An entry in the '100 Steps for Pharma' series Millions of words have been written over recent years across media channels about the relative performance of pharmaceutical companies in social enviro...
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The discussion about pharmaceutical companies’ adoption of digital health tends to revolve around what Big Pharma businesses are doing. But at the annual Health 2.0 Fall conference this week, BTG Digital Health Innovation Director Amanda Goltz made a case for the advantages of being a smaller player.
Goltz noted that the UK-based specialty pharma company’s relatively small size meant it could be more agile.
Goltz drew attention to BTG’s collaboration with Tonic Health — a digital health business that has moved from engaging patients to fill out electronic medical forms in a doctor’s office to working with payers as well as for pharma companies. With BTG, Tonic is providing support on clinical trials in interventional oncology and patient-reported outcomes in interventional medicine. She also highlighted BTG’s work with Deloitte to develop Snakebite 911 — an app to support for its snake bite antivenom. But it was with a new initiative to support cancer patients where she viewed the company’s size as an advantage.
Via Alex Butler
Health systems and hospitals that are taking financial risk for keeping people healthy aren't the only ones that want access to patient-generated data.Pharmaceutical and biotechnology companies are increasingly interested in how patient-reported information can be used to get their products to market faster and assess how they perform in the real world.At the Biotechnology Industry Organization's annual conference, familiar names in digital health were front and center in the program and exhibit hall. And for the first time, the Digital Health Summit held its annual summer meeting alongside the larger BIO conference.
Via Alex Butler
The digital revolution is well under way for pharma companies. We spoke with 20 leading executives to find out how they cope—and what they do to stay ahead. A McKinsey & Company article.
The digital revolution continues to transform healthcare fundamentally, and many people believe that a tipping point is finally within reach. In 2014, digital health investments topped $6.5 billion, compared with $2.9 billion a year earlier.1 1.StartUp Health Insights annual report 2014: The year digital health broke out, StartUp Health, December 2014, startuphealth.com.
The critical question now for pharmaceutical companies is how to stay ahead of these changes. To answer it, we sought to learn the trends and implications of digital health by interviewing 20 thought leaders across a variety of segments, including analytics, biotech, data, pharma, providers, technology, and venture capital. The consensus is that as healthcare continues to digitize, pharma companies must transform themselves in basic ways to stay competitive. Successful ones will rethink their business and operating models, transform their cultures and capabilities, and adopt a new, longer-term mind-set that fosters innovation and bold strategic moves.2 2.To read more about our experience, analysis, and views on these trends and their implications for strategy, see David Champagne, Amy Hung, and Olivier Leclerc, “The road to digital success in pharma,” August 2015. These conclusions stem from three important themes that we took away from our conversations:
Dramatic changes in the traditional roles and dynamics of healthcare stakeholders have fundamental implications for pharma companies.
It is time to reimagine them as solutions companies, not asset companies.
The technology is ready, but pharma companies must change if they are going to enable and harness it more successfully.
These themes strongly suggest that success in the new digital environment will require three big shifts: forging ahead beyond the pack mentality and embracing experimentation and risk taking, developing a collaborative culture and challenging barriers to sharing, and reinventing companies by building capabilities beyond traditional healthcare and updating the operating model.Emerging themes
Dramatic changes in the traditional roles and dynamics of healthcare stakeholders have basic implications for pharma companies. The digital revolution has spawned a consumer revolution symbolized by an increasing demand for connectedness and information. Consumers with new technology tools are becoming more active and self-directive, which changes their interactions with providers, payors, and pharma companies. As a result, new and unfamiliar forms of behavior will fundamentally affect the pharmaceutical business:
Individuals are starting to control their own health treatments. Patients are becoming more than just passive recipients of therapies. “Healthcare will be driven much more by consumers than physicians, with patients increasingly coming to their doctors with more information, parameters they measured at home, and an informed opinion about how they should be treated,” says Dr. Bertalan Mesko, medical futurist and author of My Health: Upgraded (Webicina, September 2015) and The Guide to the Future of Medicine (Webicina, 2014). Dan Goldsmith, the chief strategy officer of Veeva Systems, a cloud-based life-science business-solutions company, takes the idea further. “In the next three to five years,” Goldsmith says, “instead of patients just being informed and more inquisitive, they will be actively designing the therapeutic and treatment approaches for themselves with their physicians.”
As patients assume greater control over their own health, including the therapeutics they take, pharma companies must recognize this new decision-making power and develop better ways to engage them. That’s not easy. Li Ma, vice president of strategy and investment at Alibaba Health Information Technology, says that “many pharmacos are trying to engage patients. But it is difficult because they often don’t know exactly who their patients are and also have a hard time determining exactly what engagement model resonates with their patients.”
Some pharma companies already recognize the growing importance of connecting with patients and are doing something about it. As the customer-experience director at one top pharma company says, “We use different approaches, depending on the target audience, to reach patients across a number of channels that relate specifically to their preferences. We observe patient behavior via online communities, participate in dialogues on research communities, have in-home visits, observe patient–physician interactions, and use quantitative methods to analyze trends and adjust content as needed to drive better engagement.”
If pharma companies want to go beyond engagement and truly encourage changes in health behavior, they will need to create different kinds of solutions. Although many solutions, particularly apps, have been developed in the past few years, not all can be adopted. As Dr. Todd Johnson, the CEO of Noble.MD, puts it: “Apps that face the patient but are designed to solve pharma-company business needs should never exist. Conversely, the market desperately needs apps that focus on patient and/or provider needs—real needs with a measurable impact on health quality and cost. If those apps also meet business needs—as a secondary or tertiary outcome—they have a chance of being adopted.”
The clinical environment will change fundamentally. As consumers become more engaged and care environments more complex, physicians will need new skills and tools. “How doctors spend their time will change dramatically,” says Vinod Khosla, founding CEO of Sun Microsystems and founder of Khosla Ventures. “They will shift to spending a smaller proportion of it ordering diagnostics and interpreting results, and much more on the social elements of healthcare—helping patients and families think through treatment options.”
Physicians will also have to integrate increasingly massive quantities of traditional and nontraditional health data—for example, hundreds of fragmented electronic health records, as well as data from thousands of wearable devices and other “quantified self” technologies. This advance is crucial because “wearable devices that today are still in the more recreational-grade state are changing incredibly rapidly into research-grade and, ultimately, clinical-grade” tools, notes Dr. Eric Schadt, founding director of Icahn Institute at Mount Sinai.
In the near future, physicians may receive a constant, daily stream of data from some patients. The Diovan hypertension pill, with the embedded Proteus chip, is already in trials, with stellar patient-compliance results.3 3.Brian Dolan, “Novartis invests $24M in Proteus Biomedical,” MobiHealthNews, January 12, 2010, mobihealthnews.com. The chip records the time when the patient takes a pill and transmits this information from inside the body to a patch the patient wears. (The patch also captures other physiological data.) This information can be shared with a smartphone, a laptop, and the cloud, so the patient and provider can access it. Such developments have prompted Dr. Krishna Yeshwant, general partner at Google Ventures, to conclude that “physicians need to operate in a more complex environment with an ever-growing range of tools. Physicians need a package of solutions to navigate this environment.”
