Gamification: what’s in it for the pharma industry?

pharmafile | October 6, 2014 | Feature | Manufacturing and Production, Medical Communications, Research and Development, Sales and Marketing |  AF, Boehringer, COPD, CRUK, Gamification, ROI, Syrum, digital 

Gamification is the new buzzword in digital marketing and has the potential to engage consumers more than traditional strategies.

This idea uses gaming as a vehicle to encourage people to adopt new habits or influence their behaviour.

Companies are now using it to deliver their marketing messages and advertising to the wider public, and are increasingly involving social media to help spread its use.

And beyond just integrating social media, some new games are actually based on these platforms.

By far the biggest and most well-known use of gamification comes from the Facebook game Farmville. Its creator Zynga has made this game into such a large success story by using the popularity of its host as the platform for the game.

In Farmville players grow crops and can then sell them to their friends, or form a co-operative with other players to build a bigger and more productive farm. The aim is to ‘level-up’, and users get more rewards the further into the game they go.

It has more than 100 million users and makes money by having players purchase certain items for their farms from the developer. It is also a goldmine for Facebook, with advertisers lining up to be seen next to the game.

Farmville is successful because it keeps to the basic tenants of gamification: it’s simple, competitive, social, and above all it offers rewards, which make players return to it time and time again. This creates a community and a loyalty around the game, and ensures that it remains successful in the long term.

Pharma joins the game

Pharma has now jumped on the gamification bandwagon and is starting to use it to promote disease awareness campaigns, but it begs the question: can gamification work for pharma?

Boehringer Ingelheim is betting that it can, and is the pioneer of this idea within the industry to date. The firm launched its first game Syrum in September 2012 after months of beta testing. It is the brainchild of John Pugh, the leader of Boehringer’s global digital innovation team.

Pugh is a well-known trailblazer in pharma’s digital world, launching Boehringer’s Twitter feed in 2007, one of the first in the industry to do so. Pugh’s project works much the same way as Farmville does, but just swaps farms and crops for laboratories and molecules.

In Syrum, gamers play as an R&D pharma company that has to develop drugs and put them into clinical trials, mimicking the real industry process.

And there are social media aspects to it, as players can link up with their Facebook friends and give them gifts – these can then be used to customise their offices and laboratories. Players can also trade and collaborate to help create better compounds, but on the flipside they also have the option to steal their competitors’ staff and compounds to get ahead.

Pugh says Syrum is about promoting science, innovation and the pharma R&D process to the public, who are not always aware of how much time and effort goes into making new medicines.

But what exactly is in it for Boehringer? Pugh explains to Pharmafile: “Boehringer spends a lot of money on disease awareness campaigns for doctors and for the public. We’ve used traditional methods for years but we’re now trying to use more digital.

“So my concept is that gaming is one of the most effective ways for people to learn – when you’re a kid you play games, in education there are gaming methods entrenched into learning programmes, but we’ve never brought that into the medical or pharma realm.”

He said pharma has tried things before, such as using Pac-Man style platform games where a white blood cell eats bacteria, but argues that this was simply ‘too limited’.

He says using social games like Syrum is a big step forward, because it is more engaging and can be shared by potentially millions of people. The plan was to use Syrum as a vehicle for some of Boehringer’s disease awareness campaigns such as Drive COPD and 1 Million 1 Stroke (see further on for more on these initiatives).

As the user progresses through the game they will also learn about counterfeiting – a major problem for many pharma firms – the complexity of drug patents and the process behind clinical trials.

Pugh says users will also learn about the high levels of money that has to be re-invested in the drug pipeline in order to make new medicines. “We don’t say this explicitly,” Pugh explains, “but it’s inherent in the game.”

He says that the reputation of the pharma industry is not as bad as it was, but concedes that it’s ‘not great’.

“A lot of people think that pharma’s goal is just to make profits, but if you look at how much the industry spends and how complicated the R&D process is, it really doesn’t boil down to making money,” he says.

“I don’t think Syrum will single-handedly raise the profile of the industry to the public, but I think it will play its part, and that’s its purpose.”

COPD and AF awareness campaigns

Boehringer has already established itself on the web with interactive campaigns to raise awareness. One of these is ‘Drive for COPD’, which aims to increase the diagnosis of chronic obstructive pulmonary disease.

A recent campaign is also the aforementioned ‘1 mission 1 million’. This venture is aimed at raising awareness about stroke prevention and atrial fibrillation, which is what its new blood thinner Pradaxa (dabigatran) has just gained new licences for around the world. This campaign draws on a similar idea to gamification – that of ‘crowdsourcing’ – opening up a problem to an online community and asking their help to solve it.

