Digital Pharma news

We are reaching a unique and crucial point of convergence in this country and the opportunities and timing are ripe for mobile health.

For example, at one end we have over half of the U.S. population now carrying a smartphone of one flavor or another. At the other we have growing population health issues – consider this, by the year 2025 it is predicted that half of those age 65 or older will have at least 2 chronic diseases they will need to manage.

Where these two points meet could be critical to how we will deliver healthcare in the near future.

Today’s methods for monitoring and treating multiple chronic diseases and health in general will have to change. There is clearly a need for a more innovative approach to dealing with these challenges and mobile health (or mHealth) technology is positioning itself to be that innovative approach.

Mobile health (or more specifically mobile applications known as ‘apps’) hopes to bridge the gap between where we are and where we need to be. Dr. Eric Topol (a high profile effective evangelist in this mHealth field) has said, “these days I am prescribing as many apps as I am medications.” The future is clearly here.

As a result, mHealth is hitting its growth phase at the same time the healthcare industry is grappling with how to move from volume-based to value-based care funding models. mHealth offers not only the ability to make physicians more scalable across a broader number of patients but mHealth can clearly help influence how healthcare may be delivered.

The mobile health application space is literally evolving and taking shape before our eyes and with that much change occurring that quickly it can be difficult to get your bearings and know where to start.

A Structured Approach is Needed

What is needed now is the right strategy, the right framework. That’s what makes the mHIMSS Roadmap model so interesting.

We as a healthcare industry need to ensure that we are approaching mobile health not only with eyes wide open but to make sure that we are adopting processes that will last and are not just the glittery tech jewels of the moment. There are practices that can be leveraged from existing concepts like how pharmaceuticals are prescribed and how biomedical devices are integrated. mHealth allows providers to completely adapt to a new care setting – the home, the office, or wherever.

That drives a number of questions that we can easily think of and many that we might not consider. By using the mHIMSS Roadmap framework we can discover a number of other questions I hadn’t thought about yet.

At its core a good mobile health strategy will consider:

Device integrationData standardsData integration back into the EMRPhysician workflow and usefulnessApp usability by the patient

In short, there needs to be a practical use case with which to start and it always starts with either the patient or the physician.

That leaves us with some interesting decision points. Do you create a flexible strategy and then implement pilot projects within the framework? Or do you make one ‘digital pathway’ work from patient back to the EMR as a proof of concept?

We all have a lot of work ahead of us. Now it’s time to roll up our sleeves and get down to it.

“There’s a tension between opportunity and risk”, says Simon Quayle, Director of Digital Communications at GSK, describing his work leading the company’s corporate social media engagement. And he should know – he was responsible for making GSK’s Facebook page one of the world’s first ‘open’ pharma social media environments, encouraging public stakeholders to post comments during a time when most pharmaceutical companies kept their pages tightly locked down.

That was in the days when Facebook allowed pharmaceutical companies to ‘switch off’ commenting from their pages; a practice that has since been banned by Facebook, forcing less-prepared companies to either close down their Facebook pages or rapidly adapt to two-way public engagement.

GSK featured in my “Top 10” pharma social media firsts of 2013 for exceeding 90,000 Facebook ‘Likes’; today, Likes on the company’s page are rapidly approaching 100,000. But according to Quayle’s colleague Janet Morgan, Director of Corporate Reporting at GSK, the most successful channel of engagement is in fact not Facebook, but LinkedIn, where the company has over 400,000 followers actively sharing its content.

Quayle and Morgan tell me that their secret to success in social media is to focus on selected channels where they can be most effective: currently Twitter; Facebook; YouTube; LinkedIn and Flickr. As they share some of their stories, I sense that the lessons they have learned through both success and setback have developed the company’s mature approach to social media.

Morgan says that the most active engagement from people with a genuine interest in what GSK is doing comes via LinkedIn, where the profile and behaviour of users is quite different to Facebook. On Facebook, what works best is “feel good” stories about positive news and corporate responsibility. Quayle says that it can be surprising to learn what kinds of content leads to positive engagement. He was surprised to discover, for example, that a photo of the GSK headquarters building attracted more positive comments than a story about a community partnership.

A recent example of content that inspired a positive response was the profiling of women in management within GSK, to mark International Women’s Day which took place on 8th March. The theme of International Women’s Day was “inspiring change” and GSK’s take on that was to profile inspiring change in the workplace, with content published on the company’s website shared via a photo album on Facebook; Tweeted; and posted on LinkedIn. After just three days, Morgan says that engagement was 50% higher than average.