Patients’ brand loyalty dwindles as cost consciousness rises. People are now much less loyal to brands and companies—both their insurance companies and the pharma companies that make their medicines. “The average tenure for a member to be on an individual insurance plan is now something like two to three years,” says Sanjay Mathur, CEO of Silicon Valley Data Science. The reasons vary, from more frequent job switching to employers that adopt new plans to cut costs, he notes. “In the future, no one will care what brand of drug they will take. And with device, behavior, and health-proxy data available, their method of selecting drugs will change dramatically.” The increased cost consciousness of patients exacerbates this tendency: they compare what they would pay for different plans and the efficacy and price points of different treatments.
Pharma companies will lose exclusive control over their value stories. As the lines among payors, providers, and pharma companies blur, carefully controlled trial data will no longer be the sole source of outcome data. The dynamics between players are evolving: payors are expanding into areas that providers and pharma companies traditionally owned (for example, payors are in some cases excluding drugs completely from their formularies). “With health data becoming more readily available in a more digestible form, payors and providers alike will have more information to link drugs to outcomes and inform value-based pricing,” says Amy Abernethy, MD and PhD, the chief marketing officer and senior vice president of oncology at Flatiron Health. “The healthcare industry will start to merge, and the lines across stakeholders will blur very quickly,” adds Dr. Wolfgang Lippert of Salesforce.com’s Healthcare and Life Sciences Industry Business Unit. “Payors will become increasingly like providers in offering interventions and home care, and increasingly like pharma in analyzing data and pressure-testing value,” he predicts.
For pharma companies, it will not be enough to accept that they won’t continue to fully control their product data. To access real-world data from many sources, they will also need to provide others with more access to their own trial data and to collaborate as appropriate. As Neeraj Mohan of Blackstone Group says, “Pharma companies may think they need to keep their data secure, but not being transparent about clinical trials will in fact put them at a perilous disadvantage in front of patient groups and, eventually, regulators.”Reimagine pharma players as solutions companies, not asset companies
As healthcare start-ups and technology giants move into what was traditionally the pharmaceutical domain, pharma companies will need to revamp their value propositions significantly. Dr. Krishna Yeshwant of Google Ventures pinpoints the challenge in this potential future: “For pharma, there comes the question of whether they can tie digital to the assets they have. There is an interesting broader conversation to have with pharmacos about moving from a products-and-pills company to a solutions company.” The associate director of US medical affairs at one global pharma company agrees, adding, “One of the most exciting values of digital to the pharmaceutical industry is how technology may be able to supplement or support pharmacological therapies to more effectively address the problem of suboptimal outcomes.”
The Diovan–Proteus chip combination for hypertension, mentioned earlier, is one example. Another comes from Google and its partnerships with DexCom, Novartis, and Sanofi to combat diabetes. Among the approaches is uploading glucose and insulin levels to the cloud in real time through contact lenses (worn by the patient) that measure glucose levels in tears; a bandage-sized sensor sends the data to the cloud. This technology can greatly improve the quality of diabetic care and help prevent complications through the real-time detection of any aberrations in glucose and insulin levels, which would trigger the right type of medical attention.
Beyond partnering with technology players, if pharma companies provided solutions that combined different therapeutics from different manufacturers, they could also add an enormous amount of value. In oncology, there is a growing movement to combine novel immune and targeted therapies with market-leader PD-1s from Merck and BMS.
To develop the most promising combinations efficiently, these pharma companies need to access and share early data and improve their digital infrastructure to manage complex trials and submissions jointly. If intercompany combos are to move beyond HIV and oncology, pharma companies must realize that they themselves, and not only patients, can benefit from partnering and combo solutions. For example, they can mitigate the risk and cost of clinical trials for combo therapies and leverage the strengths of each partner for what it does best.
Chris Geissler and Sanjay Mathur of Silicon Valley Data Science stated the case for reimagining pharma companies in even stronger terms: they say it could actually make the difference between success and failure. Big Pharma, they add, may be doomed to fail unless it transforms itself, and what such a transformation looks like is an open question that depends on several factors. For instance, Mathur argues that pharma companies will have to build “trust and form personal relationships with the consumer.” Such a transformation may be difficult for big pharma companies “mired in traditional approaches and legacy organizational structures.” These companies would not be able to compete effectively with nimble, small to midsize rivals that “have nothing to lose. Change and survive or be acquired,” says Mathur.
Finally, certain disease states are ripe for the introduction of comprehensive solutions or systems. Diabetes, which affects 387 million people around the world and consumes one in nine ($612 billion) US healthcare dollars today,4 4.IDF Diabetes Atlas, sixth edition, International Diabetes Federation, 2013. is an area ready for an end-to-end solution.
As pharma companies shape their purpose and future direction, the insights from our interviewees suggest that fundamental change is needed. Companies must redefine the space they play in. They must get more specific information about their customers to identify the solutions and experiences—not just the products and drugs—those customers really need. They also have to understand precisely how such solutions will capture the most value. Then they will need to reconfigure their organizations to capture this value and realize their new approach to the business.Technology is ready, but pharma companies must change to enable and harness it
Our interviewees agreed that technology itself is not what hinders the pharma companies’ full-scale adoption of digital health technology. “Lots of people say there are technical challenges to integrating different medical-record systems, but I don’t think that’s true,” says Dr. Krishna Yeshwant of Google Ventures. “I struggle to see what the tactical limitations are from an IT perspective.”
That said, new technology often faces strong organizational barriers, such as mind-sets that resist IT change and conservative cultures that base decisions on perceived risks. These cultures often lack compelling incentives that reward employees for behaving in new ways by moving beyond the core. Their business structures discourage risk sharing among stakeholders. The performance metrics of most pharma companies connect directly with the bottom line and the current P&L, not with innovation, customer engagement, and future strategy.
As a result, these companies generally try new approaches or technologies only when they see their peers doing so. Most of the digital leaders we interviewed, like Kara Dennis, managing director of Medidata’s mHealth unit, believe that “every one of the required technologies exists or is almost there and largely good enough. The challenge is in pulling the new technologies and processes together for an integrated clinical trial, and this will require life-science companies to remove organizational barriers to change.”
Take data transparency and data aggregation, for example. Multiple third-party players are aggregating health data and making the data and insights available to providers and payors. “If I were a life-science company, I would want to know what the story about my drug is going to be before it’s told by others,” says Dr. Amy Abernethy of Flatiron Health. “I would want to know what adverse events there are before others surface this for me. With constant monitoring, you will find a lot of signals, and you will need to learn how to handle these signals with respect to reporting to the Food and Drug Administration. But this is not a reason to stick your head in the sand; this is how drug development is going to be done in the 21st century,” Dr. Abernethy predicts. A director at a top 20 pharma company adds, “There’s a lot of alarm around utilizing social-media data for fear of discovering adverse events. Ignorance is not an excuse. A company like ours would like to be responsible for understanding what is being said.”
Many companies come at this issue backward, according to Sanjay Mathur of Silicon Valley Data Science. The story should be “about the technology second”—not first, he says. “Companies are so consumed with what technology to use they forget that the most important thing, to start with, is to ask the right questions. You don’t need real-time insight if you don’t have a place for real-time action.”
