Arecent Manhattan Research report states that 88% of all physicians use the Internet to access pharmaceutical, biotech, and medical device information, and 41% of all the research that physicians conduct is now done online. Nielsen’s online data show that about half of the U.S. population visited a social networking Website in the last year. The information and benefits the industry can provide to doctors and patients will likely be marginalized if the industry does not get involved in social media, our experts warn. “The communications landscape has changed drastically in a short period of time, and we’ve reached a point where it’s not a matter of if we can effectively communicate, we have to reach the public where they are," says Greg Barrett, VP, marketing at Daiichi Sankyo. “Data have shown that not only are consumers relying on social media methods as a source of health and medical information, but almost two-thirds of physicians are using online communities for social networking." According to Phil Deschamps, president and CEO of GSW Worldwide, physicians and patients have been the drivers behind the growing use of social media tactics in the healthcare space, and they want to continue to find relevant information and have meaningful conversations with others using social media. “Patients have questions at every stage of their treatment cycle and will turn to social media to hear from others and share their own experiences with a drug," he says. “Additionally, physicians use platforms such as Sermo to share case studies, discuss effectiveness, review side effects of procedures and medications, and make recommendations to their peers." “There’s been a dramatic and substantial increase in the number of physicians using smart phones and integrating Web/mobile applications into their practices," says Meryl Allison, principal at Deloitte Consulting. “Even more apps will be developed with the advance in electronic medical records. Physicians and patients now expect to be able to access and share information through social media." Raj Singh, VP, general manager of Formedic, agrees that social media is an effective tool to reach both patients and physicians. “As physicians become harder to see and patients become harder targets to reach, I believe we are going to see a bigger push to reach these demographics through social media avenues," he says. “Online communities, whether it is through Twitter, Facebook, or message boards, are going to thrive because as more and more patients become empowered, they are going to want an outlet where they can share common experiences." Gaining Audience Trust Dave Chapman, managing partner at CommonHealth, says companies need to be genuine to gain trust when using social media. “False pretense, astroturfing, and hidden agendas are more quickly rooted out in the digital world than in any traditional media and have no place in advancing the adoption of social media," he says. “If the conversations are genuine and sincere, and coordinated with other online elements, social media can produce measurable results." Nick Colucci, president and CEO of Publicis Healthcare Communications Group, also notes that patients have concerns even when the doctor is “not in," and this underscores the key role social media plays in connecting authentically and on-demand with audiences. “When it comes to industry contributions, accuracy, clarity, and transparency are the currency to create value," he says. “If a tool advances patient care, physicians welcome the added resources. A recent survey found that two-thirds of physicians believe patients accessing health information online is a beneficial practice. Companies must see their efforts as allied to the physicians’ needs — an adjunct to the patient-counseling effort. Companies can leverage their digital presence as a competitive point of difference, fostering a more trusting relationship." The purpose of social media is less about communicating a message than providing connections through authentic communications. “Therefore, the industry needs to approach social media differently from any other channel," says Peter Nalen, CEO of Compass Healthcare Communications. “It is no longer a case of what the message is — it’s about the audience segments; how they want to consume the message — on the phone, online, in person; and knowing when they want or need the information. Companies that accept this premise have the best opportunity in building brand engagement. Going forward, marketers that serve their brands best will be the ones that internalize this approach across everything they do, from label design to brand messaging to all the promotional activities." Kelly Andrews, director, strategic planning, at Micromass Communications, says patients and physicians are already responding to pharma brands in the social media space. “Google’s Sidewiki is the most recently celebrated example," she says. “Unfortunately, the conversation is a bit one-sided." Because people use social media for many different reasons — 27% use it to connect, 19% use it as an efficiency tool, and 34% use it as a soapbox — understanding their motivations, including the factors that impede uptake and adherence, is critical to connecting with them in a way that matters, she says. Channeling Support Nancy Beesley, executive VP at HC&B Healthcare Communications, suggests that companies should assign manpower and resources