I ask Quayle & Morgan about @GSK_conferences, the dedicated Twitter profile featuring “Tweets from GSK employees attending scientific conferences”. Quayle says that this is an experiment to allow the company to engage actively at conferences without the corporate @GSK Twitter profile becoming too noisy for the majority of its 40,000+ followers who may not have an interest in the particular conference. Tweets from @GSK_conferences are sent by GSK team members while they are on site at conferences. “It’s important to actually ‘be there’ if you are tweeting form a conference”, says Quayle.

GSK uses other dedicated channels, too. In the US, for example, a dedicated customer channel exists to handle responses to product queries. Ultimately the conversation is usually taken offline, but using a dedicated account for responding to product enquiries keeps the corporate channel focused.

Quayle, who launched the company’s Facebook and corporate Twitter accounts himself, started in social media with his own personal profiles on the platforms, so that he could learn about the environment before taking the helm of GSK’s social media engagement. Quayle & Morgan tell me that GSK staff with an interest in using social media for the company are encouraged to have their own accounts, and to start out by simply following others, listening, to learn about the channel.

A key aspect of Quayle’s approach to GSK’s social media engagement is to continually be experimenting, discovering what works and learning from every experience. He likens the company’s history with social media to learning to ride a bicycle, and says while it is important to understand the opportunities and the risks, it is even more important to actually try things: “You don’t learn to ride a bicycle by reading a manual – you have to try it”, he says. “And when you go out, you need to have a rough idea of where you are going.”

“Working closely with legal and compliance colleagues is essential”, says Quayle, adding that an aspect of experimenting is being happy to close things down if they are not working.

Returning to the bicycle analogy, Quayle adds that it is important to be prepared for what could go wrong. “[When riding a bicycle, you need to] have a view about what might be ahead – take a first aid kit, and a puncture repair kit”, he says, indicating that the corporate social media equivalent to these might be a crisis management plan, and a clear escalation process.

Being prepared for change seems to be something that Quayle relishes. He is eager to make the most of opportunities as they arise, and yet both Quayle and Morgan are clear about their goals: “Building [GSK’s] reputation; building trust; developing transparency”.

Does social media bring commercial benefits to GSK? That’s not exactly the point, according to Quayle and Morgan. “Increasing sales is not one of our KPIs”, says Morgan, “although building reputation and trust will do that”.

“The way that we do business is just as important as what we achieve”, adds Quayle. “You cannot be a company that’s performing well if you’re not living up to the expectations of society, and living transparently”.

I am left with a sense that despite GSK’s success in social media to date, the team have a lot more up their sleeves yet. “We have to organise ourselves around the needs of the customer”, says Quayle. “We’re starting to do that”.

With digital marketing proving itself a juggernaut force inside of countless emerging markets where mobile technologies were largely impossible to find only a few short years ago ...

While Pfizer leads in followers, Sanofi US leads the way # of tweets and Novartis leads in engagement on Twitter

It is quite an obvious f

Despite pharma’s best efforts to improve systems for calling on physicians, access to targets remains a problem across the industry.

Janssen Healthcare Innovation (JHI) has today announced the UK launch of Care4Today™ Mobile Health Manager, a free and secure mobile app and website designed to enable people to stay on track and in control of their medicines and treatments. The platform generates medication dosing and repeat prescription reminders with the aim of improving medicines adherence. It also provides family members and carers the opportunity to provide support through Care4Family™ visit www.mhm.com

Since social media was widely adopted more than five years ago, the pharmaceutical industry has tiptoed around the edges of the platform, concerned that diving in would obligate companies and brands to keep tabs on and manage all consumer-generated content. If the content is incorrect, patient outcomes and adherence could suffer; but in the absence of FDA guidance, and with limited resources, what can our industry do? Until recently, there has been little feedback from the FDA regarding our perceived responsibility as an industry. However, the draft guidance published in January 2014 titled "Fulfilling Regulatory Requirements for Postmarketing Submissions of Interactive Promotional Media for Prescription Human and Animal Drugs and Biologics" appears to address pharma's expanding role in engaging its audiences with promotional online activities, including what it can do with content after it's been approved and published.

The FDA on real-time communications and interactions

The FDA makes an important, time-saving distinction in the draft guidance related to "real-time communications and interactions (e.g., blogs, microblogs, social networking sites, online communities, and live podcasts)." Due to the long lead time of internal promotional review, it realizes it's impossible for pharmas to submit every new piece of content for review before publication. With the volume of material generated, the submission process would impede conversation and create a backlog for the reviewers.

"The FDA makes an important, time-saving distinction in the draft guidance..."

The FDA on promotional language

The FDA's draft guidance recognizes product language as promotional even it is not physically connected to a product (e.g., a label on a bottle or package) and that the contextual relationship between a product and its labeling is the key. In the digital world, this means associations are made even if an item and its descriptor do not appear next to each other. Inference has always been an important focus for the FDA in reviewing promotional items – there have been many cases where the FDA discouraged a color scheme that links branded and non-branded material.