Pharmaceutical companies must also determine what they will need to uncover distinctive insights. These insights will drive their technology strategy, which will help them to integrate vast amounts of data from disparate sources and to use analytics or other tools that support the entire business.Three fundamental shifts
To achieve all of these goals, pharma companies must fundamentally shift their mind-sets, cultures, and capabilities. Only then can they transform themselves into the agile, experimentally minded solutions providers they need to be. The themes emerging from our interviews suggest strongly that companies must make three strategic shifts to succeed:
Go beyond the pack mentality by embracing experimentation and risk. Pharma companies must now meet the consumers’ higher expectations, which stem from their experiences with other industries. “We have seen significant evolution in the consumer-electronics space,” says Dr. Krishna Yeshwant of Google Ventures. “Now if we turn to the medical-software and device space, we can push more evolution—for example, user-friendly devices or user interfaces. Users of pharmaco products are comparing them with those of the best consumer-electronics brands. That’s the new standard.”
A lack of risk appetite appears to thwart this evolution. “There is a strong pack mentality. Organizations don’t change unless they see everyone else change at the same time,” says Dan Goldsmith of Veeva Systems. “This has resulted in slow advances and a lack of innovation across the industry for years. In essence, pharma wants to be in control and avoid the risk of standing out.” Now, despite the fact that patients are taking back control over their own health, “How many pharmacos do you see out there engaging with patients?” he asks.
Some interviewees feel that there will be action if experimentation takes place in the right place and is both encouraged and rewarded. Today, different departments in pharma companies have different appetites for “radical novelty,” says Johan Grahnen, formerly the principal data scientist at Ayasdi, an advanced-analytics company specializing in machine intelligence. “It is difficult to encourage experimentation in departments that are driven by compliance. Strong leadership buy-in and support is required to set a unified vision,” he adds.
Embrace a collaborative culture and challenge barriers to sharing. A collaborative approach is necessary if pharma companies are going to stay ahead of healthcare digitization. Significantly, some have already recognized the need to stimulate, connect, and support innovative ideas across business units and geographies. “It is critical to have grass-roots experimentation,” says Bruno Villetelle, chief digital officer at Takeda Pharmaceuticals. “We set up an internal digital accelerator and innovation fund to stimulate this, and we run a regular Dragons’ Den competition to identify and fund development and pilots for the best ideas. The competition helps us avoid waste and bring speed, focus, and energy into digital innovation. When a pilot proves its value, we stand ready to put in the resources to scale the idea up quickly to the rest of the enterprise.”
As we mentioned earlier, pharma companies should also recognize that they must contribute data if they want to see what data others have. However, as Sanjay Mathur and Chris Geissler admit, “no real mechanism or incentives currently exist to foster” this kind of sharing behavior.
Inder Singh, CEO of Kinsa, suggests another requirement. Pharma companies must “reimagine their legal and compliance organizations to work more closely with regulators as companies creatively think about how to enable new business-model innovation,” Singh says. “Health information is highly regulated, and the regulatory context has not always kept up with the pace of innovation. Pharmaceuticals will need to actively work with regulators to find a path forward.”
Kristy Junio, senior director of Healthcare & Life Sciences for Oracle Marketing Cloud Industry Solutions, argues that pharma companies need to build novel, trust-based personal relationships with consumers. These ties “replicate the experience and trust that providers were able to build with patients.” Technology, she says, is one way to create this bond—for example, by providing patients with more personalized information about their health and treatment.
Finally, pharma companies have a choice between developing digital solutions in-house or through partnerships. Some of our interview subjects, including Dr. Todd Johnson of Noble.MD, believe it would be better for these companies to partner with third-party technology providers through innovation funds or joint ventures. “With pharmacos’ solutions often offered and marketed in providers’ offices, third-party partners offer more objective, unbiased representation,” Johnson observes. He believes that objectivity and a lack of bias are critical for providers to build relationships of trust with their patients.
Reinvent companies by building nontraditional capabilities and embedding them in new operating models. Attracting, engaging, and delighting consumers requires a deep understanding of how to deliver a customer experience—far beyond just selling a product, pill, or diagnostic test. The problem is that “most healthcare innovation gets smothered in preference for something that drives the bottom line immediately,” says Aimee Jungman, who has worked at companies including Frog Design, Genomic Health, and Pfizer. “There’s a lack of commitment to building something new, which could disrupt current cash flows, and something lasting, for the patient and physician to improve care,” she says. Neither of these aims will be realized unless pharma companies build new capabilities and revitalize their existing business and operating models to foster greater experimentation and bolder strategies.
Going from selling products to selling digital solutions demands completely new processes and ways of working. As Dan Goldsmith of Veeva Systems says, “In some ways, it is easier to talk about the technology, data, and analytics aspects of the digital revolution. But the harder question is, really, what are the fundamental organizational changes that will need to occur? With great advances in technology over the past five years, technology change is the easy part.”
Our conversations and client experience reveal a widespread perception that C-suite executives have not fully embraced digital. Their incentives typically reward them for taking a “wait and see” approach, which can stifle innovation and hinder change across the organization.
Nevertheless, virtually all of the thought leaders agreed that pharma’s old model must change and new blood must enter the system. The good news is that they see some pharma companies starting to value nontraditional skill sets—hiring marketers from other industries, such as retail, and building strategic relationships with creative agencies.
Dr. Amy Abernethy of Flatiron Health says that pharma companies need to double down on talent that truly understands science and health data. Some examples? “People like clinical informaticists who know how to work with electronic health-record data, clinicians who understand the science and didn’t just drop out of academia, or data scientists who aren’t just the IT guys in the basement but are business partners with the senior leaders.” Whether pharma companies choose M&A, strategic partnerships, or organic incubation and experimentation, they must find a way to adapt and evolve quickly. If they don’t, third-party players more willing to take risks, chart the course, and listen to consumers could supersede them.
The digitization of healthcare, even in the early stages, is having a real impact on how not only doctors but also patients manage those patients’ health and how pharma companies need to do business. Digital innovation still faces challenges, such as the lack of clarity about who pays for digital solutions, but digital and data analytics should certainly be high on the C-suite agenda. Pharma companies that want to keep up—or move ahead—must be bold and adopt an act-now mentality. They must build innovative business models, invest in new capabilities, and transform their organizational cultures.
About the authors
David Champagne is an associate principal in McKinsey’s London office, Amy Hung is a specialist in the New Jersey office, and Olivier Leclerc is a director in the Southern California office.
The authors wish to thank Micah Bregman, Ting Guo, Helen Ma, and Shelley Vamadevan for their contributions to this article.
We’ve written before about Epidemico, a startup that grew out of the Boston Children’s Hospital’s work on combing social media for medical and health data. Today at the Health 2.0 conference in Santa Clara, California, Greg Powell, director of pharmacovigilance at GlaxoSmithKline, talked about how the pharma company uses the data it collects from its partnership with Epidemico.