to this burgeoning discipline sooner rather than later. “Smart marketers can use social media, and indeed, they’ll need to at some point," she says. “Imagine thousands of people flocking to a Facebook page to talk about how a drug made their lives change for the better. The cost to the pharmaceutical company — almost nothing; validated testimonials by real patients — priceless." Mike Myers, president of Palio, says if companies do not participate, audiences on some level will notice their absence. “By not participating, pharma companies will be on the outside of a new form of communication that people are flocking toward," he says. While it may seem that social media is more important to patients right now, physicians and other healthcare providers are increasingly becoming more Internet and social media savvy, says Ken Ribotsky, president and CEO of The Core Nation. “Technologies have been developed on various platforms, including smart phones and iPhones, that make information more readily accessible to the professional audience," he says. “We need to be where our audience is, and if we ensure that what we’re saying is relevant, they will listen." Jim Dayton, emerging media director at Intouch Solutions, says companies should be used to social media now, because it is just a baby step toward what is to come in terms of consumer engagement. “Web 2.0 is an evolutionary step in the development of the Web, and a building block to Web 3.0," he says. “Companies must be open to communications with consumers and include their opinions when making marketing decisions if they want to become an integral part of the consumers’ lives and be seen as part of their sphere of influence. This, in turn, will allow them to talk to consumers when the multiple layers of filters for information aggregation are adopted during Web 3.0." Experts note that social media is not going to replace other channels of marketing, and should be seen as another tool in the marketing mix and used accordingly. Ms. Allison says social media is often described as if it were a cohesive strategy, when in fact the media are just tools. “To use social media most effectively, it’s critical the companies define the specific marketing objectives desired for each target and each product," she says. “For example, if building awareness of a new dosage form is the objective, then securing uptake by blogging KOLs or tweeting may be great tactics. If protecting market share within a niche population is the goal, then building an online patient-user community may be more appropriate. Marketers have to remember though, that social media is a tool, not the Holy Grail." And as a tool, social media has staying power, says Ms. Andrews of MicroMass. “The simple truth is that social media is a fulfillment of the larger promise of the Internet, so it’s not going away," she says. “Much of the discussion about social media in the pharmaceutical industry is driven by confusion over how best to use it given pharma’s regulatory constraints. Upcoming FDA hearings may bring some clarity, but regardless of the outcomes, consumers are out there, so failing to be in social media is no longer an option." F PharmaVOICE welcomes comments about this article. E-mail us at [email protected]. Social Media Where the Consumers are While early adopters tout many reasons why the industry should engage with patients and physicians online, one of the most convincing arguments could be the growing numbers and increasing amount of time that patients and physicians are spending interacting with others in social media formats. Meryl Allison Deloitte Consulting “Physicians and patients now expect to be able to access and share information through social media." a Social media drawback: Adverse reporting The industry can use social media effectively, but the “elephant in the room" is clarification on handling adverse event reporting. The beauty (and horror) of social media is that it allows us to speak to the world, but it also allows the world to speak back. Many believe that the hurdle we’re seeking to overcome is not being able to control the conversation. Fortunately, a recent study shows that comments to specific brands in social media are predominantly neutral or, better yet, positive. The terrifying part for both the pharmaceutical industry and the FDA is how to handle the reporting of adverse events. There are significant ramifications of how much time could be spent trying to monitor all online conversations and social tools being used to market a product. It’s not difficult to imagine the damage a mischievous person could do with rampant posts, or worse yet, a programmer with the skills to disperse the negative information quickly on the grandest of scales. So what is the responsible method of monitoring an ever-growing dialogue and handling adverse event reporting? It is inconceivable to think we can monitor every blog comment, tweet, or Google Sidewiki — especially knowing that these types of tools are evolving and growing in number. One idea being discussed in the blogosphere is an effort to remove manufacturer responsibility from comments made in social media, direct links to the FDA’s AERS system, and intermittent or scheduled searches. Another possible solution may be to include a link to a form on the social media tools for reporting an adverse event. The link to report an adverse event seems not only logical, but