However in this case, Boehringer is simply donating money – €1 million to be precise – but draws in users by asking them to apply for the funding.

The donations are only campaigns to raise awareness about atrial fibrillation (AF) and stroke prevention, not for treatment. One of the most notable winners was a proposal for an online project, StrokeStrike, which was awarded €100,000.

The project is a mobile and online social platform that promotes the idea of playing sports and leading a healthier lifestyle to minimise the risk of stroke. It helps promote a healthy lifestyle by offering personalised monitoring of calories, exercise and so on, and allows your doctor to access this information.

These also tie in with the medicines that Boehringer develops and markets – namely its COPD medicine Spiriva (tiotropium bromide inhalation powder), which is co-marketed with Pfizer, and Pradaxa.

Disease education, veiled marketing

For Boehringer Ingelheim, Syrum promotes disease education for people playing it, whilst also helping them filter their marketing messages for its ongoing disease awareness campaigns.

Pugh explains that players of Syrum will be regularly asked to fill in questionnaires, or watch videos relating to its recent disease awareness campaigns. In return Boehringer will then offer players new equipment or drug compounds for Syrum as a reward.

On the face of it, Syrum is about explaining the pharma industry to the public, and the stresses and strains of getting drugs to market. But more specifically for Boehringer is its use as a vehicle to communicate messages about its new disease awareness campaigns to bigger audiences.

Pharma must tread carefully in these areas in Europe, however, as the industry is not allowed to advertise prescription medicines to the public. This is the whole reason for disease awareness campaigns, which encourage patients to think about their condition, get diagnosed and potentially be prescribed the appropriate medication.

The drive to promote COPD awareness is of course rooted in Boehringer’s aim to promote its products for the disease, most notably Spiriva.

But these games can in no way plug its products, and all of pharma’s campaigns include lengthy and prominent disclaimers that they are for providing information, and not for promotion of medicines or services. Nevertheless, their raison d’être remains perfectly clear to astute observers.

Dead in the water

Syrum has been met with criticism by some commentators. John Mack, who runs the influential Pharma Marketing blog in the US, says: “I’ve written a lot about Syrum. I believe it is a ‘bait-and-switch’ gimmick by Boehringer, merely meant to generate press and capture personal information of would-be users.

“In any case, it seems to be a failure although it is still being hyped by BI at conferences.”

He points out that despite the promises, Syrum has not launched in the US, adding that it is simply ‘dead in the water’. The game was supposed to launch in the US and Canada shortly after its European appearance in 2012, but that was two years ago and it is still yet to surface.

Boehringer has established a Facebook page for the game, but this has garnered only around 500 likes. Mack says this is ‘not surprising’ considering that the PLAY NOW button doesn’t let you play because it isn’t ready for the US.

This situation has been going on since 2012 and the error message has not been updated.

Pugh dismisses the notion that Syrum should have a return on investment, and would not tell Pharmafile how much was invested into the game, and what in financial terms would be expected out of it.

Mack says: “I seriously doubt that this has increased BI’s revenue, although it has tremendously increased the press it has received and the ‘notoriety’ as a leader in social media. Boehringer is doing other more useful social media projects, which is lost in all the glitz generated by Syrum.”

More pharma forays into gaming

Syrum was the start of gamification in pharma, but since 2012 other companies have followed suit and established their own games. One of these firms is Lilly, which in June launched an online board game called ‘Destination Discovery’ that it says can help users enjoy the challenges of “bringing a new medicine from molecule to medicine cabinet”.

In the interactive offering the player travels along a research and development course and answers trivia questions as they progress. Lilly hopes the user gets to experience overcoming the challenges and finding the opportunities in drug development.

Amy O’Conner, who is Lilly’s senior comms director, says: “The journey of a new medicine involves complex research, global collaboration, and rigorous testing and approval processes before new treatments can reach patients in need.”

Lilly’s game, obviously similar in many aspects to Syrum, had a much quieter launch than the one used by Boehringer. While the German firm hired out a section of London’s Science Museum for the evening when it was launched in 2012, inviting the media and its staff to drink alcohol from beakers and play the game on the Apple Macs provided, Lilly sent out only a press release, and did not feel the need to hire out any venues.

UCB didn’t go as far as Boehringer either, but was more vocal about the launch of its online ‘Innovation Challenge’ in January, as it looks to pay members of the public to help it develop new drugs.

The Challenge took place online and is designed to help the company find rare phenotypes – for example, people who are somehow protected from disease or possess exceptional tissue regeneration. This could then be used by UCB to help develop new drug targets.

