience – and they're generally savvy enough to sniff out inappropriate and biased content."

Paul also stresses that debate is already happening online with no intervention from the industry or healthcare professionals. Patients look for health information online, typically starting at a search engine with the name of a condition or drug.

"There is still some confusion and nervousness because much of the online content is non-moderated and non-peer reviewed," says Paul. "But this means there is an opportunity for the industry to provide expertise here."

The ideal, in Paul's view, is to develop a 'push-pull' strategy, with content geared to the healthcare professional pushed out to them alongside content designed to create awareness in the patient community to build a 'pull' or demand for more information.

Content is king

Kay Wesley believes it is vital to supply the target audience with content appropriate to them. She stresses: "Content is king."

Patients and physicians both want high-quality medical information. Pharma is an information-rich industry and Wesley says it is pharma's responsibility to disseminate this knowledge. "New web technologies make this now relatively easy to do. But we need to think about this channel very differently," cautions Kay. "It should not simply be a push channel that mirrors other types of selling."

Someone who has experience of building online relationships is Teresa Roberts, communication manager at Napp Pharmaceuticals. She says: "The 'Control pain – live life' website includes content for both healthcare professionals and patients and has received 79,000 hits since its launch in early October 2006. The redevelopment of the website provides a platform for developing relationships in the future." But she stresses that measuring return on investment is difficult. "The hope is that informing patients will grow market share."

Interaction equals impact

Clearly, the new web 2.0 technologies allow online research capable of providing insights into customers' preferences and opinions. E-research also facilitates both quantitative and qualitative market research and permits testing of marketing materials, tracking competitor activity, and assessing the reaction of key opinion leaders to emerging evidence. In addition, it provides insight on the views of healthcare professionals and patient groups. Most importantly, unlike traditional research, online research results are 'real-time'.

At Janssen-Cilag, marketing research manager Steve Curtis has been using online research for three years, particularly in the form of e-detailing. Steve stresses the importance of getting doctors to engage. "Maximise interaction to maximise impact. As doctors increasingly interact, the benefit increases. But doctors aren't always 100% compliant, so expect drop-out. That means it's vital to prioritise messages."

Charlie Grieve, managing director of Medicast Communications, has been instrumental in setting up and managing the O2 guru online research initiative which takes e-research a step further. Using members recruited from the O2 user database, data is extracted online that provides customer insights and opinions via searchable forums, live chat, open and private blogs, questionnaires and polling, and offers members news feeds and e-mail and text alerts.

Charlie Grieve believes similar tools could  and should  be used by the pharma industry. Open and private blogs have the potential to provide a research portal for key opinion leaders, with secure research areas for KOL interaction that can be tracked in real time.

As Charlie says: "There is the potential to build loyalty and advocacy within a KOL group, and to generate a sense of ownership. This allows users to feel good about their association with your brand. And bringing KOLs together as an e-community online has huge cost efficiencies."

Inform and educate

Well-informed and well-educated health professionals who have access to accurate and up-to-date prescribing and diagnostic data from ongoing education, obtain a benefit not only for themselves, but also for their patients and the pharmaceutical industry as a whole.

Traditionally, doctors have learned from CPD accredited lectures. But as Kieran Walsh, clinical editor at BMJ Learning, points out: "This is a passive process and is expensive in terms of off-the-job time. By contrast, e-learning from work or home is more cost-effective."

E-learning can provide an assessment of learning needs, and an electronic portfolio that automatically records those needs, plans study and details work completed. It is modular in approach, and up-to-date educational content on a wide range of clinical and non-clinical topics can be regularly and easily updated in response to users' needs.

Most importantly, e-learning can be undertaken at any time, in any place, and does not require trainer or learner accommodation, travel and subsistence costs, or any premises, equipment and print investment, while cutting down that all important off-the-job time. So, the possibilities and potential of e-marketing (along with associated e-research, e-communities and e-learning) sound exciting and innovative, but does e-marketing really make any difference?

For Nina Felton of IMS, the overriding issue is to spend appropriate resources on the right customers. "To maximise ROI, the trick is to understand what does and doesn't work for which customers," says Nina. "That way, we have confidence in making the best strategic decision and allocating the right resources to the right brands at the right time."

Evaluating e-marketing ROI

Measuring ROI is often an afterthought but the budget for any programme should also include the cost of the ROI evaluation. It is important to understand whether messages are resonating with physicians and having any impact on brand performance, and to check the influence on the brand's competitors. Above all, the impact of e-marketing needs to be teased out from the effect of other activities and the marketing mix flexed according to the customer base.