also easy to define, execute, and maintain. It also has the potential to reduce some uncertainties by requiring contact information from the reporter of the adverse events, including radio buttons for scaling the severity of the event, and providing accurate identification of the specific drug in question. Source: Ben Currie, Director, Emerging Technologies, Purohit Navigation 60% of U.S. doctors use social ­networking sites for physicians, or are interested in joining them. ______ Manhattan research n 2009, a gazillion discussions, reports, and conference sessions centered on social media use in pharma marketing. Not everyone agrees on its value and its effectiveness as a tool to reach physicians and patients, but our experts say that in the future, social media in some shape or form will have a viable place at the marketing table. According to Tony Chant, managing director at Eurocom Healthcare Communications, one of the reasons for an uptake in social media in the industry is cost savings. The industry needs to take advantage of the fast pace of development in digital and social media communications to reduce marketing costs, especially as more guidance and clarity on how to use these media develop, he says. “This shift will lead pharma to revisit and scrutinize its traditional business models surrounding delivering communications," he says. “While the industry as a whole has been slower off the mark to embrace technology that has become part of normal daily life, the race will be truly on to maximize the opportunities to communicate with customers in a fast and cost-efficient manner." “I believe that some of the hoopla of social media will subside, but it is here to stay," says Mike Myers, president of Palio. “It will take on an evolved role in both physician and patient dialogues and education." Marketers will soon be treating social media like TV, radio, print, outdoor, and in-person meetings — in other words, as another channel to reach doctors and patients. “But the exact way that the tool will be used is hard to predict," he adds. “As for platforms and which media will survive, I believe that it is too early to tell at this point, as there are so many avenues available and more that are continuing to be rolled out." While social media are relatively new, the old rules of marketing still apply: greater exposure equals greater engagement, says Ben Currie, director, emerging technologies, Purohit Navigation. According to Mr. Currie, people are more likely to seek product information if they have encountered the brand via social media, and even more so when combined with paid searches. Increasingly, patients can choose multiple platforms to engage in social media. “Currently, more than one-third of patients seek health information through social media sites," says Peter Nalen, CEO at Compass HC. “Social media are beginning to take a larger stage in advising patients on disease management decisions." Patients and physicians alike have adopted social media because the interactions and information are perceived as valuable, Mr. Currie says. “It behooves the industry to include it in the marketing mix, and learn how to most effectively deliver the message as a responsible and courteous member of the network," he adds. General networking sites, such as Facebook, may be useful for patients who need frequent touch points. Other health outposts, such as DailyStrength, HealingWell, and Inspire have condition-specific boards that may compete with communities established by patient advocacy organizations and industry, Mr. Nalen says. “This trend makes reaching patients on social media a no-brainer," he says. “We’re seeing certain patients engaging with others across multiple platforms, and recommending sites where others can get specific information they’re seeking. These alpha patients are quickly becoming more crucial to brands than ever before." Some view social media as the next logical step within the advanced capability of communicating in real time, and project that marketing will shift away from being a one-sided push approach to a “real-time-ification," give-and-take approach to engage customers in conversations online when they are seeking health information. “It used to be as marketers, we put our message out into the world after carefully crafting it and selecting who would listen to it and when they’d hear it," says Nancy Beesley, executive VP at HC&B Healthcare Communications. “Not anymore, the new paradigm is to find a way to let that conversation happen and be okay with what takes place during it." According to Michael Laferrera, senior VP, sales and marketing, at J. Knipper & Co, as one of the least overregulated, affordable, and scalable channels for pharmaceutical marketing, the Internet is currently providing both prime real estate for advertising and a key platform for sales and marketing automation. “Some keys to the success of growth in this channel are increased introduction to and education of t e physician community and further integration of social media into the DTC market space," he says. “The industry’s ability to adopt methods will create both convenience and cost savings within the physician practices." Experts suggest that becoming a genuine and active participant in online communities will position pharmaceutical brands for the future. “With the rise of social networking, micro-blogging, and blogging, social media