“People really are communicating a lot online on social media,” Powell said. “There’s actually a wealth of information here that potentially hasn’t been tapped into until recently. The question is ‘If people are talking about our products, should we be listening to what they’re saying?’ The answer is ‘Of course’.”
GlaxoSmithKline collected data about public postings on Twitter and Facebook that mentioned any of a list of 1,000 of the companies drugs. Altogether, they found more than 6 million hits on Twitter and more than 15 million hits on Facebook.
“To put that in perspective, there’s more adverse events discussions online, in social media, in one year than there are in the FDA database since it started in 1968,” Powell said.
Epidemico helps GSK to filter that data, eliminate the noise posts, de-identify it (which importantly helps GSK get around FDA reporting requirements) and standardized the language around things like drug names and medical conditions.
The company uses the data more or less the same way it uses drug safety and usage data from other sources, Powell said: it gets turned over to the drug safety team, which identifies trends and takes action if necessary. In at least one case, Facebook postings monitored through this initiative directly led to a recall of an over-the-counter offering in Australia that had a manufacturing defect.
But sometimes social media turns out data that’s not really like anything pharma companies have ever had access to before. For instance, the company has come across rich sources of information about how people are abusing their drugs.
“There are three websites particularly rich in abuse data,” he said. “What people are doing on these websites is they’re actually coordinating clinical trial activities on abuse. They want to abuse drugs, get the maximum high out of it, and they don’t want to kill themselves doing it. So what they’re doing is they’re actually going in and telling people and coordinating, collecting data on the highs they get, collecting safety data, and then communicating to the abuse community how to abuse the drug.”
This can help the company make its drugs harder to abuse, and it’s information that simply doesn’t exist elsewhere.
“People don’t call their pharmaceutical companies and say ‘This is how I’m abusing your drug’,” he said. “They don’t go into their medical records and say ‘Can you add in that I’m snorting Bupropion?’”
The data can also be unexpectedly rich in helping compare adverse events to benefits of the drug. Twenty-nine percent of drug mentions the company has tracked mention the benefits patients received and 16 percent contextualize benefits around adverse events — as in “this drug gave me a migraine, but it was worth it”. Eleven percent of postings compared the drug to other treatment options.
Listening in on social media also helps GSK take the pulse on how well they’re communicating to their patients. By looking at the 6 percent of mentions that were information seeking, the company can identify information it isn’t presenting well.
In addition to the GSK presentation, Tim Fitzgerald, a Director in Merck’s Center for Observational and Real-World Evidence spoke at the event about how his company has used data from PatientsLikeMe. While GSK used social media data for postmarket research, Merck used PatientsLikeMe to do premarket research on Belsombra, an insomnia drug.
“Belsomra was launched in February of this year,” Fitzgerald said. “I did this project prior to launch with the idea to try to get a gauge on what is working, what is not working with the generic medications. To get an idea of what are patients saying about the drugs as far as their satisfaction. And then get into what are their sleep outcomes.”
What Merck found by examining data from the 90,000 insomnia patients on PatientsLikeMe was that even patients who tell their doctor they’re satisfied with their sleep medication are often continuing to have sleep problems. The benefits of existing drugs tended to decline over time and, most interestingly, people said the drugs worked to help them get to sleep, but didn’t keep them from waking up in the middle of the night.
The value proposition for Belsomra addressed some of these problems: it was designed to work over the long term for chronic insomnia, and to help people sleep the whole night. The data, Fitzgerald said, helped Merck to decide how best to market the drug.
At this same session last year, Genentech shared details about their partnership with PatientsLikeMe and other patient communities, and how they were using those insights.
At Apple’s much-anticipated Watch launch event in San Francisco yesterday they delivered what was largely a surprise announcement. For months there has been speculation about the Watch and its possible implications and applications for health. Recently these expectations had been diminished by leaked reports of greatly scaled back integrated sensor technology..
Via Alex Butler
Novartis establishing a joint investment company with Qualcomm Ventures of up to USD 100 million to support early stage companies with technologies, products or services that "go beyond the pill"Digital technologies can optimize the value of innovative medicines by providing integrated solutions for physicians and patients and changing the practice of medicineQualcomm Ventures, the venture investment group of Qualcomm Incorporated, is a leading global investor in wireless technologies and one of the most active strategic investors in digital health
Basel, January 12, 2015 - Novartis Pharmaceuticals announced today the establishment of a joint investment company with Qualcomm Ventures to target early stage companies who offer technologies, products or services that "go beyond the pill" to benefit physicians and patients.
"By working with Qualcomm Ventures, Novartis sees the opportunity to take a greater leadership role in introducing new mobile or digital technologies that have the potential to change the practice of medicine and bring more breakthroughs with real benefits to patients and society," said David Epstein, Division Head, Novartis Pharmaceuticals. "We are excited by the potential of digital medicines to further enhance our mission of the right drug for the right patient at the right time helping people live longer with a better quality of life giving more time to do the things that matter to them."
Digital and mobile technologies are expected to make a significant difference in the pharmaceutical industry. New technologies are emerging such as telephone enabled devices, mobile applications, wearable devices, and technologies for big and small data to enable delivery of the right medicine to the right patients and more robust pharmacoeconomic analyses. The establishment of the joint investment company combines the knowledge of Novartis' innovation in the research, development and manufacturing of innovative medicines with Qualcomm's expertise in digital and mobile technologies.
Healthcare reform is prompting consolidation and leaner pharmaceutical companies and personalized medicine applications are a source of growing interest. But what other trends figure in to the future of the life sciences industry? How about adding healthcare services and competition with big data analysis companies? Those were a couple of the findings from an Industry Healthcheck survey of 1,600 pharmacy professionals by EyeforPharma.
The 971 who responded included managers (39 percent), directors (30 percent), consultants (10 percent), CEOs (9 percent), and sales reps (9 percent). Most of the respondents are in Europe, Asia and the U.S. The majority are in marketing, sales and general management.
Is patient-centric push lip service or reality? Justifiably, there’s a certain amount of cynicism around this issue. Asked if they agreed with the statement, “I believe a focus on patient-centricity is the best route to future profitability,” 80 percent agreed — 30 percent said they strongly agreed. The fact that the majority of the respondents are in sales and marketing underscores that it’s a big talking point, sure. But pharmaceutical companies have seen that to generate greater participation in clinical trials, improving adherence and understanding patients’ needs they need to have more conversations with patients and their advocates and that’s happening.
Christoph Schmidt, the head of global commercial excellence at Actelion Pharmaceuticals, agrees. “Patient centricity as a strategy is also the result of the shift in decision-making power in the more complex and educated stakeholder landscape,” the report notes. But David Laws of Global Partners said there’s a huge disconnect between intent and action.
“I guess pharma’s definition of patient centricity is going to be somewhat different from other stakeholders and this may help explain the perception gap. Pharma is all talk in this area and continues to behave as a product focused industry… Clearly good products are important but on their own they do not produce any income and certainly no profits. Profits come from customers!”
