Problems and solutions
pharmafile | January 20, 2014 | Feature | Manufacturing and Production, Medical Communications, Research and Development, Sales and Marketing | adams, culture, pharma, problems, social media
Not long ago I was asked to be involved in a project that filmed UK-based pharma journalists in order to quiz them on how the industry can better itself in terms of outcomes, reputation and speaking to patients.
The film was then edited down and shown to the management of a major pharma firm, in what I believe is a bold and progressive move as it is essentially allowing us journalists to critically appraise a firm directly to its leaders.
The company, who I will not name for reasons of fairness, specifically wanted the discussions to focus around three elements: outcomes for patients and society; leadership in trust and reputation; and the best customer interaction models.
Below is the transcript from the film, written out in full.
Transcript to pharma
In terms of your focus on ‘the best customer interaction models’, this seemingly is leading to digital strategies and self-styled ‘digital gurus’.
I personally feel that this is a dangerous area – medical communications firms and digital advocates push the idea of a digital strategy as a necessity, but I think there needs to be some serious thought about these plans – especially in Europe where pharma is unable to speak directly to patients.
One of the major questions for the industry needs to be: why are we on Twitter, Facebook and Google+? Everything that you say there is closely monitored for any breaches of local rules and regulations, and what is posted generally are press releases (that patients have little interest in), or disease awareness campaigns that are sometimes too weak to be effective.
Another question that needs to be addressed is what is the return on investment (ROI) of a digital strategy? Is getting 100,000 – or even 1,000,000 – likes on Facebook increasing uptake of your medicines, or is it giving an individual in the company a lot of press-time, forsaking the actual goal of a campaign, which is to educate patients about treatments and their disease?
And things can go wrong. Looking at Facebook, Janssen’s Psoriasis 360 campaign was taken down in 2011 due to a stream of negative comments that the firm couldn’t keep up with. What was the ROI of this project, and did the company sell more of its psoriasis drug Stelara on the back of it? If not, what was its purpose – and was the pain of pulling it worth it?
Ditch the clunky corporate slogans
I’d also say that using plain language is the key to communicating with the wider world: the term ‘the best customer interaction models’ sounds too prescribed – “how do we speak to patients?” is much clearer.
This may seem a trivial point, but one of the major problems with corporate communication in general – and with pharma specifically – is that all communication seems to emanate from the marketing department: patients do not want to hear clunky corporate slogans – they respond better to messages that relate to them and their experiences.
Another symptom of this is the new wave in pharma marketing of ‘empowering the patient’, in which medicines and services – in line with digital strategies – are putting the patient in charge of their care and treatment decisions.
But this is largely nonsense. There is some merit in the idea for younger people with chronic diseases but, for the most part, patients who are ill don’t feel in control, nor do they want to be in control of their care. They want to get better as soon as possible and be told how to do that from a healthcare professional they trust.
The overriding emotion patients with diseases like cancer, heart disease, AIDS or chronic pain feel is fear for themselves and for their families. If there is a drug out there that can help them, they want a doctor to give it to them as soon as possible in order to stop being a patient and become a healthy person again.
They don’t care much about pharma, about pathways, about tweeting a company or liking a company’s Facebook page; they care instead about the person they were before they became a ‘patient’. It is not empowering to be seriously ill, it robs people of who they were and makes them worry about becoming a burden to those they love.
In general, a patient wants reliable information and products that work – this should be the focus of any pharma company and its communication strategy, rather than focussing on digital as a strategy per se, or using unsuitable marketing terms to make patients out to be something they are not.
It is also worth mentioning in the context of a digital strategy, that most patients are elderly with little to no access to the internet so may not be able to use Facebook, Twitter or any other social media. Why should your main customers be left out of any communication just because of their age?
Profit and patients
Getting back to terminology, ‘patient-centric’ is another term that I find difficult to swallow. Any multimillion dollar company is essentially profit-centric – it has to be to survive and to keep shareholders happy.
I realise that not since the era of former US president Ronald Reagan and British prime minister Margaret Thatcher has it been acceptable to use the ‘p’ word in public, but it needn’t have negative connotations.
This is linked to the most important issue for me, which is trust: you’re working towards profit and that is the primary goal. I’ve seen it in analysts’ meetings where chief executives have squirmed under intense pressure from financial journalists, and I’ve seen it with multibillion share buyback deals to keep investors happy – that’s the business you are in.
But for PR and marketing reasons, the industry is trying to make it appear as if this is not the case. It would rather hide its profit motivations and ostensibly set itself up as a philanthropic industry devoted to the needs of a patient. It isn’t – it sees a market and works hard to get its product in there and producing revenue.
Making a firm out to be above moral in its approach is a dangerous tactic, and one that can backfire. There have been many multibillion dollar fines in recent years where firms have sold drugs off-label for conditions for which they have no licence, or kept a dangerous drug on the market when it was causing death and/or severe illness.
Yes, much of this happened in the past and yes, I truly believe the industry as a whole is trying to shake this toxic culture off its back and is becoming more professional, but the memory of these fines – some of which are still very recent – and the perceived greed behind them will remain with patients and journalists alike.
Any company caught being overly defensive will suffer and it is worth taking a leaf out of GlaxoSmithKline’s book: they apologised for their massive $3 billion fine in 2012 for a host of abuses but have still managed – through careful strategy, it must be said – to be seen as a moral company.
This is where we come back to the need for honesty. Pharma firms make drugs for patients but their goal is to drive up revenue and profit in order to reward themselves, their shareholders and, naturally, to invest in new R&D projects. Most drugs are priced at the highest possible price to achieve this end – it is the cornerstone of 21st century capitalism, and I don’t think companies should shy away from expressing this motivation.
Need for re-assessment
Of course, researchers and managers can feel good about developing a medicine that helps a person with MS walk where they could barely stand before, or allow a sufferer of Alzheimer’s some respite and a brief return home.
And none of this is possible without a competitive industry motivated by financial rewards. But from this needs to come a re-assessment – especially in light of ongoing global austerity – of whether drugs are priced too highly and whether the R&D model is too expensive, inefficient and in need of major change.
Only pharma can truly say whether this needs change, as external parties are not privy to internal pricing negotiations, but my feeling is that the industry could lower prices in tandem with a more efficient R&D model and still be just as profitable, but win the PR war in producing cheaper medicines.
I don’t say this knowing it would be an easy thing to do, but it would be the right thing to aim for, as that is how real trust can be earned.
In the end, what I think pharma needs is a counter-culture in order to combat the threat of internal complacency. When the majority in a company use marketing language and believe in the hype that they are saving the world, then you start to ignore all the major problems the industry has and disregard criticism.
There needs to be an independent panel of individuals – perhaps journalists and editors of a health and pharma persuasion – who can sit down and illustrate how the world sees you and what needs to change. There should be no financial transactions involved as it should be done in the best interests of the company, rather than for a monetary reward.
The video I was asked to participate in is an excellent example of leaders really wanting to hear and potentially change some aspects of their culture. But at the moment it is only one company – I would like to think that more will indeed open their doors to this kind of conversation in the future.
Ben Adams
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