have become a more trusted source for information than broadcast media," says Jim Dayton, emerging media director at Intouch Solutions. “I would expect marketing strategies to reflect this fundamental shift in consumer attitudes and find the best way to become ‘trusted friends’ with consumers. Only then, will the information they provide be seen as helpful and the company be regarded as a resource within an individual’s sphere of influence." Traditional pharmaceutical companies will be challenged to evolve their processes quickly enough to allow for the nimbleness and flexibility that the social media environment demands, says Ken Ribotsky, president and CEO of The Core Nation. “Similar to other marketing communications efforts, a social media communications strategy should be focused on clear objectives and a willingness to keep it real — it’s about listening and participating and not about selling," he says. “I’m not sure that many companies have really thought that through as of yet." Note to healthcare marketers: The consumer is now in charge of your brand. “Pharmaceutical marketers must be willing to take a bit of risk and accept a little bit of failure in the process of adopting this new phenomenon," says Peter Collins, president of 5th Finger. His advice is to watch how other brand experts are fostering social media, such as Scott Monty of Ford Motors, who says: “Your brand is not my friend. I don’t want your brand to ‘friend’ me, I want to hear from the designer, the engineer, the CEO — someone who can listen to my opinion." Adapting to this shift in communications will be one of the industry’s biggest hurdles, but an extremely important one to conquer, says Greg Barrett, VP of marketing at Daiichi Sankyo. “It’s vital to our patients and healthcare communities that we engage, because we want to serve the best interests of physicians and their patients while remaining compliant with the laws and regulations that govern such communications," he says. Mr. Barrett predicts the switch to newer communications will occur on the back of technologies that link individuals and online communities via mobile devices. Brand experts say marketing must incorporate permission-based, inbound marketing techniques, such as search engine marketing, social media, and blogging. And the organizations that effectively leverage a mix of the new inbound marketing techniques with successful outbound marketing techniques will capture the mindshare of providers and patients. The next few years will continue to define the difference between the vast volume of noise and the influence of the information. “The marketplace will push toward providing greater clarity between sponsored discussions and independent voices," says Dave Chapman, managing partner at CommonHealth. “Studies show that it pays to be on social media," he says. “The advanced work CommonHealth is doing in both analysis and use of social media from Twitter to Sermo and from blogs to chat rooms has made it clear that the value and effectiveness are indisputable." For those in the industry who are more comfortable with a traditional media setting, keeping up with the demands of the social media environment will be a challenge, but to be successful marketers need to get on board. “Using multiple vehicles simultaneously and interacting with peers online has quickly become the norm," Mr. Chapman says. Mr. Ribotsky says as overwhelming as participating in social media may seem, marketers need to remember that they are not the target audience, and that not everyone is daunted by social media. “Flexibility will be the key word for success," Mr. Ribotsky says. “As channels further splinter or efforts are redirected from one media vehicle to another, flexibility, innovation, and simple street smarts will be crucial." Nick Colucci, president and CEO of Publicis Healthcare Communications Group, agrees. “With 100 million Americans now seeking brand- and category-specific information online, company-driven social media will become the gold standard of information for digital consumers, as brand sites and company-sponsored social networks provide 24/7 information access with the guardian shield of FDA oversight," he says. “While specific channels may change, campaigns offering the clinical and patient community the full informational experience — one that is dynamic, interactive, and innovative — will continue to thrive." Pharma companies are entering the game late and now run the risk of being lost in the clutter, says Alan Topin, president of Topin & Associates. “After sitting on the sidelines for the earlier part of the decade, healthcare and pharma companies have enthusiastically embraced the world of digital marketing, as has every other industry association, club, itinerant cause, and local teenager," he says. “And we now get spam by the bargeful, and engage in Twitter, Facebook, and LinkedIn till the late hours of the day. The content is sliced and diced between channels and media until there’s no purpose left in repurposing. “The result is a digital landscape of regurgitated information and overused offers that hide the valuable and useable," Mr. Topin continues. “2010 is fast becoming the year of digital clutter, a wasteland of content echoing back and forth while legitimate, useful content is buried under mounds of noise, dead-end URLs, and self-promotion." To overcome the clutter, marketers must first return