Life science innovation is key to profitability: Asked whether they agreed with the statement “Quality medicines are the best route to future profitability for the company,” 77 percent agreed. The debate over the cost of Gilead’s drug Sovaldi — the first drug to cure Hepatitis C — is a good example of the upside and downside of how innovation is viewed. Everybody seems to want innovation, but if the price is too high, there’s a lot of grousing, particularly from payers and patients. It’s understandable but in cases where it’s a question of costs down the road and more immediate costs, it should be a no-brainer. Still, reimbursement isn’t the only challenge to innovation. More than half of respondents (56 percent) view the success of new medicines as hampered by an outdated regulatory system rather than an ability to innovate.
Pierre Morgon, CMO at Cegedim, said the pharmaceutical industry will need to change to adjust to these cost concerns.
“Going forward, the industry will have to take a different stance on affordability of novel therapies as perceived by the payers and the net consequence for the shareholders will be to admit that the story becomes ‘profitability, but not at any cost,’ almost as an integral component of the company’s CSR policy.”
Healthcare services will be part of pharma strategy: About 73 percent of respondents agreed that they need to become genuine healthcare providers and offer healthcare services. Still, there are a lot of challenges ahead for companies to move “beyond the pill.” Although Pfizer’s Integrated Health division only lasted a couple of years, Christian Isler, the former global head of solution and product development for Pfizer Integrated Health, learned a good few lessons from the experience. It will take years before it’s profitable. He recommends setting up a separate legal entity. It also will require a change in culture — more listening and responding to customer needs.
The competitive landscape will shift in the future: It seems like a weird statement but 59 percent believe that pharma’s greatest competition will be from companies other than current pharmaceutical manufacturers in 20 years. So who will that competition be? Big data analytics companies seem to be the biggest suspect. I tend to see them as complementing pharma, but others view that dynamic differently, as Morgon suggests. ”
When it comes to discovering new medicines, the ‘competition’ will likely remain within the space that we know today, involving academia, start-up companies and larger ones. But there will be other players, specializing in the mining of the huge amount of data allowing to better profile responders to a given treatment. These new players will play a critical role in the generation of insights and the subsequent discussion on the value of the medical interventions.
The life science industry as we know it today will therefore need to learn how to partner with these new players, if it wants to retain a seat at the table of the decision makers about the real life, and not be “cornered” in the world of the laboratory and the randomized clinical trials.”
Cyndy Nayer, the founder and CEO of the Center of Health Engagement, an agency promoting strategic investments in health value for employers, health plans and provider organizations. She has been called the ‘voice of value-based designs’ and selected by EY as a national thought leader in health care innovation.
Apple's ResearchKit was quickly adopted by clinical studies at a series of universities and hospitals, but a new iOS app focused on rheumatoid arthritis from pharmaceutical firm GlaxoSmithKline marks the first time a drug company has made use of the framework.
Via Alex Butler
A panel discussion on the future of digital health in pharma at the MedCity CONVERGE conference in Philadelphia this week highlighted how Pfizer, Eli Lilly and Roche are using telemedicine, mobile health and connected devices as part of their drug development strategy. They also called attention to the impact of compliance on implementing these technologies.
Via Alex Butler
Japanese pharmaceutical firms Astellas, Daiichi Sankyo and Takeda have joined forces to create a comprehensive database of biomarkers from healthy adults. Each company will collect and analyse biomarker data from healthy volunteers, pooling this for comparison with patients taking part in preclinical and clinical research. The patient data will come from Astellas, Daiichi Sankyo and Takeda clinical studies that use protein and metabolite biomarkers that will be carried out at their respective research bases in Japan. In a joint statement, the three companies said they intend to publicise the resulting analysis, commenting that “fundamental biomarker data from healthy adults … has not been sufficiently accumulated globally” to date. They hope that the research collaboration will subsequently accelerate the development of innovative new medicines, particularly in Japan but also worldwide. The collection of the data samples will be overseen by Dr Thomas Hankemeier in association with a local CRO at Leiden University in the Netherlands. Biomarkers are naturally occurring characteristics formed from ordinary biological, pathological or physiological processes and which can be objectively measured to document pharmacological responses to therapeutic intervention. Biomarker collaborations have become increasingly common in the industry, with AstraZeneca's new drug discovery genomics consortium also planning to publish its findings. Similarly in 2015 Genentech partnered with 23andMe to analyse genomic data for Parkinson's disease. Meanwhile, at a regulatory level, the EMA's recent draft Alzheimer's disease research guidelines looks at the need for biomarkers.
UCB has restructured in order to put more emphasis on finding what its patients need. Bharat Tewarie, Chief Marketing Officer at UCB, is musing on his days as a medical doctor and considering how the experience has shaped his subsequent work in pharma. “What did I do when I was a doctor?” he asks in an interview ahead of his presentation at eyeforpharma Barcelona 2016. “I was focusing on understanding my patients, helping them move forward with their lives realizing that each patient experience is different.”
His training in the Netherlands was nearly three decades ago, but it has left its mark. “Fast-forward to the role I have now and that attitude fits hand in glove with where UCB is,” he goes on. “At UCB we ask ourselves, how will what we are doing create value in the lives of people living with severe chronic diseases?"
Perhaps this is what attracted him to the company. Tewarie joined UCB earlier this year as part of CEO Jean-Christophe Tellier’s shake-up of the organization. UCB has made clear its ambition to better understand patients and provide a more holistic approach to care and reshaped its internal structures to achieve this: the executive committee - of which Tewarie is a member - has been realigned to get the company closer to its end user: the patient. "UCB today is not organized by function, but instead by the patient value that we want to create. We have patient value teams in each of our major therapeutic areas. That has facilitated cross-functional teams working at every level of the organization to be as close as possible to the patients and to the outcomes we want to deliver for them".
No wonder Tewarie considers himself such a good fit. “I use this example. In marketing, one of the concepts is that you create solutions for the patient. But I say: ‘Move away from creating solutions for the patients…to creating them as the patient’…When you do that, your insight changes completely".
This is certainly in tune with the prevailing mood. “At UCB now, the key characteristic of our new organizational structure is that it is more connected. No one person owns the solution. It’s always the result of a cross-functional team with shared accountability working together to understand the complexity of the environment”.
Tellier has talked before about the need for pharma to look from the ‘outside in’. Tewarie knows what his CEO means, bringing 27 years of experience in the pharma and biotech industry to UCB. He has, you suspect, seen his share of initiatives before which still did not really come up with the goods: he clearly believes UCB’s approach will be different. There is a lot to learn from other industries if you are prepared to look.
Focusing on delivering value for the patient will in turn deliver success for the company and revenue for shareholders, Tellier has insisted. Yet research over the past couple of years has suggested that pharma companies are split when it comes to the idea of who their real customer actually is: despite fine words about patient-centricity, many still believe it to be doctors and other healthcare professionals.
There is no debate at UCB, however, insists Tewarie. “The patient is the first customer. To make this a success, every person in the company must live and breathe it. It must also be consistent: the leadership team leads it, but at every meeting people must be asking themselves: ‘what difference am I making today in the lives of our patients?’”
Developing cross-functional teams and getting the internal culture right are key points when it comes to achieving what UCB has set out to do. To that end, Tewarie heads the Global Marketing and Market Access Patient Value Practice and explains that this is made up of a variety of strands: a Strategic Marketing practice, a Market Access and Pricing practice and 2 centers of excellence, namely Insight and Foresight.