"Content matters and the way you interact matters," says Nina Felton. "Senior management will ask whether this is a good way of spending money. Test and control methodology allows comparison of a group with whom you have interacted against a matched group with no interaction. Econometric time series analysis provides a time-based cause/effect approach that will measure multiple media in combination and also help generate a response curve based on investment."

Once the impact and relative contribution of e-marketing has been established, the break-even point can be manoeuvred to create a positive ROI, for example by widening the scope of the activity so the relative cost per head decreases, by changing the audience, or by decreasing unit costs.

"E-marketing activities should focus on optimising the target customer at the right frequency with the right message and ensuring that a greater commitment to prescribe the brand is built into the campaign," says Nina. "And if you don't ask whether you are getting return on your investment, somebody else in your organisation will."

Kay Wesley agrees: "ROI needs to be measured. It is important to understand why we are doing what we are doing. This applies to all channels, and not just e-marketing."

While other industries have embraced e-marketing wholeheartedly, the pharma industry is still dipping its toes in the water. If it doesn't want to get left behind, it must take the plunge and dive in.

"These new techniques are out there now," says Charlie Grieve. "GPs, KOLs and patients are on the web and using it. There is so much online activity, you have to use it and start learning from it. Putting your head in the sand and doing nothing is not an option."

Now that so much content is user-generated, the pharma industry needs to be active rather than passive in embracing the possibilities offered by the new web 2.0 technologies.

As Paul Hartigan says: "The industry must to get together  with each other and with the ABPI  to look at what's possible, as well as talking to professional bodies and patient-support groups, to drive the agenda for change."

Companies that took a risk when there was no proof that e-marketing would grow are now the market leaders. Those with successful brands, such as CocaCola and Shell, change their marketing mix completely every year, measuring campaign impact all the time.

"Pharma has a lot of growing up to do, to get to the same point as Tesco, for instance," says Kay Wesley. "We in pharma are not being brave enough, not looking at what our business shape should be and how we can change the marketing mix.

"These new ways of interacting with our customers will force us to think much harder about the organisational changes we need to make to really get ahead with e-marketing."

Napp Pharmaceuticals' e-community web initiative

Chronic pain is Napp Pharmaceuticals' largest area of expertise, particularly the treatment of pain from cancer, osteoarthritis and neuralgia. Teresa Roberts, communication manager at Napp, explained how the company has invested time and funds in a website dedicated to the management of chronic pain, with the aim of benefiting patients and healthcare professionals.

Patient-friendly advice

The recent Pain in Europe survey revealed that 13% of people suffer chronic pain in the UK. And while as many as 70% suffer pain on at least a daily basis, only 2%  have seen a pain specialist. At the same time, pain relief is given very little time on the medical teaching curriculum.

Napp set out to approach this under-treatment of chronic pain by addressing the education of healthcare professionals via the internet. Research by NOP and doctors.net.uk in 2004 showed 91% of the 100 GPs questioned searched for disease treatment and management on the internet.

From the patient angle, the existing Napp website already contained a dedicated patient section, though this was aimed at the expert patient. As part of the development of the new website, together with Pharmiweb, Napp talked to patients and found the information provided was regarded as good, but not well organised (e.g. rather text heavy, too advanced).

The patients also noted that navigation around the site was not easy. While the background information was thought to be excellent, what patients wanted most were practical approaches to living with their pain.

In the light of this information, Napp  created the new 'Control pain – live life' website, which runs alongside other marketing and educational initiatives with the aim of providing a platform for future developments. Navigation has been improved and information is now provided on two levels. Access is better and downloadable pdf factsheets have been added.

Napp will continue to work closely with patient groups, particularly in the 'Living with pain' section. Indeed, subsequent visits to Napp's headquarters by patient groups have been well received and have provided a valued extension to the online community.

Spreading the word

Napp currently has a six-month agreement with Waiting Room Information Services who market the site by placing 150,000 chronic pain leaflets per quarter into 6,000 GP surgeries (covering a potential 38 million patients). Since doctors and nurses often recommend websites to their patients, the salesforce will also figure in actively promoting the website.

The latest quarterly report shows 79,000 hits on the 'Control pain – live life' website since launch in October 2006, with 2,419 unique visitors and around 700 repeat visitors. Feedback from individual customers is good, though the site is not yet as broadly received as Napp would wish.

For the future, alongside working with patient groups, Napp will continue to add new content, and aims to optimise the sites ranking in internet search engines such as Google. The use of key words should ensure the site appears on the first search page, combined, where appropriate, with paid-for advertising links.

The Napp website can be found at www.controlpain-livelife.com

Helen Lawn is director of Helen Lawn and Associates Ltd and PR Officer for The PM Society. e-mail: helen@helenlawn.co.uk