to the fundamentals before turning to digital. “Given the ongoing and never-ending change in digital, the ‘next big thing’ or the ‘hottest trend’ will be about starting with the basics and making sure the strategy remains aligned with the goals, so the digital tactics don’t become a jumble of new ideas in search of a strategy," Mr. Topin says. Will There be a Digital Top Dog? Of all the different avenues for reaching consumers through social media, none stand out as a better choice than others, our experts say. Choice depends on the need, the audience, and the message, much like in traditional media. The evolution of social media will be an interesting one, because who knows what the future may bring in terms of evolving technology and platforms. Social media outlets are still growing, evolving, and changing the communication paradigm by providing more options at breakneck pace. The newest development is aggregating communications, which is now becoming a reality with the preview release of Google Wave. “All of these options allow us to think about social media services as individual features that can be integrated to meet the needs of a specific application," Mr. Currie says. “All media will prevail, and none of them will," says Donna Wray, director, management advisor, TGaS Advisors. “The functionality behind Facebook and Twitter is useful, but the idea of a separate platform for Twitter will be obsolete in a few years. People want to work in one integrated social space that shows them what their friends and colleagues are doing, as well as other communities of interest they care about, such as patient communities. Whoever gets these communities organized fast enough will prevail — in fact some are already prevailing; check out the sites of Juvenation.org, DailyStrength, or PatientsLikeMe. Over the next three years, sites like these will adopt Twitter-like features, plus functions that are not yet prevalent, such as the ability to see relevant national news and comment on it within the community." The rapid growth previously seen in Twitter and Facebook has shown signs of flattening, although that doesn’t mean that the services are short-lived or that the use of social media is in any way fading. “What it does indicate is that these services — and their current feature sets — are reaching the point of saturation," Mr. Currie says. “Consumers now have a multitude of options: when I need to post a content-rich message, solicit comments, or provide a link, I blog; when I need to burst out a quick statement or question, I tweet; and when I need to collaborate with a controlled group, I wave. The winner of the social media contest will be the service that successfully provides continuous innovation." Mr. Collins of 5th Finger agrees, saying many outlets are already getting results in this nascent market. “No one has a crystal ball," he says. “Even the most experienced social media marketers are still in experimentation mode, but they’re well-positioned to master the medium as it matures and get an edge on their competitors." F Nick Colucci Publicis Healthcare Communications Group “Company-driven social media are the gold standard of information for digital consumers." Ben Currie Purohit Navigation “While social media are relatively new, the old rules of marketing still apply — greater exposure equals greater engagement." Patrick Collins 5th Finger “Healthcare ­marketers must understand that the consumer is now in charge of their brands." Greg Barrett Daiichi Sankyo “We are currently ­operating in a fast- ­evolving landscape that requires new resources and new skills to ­participate effectively." Alan Topin Topin & Associates “2010 is fast becoming the year of digital clutter. “ Ken Ribotsky Core Nation “As channels further splinter or efforts are ­redirected from one media vehicle to another, flexibility, innovation, and simple street smarts will be crucial." PharmaVOICE welcomes comments about this article. E-mail us at [email protected]. Donna Wray TGaS Advisors “In 2010, the companies that are able to merge both social and traditional media will have a significant competitive advantage." Peter Nalen Compass Healthcare ­Communications “Alpha patients who are engaging with others cross-platforms and recommending sites are more crucial to brands than ever before." Mike Myers Palio “The $64,000 question in front of pharma today is how to use social media effectively." Tony Chant Eurocom Healthcare ­Communications “The race is on to ­maximize opportunities to communicate with ­customers in a fast and cost-efficient manner." Nancy Beesley HC&B Healthcare ­Communications “Social media is not a trend, but the next logical step in the ‘real ­time-ification’ of the world." Jim Dayton Intouch Solutions “Positioning the pharmaceutical brands of the future will take genuine and active participation in online communities. “Michael Laferrera J. Knipper “The Internet is currently providing both prime real estate for advertising and a key platform for sales and marketing automation." Dave Chapman CommonHealth “The value and effectiveness of social media are indisputable." Kelly Andrews MicroMass Communications “Social media is a fulfillment of the larger promise of the Internet, and it’s not going away." About half of the U.S. population visited a social networking Website in the last year. ______ Nielsen

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