“Our Patient Value Practice consists of colleagues from marketing, market access, pricing, insight, foresight, all together,” he enthuses. “Each has a part of the value chain. Not one single person owns it –the idea is that we think, connect, and co-create ideas together, before piloting to see if it works. If you find that it does, and the whole company could benefit from it –then share it with agility.”
A patient value practice with four main priorities
“The teams have various priorities,” Tewarie explains. “We look at the ecosystem on the outside –what trends are happening, which of these are sustainable, and which of them would have an impact on UCB’s strategy”.
The second is to focus on the "how" to create patient value. We use external benchmarking of what "good" looks like. “For example, we take a look at the last successful launches inside and outside our industry to learn and see what worked and what could have been better.”
Third is that external focus which Tellier has insisted needs to be part of UCB’s make-up. “We need to be looking at ourselves from the outside in and learning from other industries,” Tewarie says. “We need to look at novel methodologies and new approaches to drive new and unique models for innovation–we can’t just be the same”.
This means looking at how consumerism poses new challenges for pharma with patients having unique priorities, expectations, and demands that companies must take into account if they want to meet expectations.
“We must also look at how new trends in technology and Big Data analytics can help our business to generate patient value. We want to innovate to drive the development of differentiated solutions as well as working out how we can bring them to the patient in an agile way”, states Tewarie.
Finally, there is a focus on the people, their competencies and potential, that are essential to delivering on these priorities. “We have to keep a close eye on what the organization of the future will look like and which capabilities will be the winning ones,” he says. UCB is keen to emphasize the importance of its employees. “How do I develop my talents so that we are ready for the future?” Tewarie says. “We try to groom the talent, rotating them around the company so that their potential is unlocked.”
Following his medical training, Tewarie has had a broad background in multiple aspects of pharmaceutical management, including P&L responsibility, business development, sales, global marketing, clinical research and medical affairs.
A veteran of large companies like Roche and BoehringerIngelheim, he spent most of his working life prior to UCB at various parts of Merck Serono specializing in areas such as neurology, immunology, medical devices, endocrinology and reproductive health.
Focused today on two key therapy areas –immunology and neurology - UCB is sizeable. Yet although it has a presence in 40 countries and brought in revenues of €3.3 billion last year, it is by no means among the big beasts in pharma’s jungle. With that in mind, does Tewarie think it is easier for a mid-size company to introduce initiatives like patient value? “Maybe, maybe not,” he muses. But he has no doubt that this is the direction in which pharma needs to go. “Patients are more empowered now because of the digital revolution, and there is more information available to which they have more access. At the same time, there is pressure on payment systems. Co-pays are increasing, hence payers and patients are asking for value. This all means you need to deliver value for those people who use the products.”
Pharma is – for good reason – heavily regulated, which means that interacting with patients carries with it legal and ethical restrictions, which differ from country to country. But UCB is confident that it can keep on top of the various demands this engenders. “We’ve created a framework, “he says. “A formal process is in place to listen better to patients and govern interactions in a compliant way with patients.”
All of this is particularly interesting to Tewarie, because he insists that the biggest change he has seen in his long career is the one the industry is going through now. “It’s this slow dawning of how the shift is happening about who is the true customer, “he says. “It has been the physician, then the payer, and now the patient.”
Technological change – allowing access to ever-greater amounts of information, for instance - and the increasing empowerment of patients are among the most important factors driving these changes. The insight that companies can gather about these audiences is changing rapidly too, with ethnographic research, social media listening or online community management giving pharma the chance to tap into the patterns of behavior that it finds and use them to shape strategy.
“However we do it, the focus 100% is on generating patient value,” he concludes. “We must focus on the outcomes –as defined by the patient. Using the framework, UCB is speaking to patients, hearing their experiences in their own words. By knowing the patients not only from research but also from these first-hand experiences, UCB employees are better able to respond to their needs and keep them in mind on a daily basis. Understanding will happen more and more when we keep having these conversations with patients…allowing us to develop better solutions to help them live the life they choose rather than the one dictated by their disease”.
Bharat Tewarie will be presenting at eyeforpharma Barcelona 2016 on "Establishing Meaningful Communication with Your Patients". To download the brochure, click here.
There’s no debate that the growth of social media has changed the way that we, as consumers, access and share information. The proliferation of mHealth and other health care social platforms targeted at physicians suggests that this dynamic is no different for our doctors. With health care social media sites now reaching 50% of physicians1 and the user base for third-party physician social platforms growing rapidly, it is clear that the value perceived by physicians regarding interactions in the social space is increasing. Additionally, more than half of physicians polled in a recent survey expressed interest in interacting with pharma for practice-related purposes.2 Given the increased level of physician engagement in social, we are forced to wonder: What opportunities exist for pharma? What should pharma companies do to “win” in this new environment?
Via Olivier Delannoy
NEW YORK, Mar 16, 2015 (BUSINESS WIRE) -- Chief marketing officers (CMOs) and chief information officers (CIOs) in the pharmaceutical industry may be missing the opportunity to optimize the impact of digital technologies due to a lack of alignment on how they should respond, according to a new Accenture ACN, -0.82% industry report, The Rising Opportunity for CMO and CIO Collaboration in the Pharmaceutical Industry, based on a global Accenture survey.
More than nine out of 10 large pharmaceutical company CIOs (91 percent) who participated in the Accenture Interactive 2014 CMO-CIO Alignment survey of senior marketing and IT executives believe that their companies are in need of greater marketing/IT alignment. By contrast, fewer than two out of three pharmaceutical CMOs (58 percent) agreed with that statement – a discrepancy of 33 percent. This difference in perspective is greater in the pharmaceutical industry than in all other industries surveyed by Accenture at the same time – where the average discrepancy was only 14 percent.
Anne O’Riordan, senior managing director of Accenture’s Life Sciences industry group, said, “The reasons for the difference include traditional structures, cultures and sales representative-led commercial models. The industry faces a period of rapid change marked by digital advances, new expectations from health care professionals and patients, and a dominant outcomes-based reimbursement environment. This requires CMO-CIO collaboration to increase as patients and healthcare providers move more aggressively into the digital world.”
CMOs and CIOs in the pharmaceutical industry have different views of integration and overall investment in the marketing function. According to the report, pharmaceutical CIOs view analytics as the top driver of integration (cited by 52 percent of respondents), but pharmaceutical CMOs rank analytics near the bottom (cited by just 13 percent). Priorities for technology spend were similarly divided:
A majority of pharmaceutical CMOs (54 percent) have spent the most in applying technology on customer experience, while just 14 percent of CIOs cited customer experience as a priority to further market impact and outcomes.Only 17 percent of pharmaceutical CMOs have spent funds to equip a mobile-enabled sales force, compared to 43 percent of pharmaceutical CIOs.Just 13 percent of pharmaceutical CMOs said they have spent the most to invest in multichannel analytics, compared to 43 percent of pharmaceutical CIOs.