What you're really responsible for

Next we get to the meat of the guidance: in short, if you own it, control it, create it, influence it (more about this in a minute), or operate it, then you are responsible for it. Clear, simple, specific. In prior discussions with the FDA, its representatives have been resolute on this point. If the FDA can ultimately prove that you knew about content you should be responsible for, it will insist you take responsibility for it.

"If the FDA can ultimately prove that you knew about content you should be responsible for, it will insist you take responsibility for it."

The FDA on third-party site promotion

"Under certain circumstances, a firm is responsible for promotion on third-party sites." The FDA clarifies this to be content focused: if you read and / or revise content for a digital venue, such as an advocacy resource like an organization's Facebook page before publication, then you are responsible for the content and must follow the FDA's standard procedures. Financial responsibility (such as providing a grant that enables the content to be developed) does not equate to content responsibility. This distinction is important because it means there is a growing opportunity for pharmaceutical companies to use existing healthcare communications – such as mobile health apps, health activist blogs and foundation sites – instead of building the digital venues themselves. This could be a real benefit to consumers and pharma by reaching the audience where they are already engaged and saving promotional dollars.

The FDA adds that although content submitted to these venues must be approved, how the third party uses the materials is not the pharmaceutical company's responsibility. A great example (non-digital) is one from years ago when a TV news program that was integrating approved product messaging decided to shorten the program and deleted some critical compliance information. The pharmaceutical company was not held responsible, and the current guidance reiterates the FDA's commitment to evaluate these types of circumstances independently.

The current draft guidance does state that employees or agents (vendors, agency partners) are responsible for publicly communicated product promotions. Therefore, pharmaceutical companies should clarify their internal employee social media guidelines. And, they need to take care when providing materials to health activists if there is any financial remuneration since the FDA will hold pharma companies accountable for the relationship. The FDA wants relationships clearly identified but is appearing lenient if there is no direct financially beneficial relationship with the company.

Overall, the recent draft guidance goes a long way to opening the door for pharma to participate in digital channels with user-generated content, provided there is transparency with the FDA all along the way. The draft guidance reduces many barriers to engaging in social media as a promotional vehicle, while highlighting the importance of being responsible for content you place, manage, or maintain, as well as the need for fully transparent relationships. It also puts a spotlight on the significant resources required to support the management of social media content; to many, it simply may not be worth the investment. That said, we hope to see the industry take advantage of the opportunity to develop deeper connections and support better health outcomes through these communication channels.

Over the last 12 months, many people – myself included – have spoken about the ways in which the pharmaceutical marketplace is really beginning to embrace the digital revolution; mobile technology, social media…the list of tactics goes on and on. But in contrast, the study 'Engaging Patients through Social Media', published in January 2014 by the IMS Institute for Healthcare Informatics, has suggested that pharma is not as comfortable with digital techniques as we might think. You can request a copy of the report here. 

'Engaging Patients through Social Media': the findings  

The report begins with an assessment of the changing role of the 'engaged' patient and the impact of digital in healthcare. The report then goes on to discuss the level of social engagement achieved with the top three most popular social media channels – Facebook, Twitter and You Tube - by the top 50 pharmaceutical companies; each company's performance has been ranked in terms of reach, relevance and relationships.

Researchers found that half of the top 50 pharmaceutical companies do not engage with consumers or patients on social media about healthcare-themed topics.

Johnson & Johnson ranked 1st in reach, relevance and relationships indices; in the IMS Health Social Media Engagement Index – an amalgamation of all 3 indicies – Johnson & Johnson came out on top again with a score of 70. Overall, J&J’s closest competitor is GlaxoSmithKline, in second place with a score of 25. In tenth place is UCB, scoring 9.

How can pharma move forwards with social media?

The IMS concludes that 'in general, the industry needs to become less risk averse to new engagements with stakeholders to remain relevant in the overall healthcare discussion.’ Responding to online interactions and managing the large volumes of data that social media generates are two key challenges; the report recommends that pharma seeks support from outsourced tools that help companies monitor and respond to social media.

Early movers are testing the social waters with the trial and error approach, but to be successful, pharma companies must also recognise that social media is unpredictable and mistakes are inevitable; pharma companies must have a robust contingency plan in place for response during times when plans go awry.

What do you think?

Ultimately, patients are using social media and digital channels to become more informed about their health and to help them manage illness; Eyeforpharma reports that globally, 83% of people are using online resources to find information about chronic illnesses. How do you think pharma should adapt? What’s pharma doing well, and not so well, when it comes to social media.