The best entry receives an award of $10,000 – UCB also hands out ‘bonus awards’ (no smaller than $1,000) to those who the judges feel submitted an ‘especially interesting or relevant entry’.

Although different to the offerings of Lilly and Boehringer, the basic elements of gamification – i.e., taking part and being rewarded – still hold true for UCB. It also takes on the ethos of Boehringer’s ‘1 mission 1 million’ initiative, but takes it further and into more practical, research-based areas.

In all three cases, the ultimate marketing goal is to help shore up awareness of the company, their research efforts and (indirectly) their medicines, as well as helping their R&D processes.

Promoting health, curing cancer

But outside of corporate marketing concerns, some groups and charities are looking at ways that gamification can help patients and research.

In August, new findings published in the journal Radiology suggest that patients suffering from multiple sclerosis (MS) can improve their balance by using an exercise component of the Wii Fit video game.

MS is an inflammatory condition that hampers the ability of the brain to communicate with the body. The disorder is characterised by muscle weakness, blurred vision and problems with balance and co-ordination.

Luca Prosperini, a neurologist from the Sapienza University in Rome, Italy, says that to date no medication is yet available to preserve the balance of patients with MS. However, the battery-powered Wii Balance Board system from Nintendo, which is used for games that involve moving, snowboarding and dancing, shows promise as a tool that could help boost balance in MS patients.

In the new study Prosperini and his colleagues wanted to determine the effects of using the Nintendo Wii Balance Board on MS patients and involved 27 patients that they split into two groups.

The patients in one group did nothing special for three months while those in the other group played with the Wii Balance Board for between 30 to 40 minutes per day for five days a week. The researchers then reversed the roles of the patients in the two groups and used an MRI technique known as diffusion tensor imaging to identify any physiological changes in the participants’ brains.

Prosperini and his colleagues found that the patients regained some balance after their balance training. They also detected positive changes in the patients’ brains that they associated with video games.

Prosperini pointed out that they observed improvements in the protective sheath around the nerves and this leads to improved conduction of impulses between the brain and the body.

He also says that how video games benefit MS patients may have something to do with neural plasticity, or the brain’s ability to adapt and form new connections, although a causal link between the two cannot definitely be established yet.

Charities are also using gamification. In February Cancer Research UK launched a new citizen science game aimed at helping its scientists discover new treatments for cancer. The mission of ‘Genes in Space’, which can be downloaded as an app via Google Play or Apple’s iTunes, is to collect a fictional substance dubbed Element Alpha.

This represents genetic cancer data, which might underpin certain types of cancer. The data analysis goes back to CRUK’s scientists in two ways. First, when a player maps a route through the Element Alpha, and secondly when they fly their spaceship through the intergalactic space course to collect this substance.

By playing Genes in Space players will be analysing significant amounts of genetic data which would have taken scientists hours to do. These data can then be used to develop new and potentially life-saving treatments.

Hannah Keartland, citizen science lead for Cancer Research UK, explains: “Our scientists have huge amounts of data that they need to analyse.

“We’d noticed the number of people who play mobile phone games – what if they could analyse cancer data at the same time? “The potential to accelerate research could be mind-blowing.”

When asked if this type of crowd-sourcing is the way forward for data analysis – and also a good way of promoting what CRUK does – Keartland says that crowd-sourcing and this type of gamification “could have a really important role to play in carrying out analysis that needs to be done by the human eye”. 

Are games able to change behaviour?

But the big question is: can games change entrenched human behaviour? There is little available long-term research to answer this question, but it does not seem that shooting cigarette-shaped enemies will make a player change a 30-year smoking habit, for instance.

In terms of marketing – and what Boehringer is doing with Syrum – it certainly seems to grab people’s attention. But it also opens a company up to criticism from the likes of Mack and others within the industry who question whether there is any ROI on these types of games. 

So it is the future? Possibly – but at the moment it is still a novelty, and one that leaves a bad taste in some people’s mouths. The real ROI, as identified by UBC, CRUK and Prosperini, seems to be the ability to help and even speed up research.

The Innovation Challenge and Genes in Space and the use of the Wii Balance Board are good examples of how both crowd-sourcing and big data can be used in more fun and rewarding ways: the player gets a cash prize and/or entertainment, and in return the company or charity gains greater insight into certain diseases at a much quicker rate than it could have ever done internally.

Or as is the case with the Radiology journal study, patients could actually get help for their condition.

Perhaps this should be the real focus for life sciences: forget the marketing ploys and the attempt to indirectly increase prescriptions to new medicines, and instead find new innovative ways of using gamification to spread research outside of the laboratory and into the public domain.