The survey also pointed to a lack of a common vision for technology and understanding between CIOs and CMOs in the pharmaceutical industry. For example, two-thirds (67 percent) of the CMO respondents do not view IT as a strategic partner, compared to 50 percent of CMOs surveyed in all industries. Additionally, while nearly 80 percent (77 percent) of pharmaceutical CIOs see the need for greater alignment with CMOs, just 44 percent of pharmaceutical CMOs feel that way.
CIOs and CMOs in the pharmaceutical industry also have differing attitudes on how to make alignment work between the two functions: Nearly four out of 10 pharmaceutical CIOs (38 percent) would favor co-locating IT and marketing staff, an option favored by only 13 percent of pharmaceutical CMOs. At the same time, nearly four out of 10 pharmaceutical CMOs (38 percent) said they would support creating an IT lead within the marketing function, and a marketing lead within IT, a solution that only 19 percent of pharmaceutical CIOs favored.
“We suggest key steps to closing the gap between pharmaceutical CIOs and CMOs, including establishing a vision and set of common objectives for marketing IT that leverage the power of digital and unifying around the customer and patient experience,” added O’Riordan. “They should also integrate customer/patient-focused skills throughout the company, and focus the IT agenda to empower marketing to exploit digital technologies.”
To view more detail on the industries surveyed, click here and go to the Interactive Toolbox.
Accenture’s The Rising Opportunity for CMO and CIO Collaboration in the Pharmaceutical Industry report is based on interviews with 22 CIOs and 24 CMOs from pharmaceutical companies from eight countries (Australia, Canada, France, Germany, Italy, Japan, United Kingdom, United States) with at least US$5 billion in annual revenues. Respondents were interviewed for the Accenture Interactive 2014 CMO-CIO Alignment survey, which is the fourth in a series of studies aimed at understanding the options, challenges and points of view of senior marketing and IT executives on the impact of digital strategies and capabilities on their business. The survey was in the field in December 2013 and January 2014, and respondents were from 11 countries and 10 industries. More details about the full research and the methodology behind it can be found here.
Accenture is a global management consulting, technology services and outsourcing company, with approximately 319,000 people serving clients in more than 120 countries. Combining unparalleled experience, comprehensive capabilities across all industries and business functions, and extensive research on the world’s most successful companies, Accenture collaborates with clients to help them become high-performance businesses and governments. The company generated net revenues of US $30.0 billion for the fiscal year ended Aug. 31, 2014. Its home page is www.accenture.com.
The need for new drugs seems higher than ever with population-wide health crises such as Ebola, H1N1, Anthrax and HIV/AIDS. Maintaining an innovative drug development environment seems increasingly critical for our existence. In addition, we are facing healthcare issues related to our lifestyle, which through cardiovascular disease and diabetes alone contribute heavily to escalating healthcare costs.
We do need to find a solution for the funding challenges that these new treatments are causing in the short run and celebrate the long-term public health improvements that they help us achieve. I would encourage health insurance companies to collaborate with drug companies in finding solutions for patients in need, rather than challenging the value of these miracle drugs.
The medical app market is dominated by the big players, since they have the resources to create the best apps and the financial muscle to push their products in the market.
The lion’s share of the medical apps market is occupied by established companies with historically strong brands. Bayer leads the pack with 11.2% market share, followed closely by Merck, Novartis, Pfizer, and Boehringer Ingelheim
Via Andrew Spong
A young woman sits stunned in an oncologist’s office, unsure of where to look or how to react to the terrible news. The doctor is telling her that she has cancer – meaning the woman is no longer the same person she was when she walked into the office, as for now she has become a ‘patient’.
And as a patient, she will have to make all sorts of life-changing – and possibly life-saving – decisions in the coming weeks and months. The news is a blow, but the doctor has many other people to see, and only has time to give a brief overview of her diagnosis and the basics about what to expect.
Our typical patient’s life has now changed irrevocably, but she feels unequipped to deal with whatever may lay ahead. Twenty years’ ago, this scenario would have been left right there. The patient would have been expected to cope largely on her own, occasionally being told by doctors and consultants what procedures she would have and what drugs she would take.
But there has been a quiet revolution in recent years – a shift which is restructuring healthcare across the world. This revolution has come from digital. There is always a danger of over-romanticising digital. Etymologically the word comes from the Latin digitus, meaning fingers or toes – thus to be ‘digital’ simply means to use one’s digits when performing an action.
But of course it now means so much more than that. ‘Digital’ now incorporates much deeper connotations of engagement, networking and commercial opportunity. Today, our patient can face her disease in new ways: by writing blogs about her progress for instance, or engaging with an entire community of patients going through similar treatments. This can help her to predict what could happen further down the road, or even help her through the difficult first few weeks following diagnosis.
She can also do some research online to find out what treatments are available beyond what her doctors are advising, giving her the confidence to seek out different options, or even find new clinical trials that could benefit her. The young woman has gone beyond being a patient and become an ‘ePatient’ – an evolution of sorts, and increasingly the norm as people further their engagement with online information.
The rise of the ePatient
For pharma, this represents a major new opportunity to not only promote new medicines via social media and disease awareness campaigns, but also to come out of the shadows, to become more transparent and – for the first time – engage with patients on a one-to-one basis.
Digital is now becoming the tool of choice for many pharma marketers, where the line between traditional marketing and digital marketing is so blurred, the two have essentially amalgamated. Increasingly, if you want to deliver a message – especially to patients – you have to go online.
But the pharma industry as a whole has not embraced any form of digital revolution as readily as other sectors. There are many reasons for this, with legal restrictions being chief among them, especially in the European Union, where rules forbid pharma from discussing its products directly with the public. This limits just how much – and what – it can say to patients.
But whilst the industry may not have taken on digital wholeheartedly, some individual firms, and individuals within those firms, have taken up the challenge of finding a way through the legal quagmire. At the beginning of the year, those pharma companies willing to embrace digital came to the fore through an IMS Institute poll of the best pharma firms in social media.
Johnson & Johnson, which also has a large consumer unit, came top by some margin according to the metrics of IMS, followed by a close cluster of other companies: GSK, Novo Nordisk, Pfizer, Novartis and Boehringer, respectively.
You would expect most of these at the top given their large budgets and digital willingness – although Boehringer, which almost defines itself via its social media presence, may feel a little disappointed to be sixth on the list.
But whilst lauding the success of the top 10 firms, the IMS Institute was quick to caution that pharma may not be using these new media platforms to the best of their ability, and will need to invest more to engage with younger, digital-savvy consumers.
And this is a problem. The young cancer patient can benefit from digital, but a fundamental demographic difficulty remains: the majority of people who require prescription medicines are over 50 – with many larger groups in their 70s, 80s and 90s. Patients in these age brackets use social media far less than their younger peers and are therefore largely ignored by pharma’s foray into social media.
However, recent reports suggest the tide may be slowly turning. Specifically, an annual survey by a UK governmental communications group says that the emergence of tablet computers is behind a swift rise in people aged 65 and over using the internet.
Drawn up by the UK government’s Office of Communication (Ofcom), this report indicates that, in the past 12 months, the percentage of older people going online rose by more than a quarter to 42%, which could fuel more interest in health-based media. Despite this increase, however, the oldest group of people still spend the least amount of time online of any adult age group.
According to Ofcom’s report, the over-65s spend nine hours and 12 minutes online every week on average. By contrast, those aged between 16 and 24 devote about 24 hours each week to online activities. In healthcare terms, this means that younger, chronic patients may well be the greater beneficiaries of digital campaigns.
The same study found that half of the apps people download are redundant because they are used so infrequently. On average, the survey says, smartphone users have 23 apps installed – but make regular use of only 10.
This is a major problem for developers, especially pharma and health app creators, who require regulator engagement with users for their programmes to work successfully. Finding a way to engage with older patients – and holding the attention of the younger ones – remains a key challenge for pharma if it wants to nurture any digital revolution.
Pharma’s foray into digital
But just what has the industry done to engage with the ePatient? Pharma has traditionally been publicity-shy, hoping instead for its products to be better known than its producers. As mentioned before, there are good reasons for this as they cannot be seen to promote prescription drugs on these platforms, and have to be very careful not to cross any legal parameters when talking to users.
But this has not stopped the industry using social media, notably Twitter and Facebook, in order to (legally) engage the general public. So how do pharma companies use these new channels? Many use Twitter to publish links to press releases, which are primarily of use for journalists.
Some tweet about events they are running/sponsoring. Others attempt to increase their public reputation by announcing plans to increase access to medicines abroad, or other seemingly philanthropic gestures.
There appears to be less engagement on Twitter – visibly less anyway, as interactions and direct messages cannot always be seen. Most companies do enjoy a fairly large following, however. GSK’s main Twitter account has nearly 50,000 followers, Boehringer has 32,000, Sanofi 40,000, and top dog Pfizer is closing in on the 100,000 mark. (This seems to reflect global size: Pfizer is the world’s biggest pharma firm by revenue, so it’s no surprise it has the most followers.)
The majority of these firms follow very few people in return – typically just a few thousand or even a few hundred. These are predominately news services and other medical charities and groups. But pharma’s figures are fairly high compared to other industries – BP Oil, for example, has fewer than 2,000 followers, whilst Barclays Bank has only 22,000. This is more impressive given that Sanofi, Boehringer and others are not the household names that BP and Barclays are.
But pharma’s use of Twitter has not always been positive. The first reported case of a tweet landing a company in hot water came in 2011 when Bayer was reprimanded by the PMCPA, which polices the ABPI’s Code of Practice in the UK, after its UK Twitter account promoted a prescription-only drug to the public when it sent two product-related tweets.
These tweets concerned the company’s erectile dysfunction treatment Levitra and its multiple sclerosis spasticity drug Sativex, both of which were published in a way that made them seem promotional. Bayer was hit with a major reprimand from the PMCPA, and fined thousands of pounds.
And last year a European NASDAQ disciplinary committee found virology specialist Medivir guilty of breaching its rules, after data from a clinical trial were posted on Twitter before their formal release. This case, however, was a little more complicated as it was not Medivir who sent the tweet, but rather a participant who took a picture with his smartphone at an event the firm was hosting.
The picture was then published on social media hours before the data was officially made available to the public, thus breaking NASDAQ rules. Much was made of these cases in the press – especially Bayer’s tangle with the PMCPA– but they certainly weren’t earth-shattering enough to warrant rejecting digital in all of its forms.
In Bayer’s case, the tweets were sent mistakenly with perhaps a slight misunderstanding of the lines between information and promotion. And Medivir’s example was again a mistake, rather than intentional – there should have been a direct conversation with attendees that data were embargoed. In reality, neither firm was looking to use these media to advertise.
A bigger problem has stemmed from Facebook, after the social media platform decided in 2011 that firms running corporate profiles can no longer simply delete comments they didn’t like. This means that companies can only retroactively delete comments if they break Facebook’s terms, or are illegal.
Janssen’s award-winning Psoriasis 360 Facebook offering was quick to fall foul of these new rules, and in 2012 the firm said it was ‘forced’ to remove the page – which also had Twitter and YouTube counterparts – after an increasing amount of ‘troublesome comments’ were posted.
Janssen said at the time: “Whenever a post on this page [Psoriasis 360] mentions a specific drug by name, or talks about the efficacy of a particular treatment (or its side effects), we have to ask for it to be changed, or pull it.”
The J&J pharmaceuticals subsidiary went on to say that this was ‘stifling worthwhile discussions’, and constantly removing these posts simply become too onerous for the firm. Psoriasis 360 was seen as one of the shining beacons of what pharma could do with digital, but its removal from Facebook was worrying given that the firm had done nothing wrong – it simply couldn’t keep up with the public’s comments.
This is the reality of becoming more open on the internet – a company that was once immune to direct public criticism can instantly become the target of ‘trolls’, rather than receive helpful feedback from people who are genuinely upset or concerned about a firm or its products.
Pharma may well have to develop a thicker skin and recruit more staff who are used to monitoring web comments. The travails here are certainly ones that pharma must be aware of, but if it wants to succeed in a brave new world risks will have to be taken – and understanding risk is, after all, what the industry is all about.
An argument remains that too much time and effort is being spent on digital communications, when the primary job of pharma should be to concentrate on its research and development. And a large question mark hangs over just what the return on investment (ROI) is for firms who want to grow their presence on platforms such as Facebook and Twitter.
Digital is a major buzzword and becoming all-encompassing at many pharma conferences. This was no more evident than at the recent eyeforpharma offering in Barcelona, where much emphasis was put on the use of digital to aid the industry’s future.
But this focus was at one point sharply put into perspective by a single slide, that showed only 6% of pharma’s entire marketing budget is spent on digital marketing. The question is: just how measureable is this 6% investment? Have more drugs been sold as a result, and is this even the point for pharma’s foray into digital? Can engagement be successfully measured and pitted against the cost of creating a campaign?
These questions are not benign and the lack of answers is what prevents many pharma firms from fully embracing digital. In an interview with Pharmafocus in 2012, during the launch of Syrum – Boehringer Ingelheim’s Facebook game designed to promote disease awareness campaigns – its creator John Pugh dismissed enquiries about ROI, saying it ‘wasn’t relevant’ to ask that sort of question in relation to a digital operation.
ROI is a key component of digital which is not discussed readily, but remains important to chief financial officers and to the healthcare payers who are ultimately funding pharma. The marketing budget for digital may certainly be small, but it still represents billions of dollars across the industry – and a good prediction of ROI is surely a necessary part of any business plan.
Embracing digital for the right reasons
Ultimately, as is so often the case with pharma, the issue boils down to trust: patients and lawmakers want to know that pharma’s use of digital media – and indeed its interaction with patients – is based on sharing information openly and helping to improve the experience of having a condition, whilst also aiming to deliver better medicines.
It should not be, as some fear, an attempt at ‘back door’ direct-to-consumer advertising or in any way promotional. There is an opportunity here for pharma and medical communication firms to help shape the future of healthcare and chart the course of the ePatient.
Our young cancer patient has now been given a louder voice and a community to engage with – and all at the touch of a button. The patients’ needs must remain the top priority for pharma and doctors, if the promise of digital is to be fully realised