The battle over data

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It seems that the latest tactics from the pharma marketing playbook is to promote data when the news is good and hide it or challenge the data, and the study, when it's bad. I was reading today's NY Times and right on page one of the business section is an article about the ALLHAT study that showed that millions of dollars could be saved by having patients who have high blood pressure use generic medication versus branded. The main point of the article was that this in fact did not happen because drug companies challenged the study and the data with big marketing budgets that included paid speakers.

Now criticism of research is nothing new, hell the car manufacturers challenge safety crash tests data all the time but wait a minute, aren't these the same companies that are now asking for billions of dollars in guaranteed government loans? Ooops bad analogy..

Anyone who has attended college knows that data can be interrupted in several ways. In addition people can also interrupt how studies were conducted and the methodology of data collection. But what does this communicate to customers? Physicians are becoming more connected and really don't have the time to sought through a lot of documents like detectives to get to the real data conclusions. For them it's probably easier to just write an Rx for a branded medication than to switch people to generics and ensure that the generics do just as good a job as branded. But the level if inconsistent transparency is indeed troublesome for me.

Drug companies have the right to challenge data but as I have learned from my selling days it's often better to say "that data is good but let me show you why ours might tell a better story". I never bad mouthed the competition even when we were told to use negative selling to promote products. I found out that it just confused HCP's and made some resentful.

Pharma and biotech companies are going to have to do a lot better job when conducting clinical studies to ensure that most of the loopholes are closed and that people from all areas of the health marketing channel are bought into the study before the results are in so that they can't later challenge the data. With social media taking off it's now more easier than ever to share data among colleagues and clinical trial physicians. However, pharma had better learn that these old tactics of heavy marketing dollars against study data are quickly coming to an end in the era of transparency.
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Be Thankful for making a difference

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The incidence of new cancer cases has been falling in recent years in the United States, the first time such an extended decline has been documented, researchers reported Tuesday. The report attributes the reductions to adoption of healthier lifestyles and improved screening, as well as advances in treatment. Advances in treatment and adoption of healthier lifestyles; think DTC advertising has anything to do with this?

America's pharmaceutical companies have been taking it on the chin in recent years but at this time of the year when we say thanks it's also important to remember that we are part of an industry that can extend the quality of life. In this BLOG I have, at times, been critical of some of the moves that the industry makes but it's only because I am passionate about making a difference in the world in which we work. It's our job to leave things better then when we found them and I can't think of a more rewarding profession than helping consumers and patients become more empowered in their healthcare decisions.

To all my readers I want to wish you a very happy Thanksgiving and after you sit down at the dinner table with family and friends and before you start to eat remember the troops who are in harms way serving their country. Remember that some people are sitting down at Thanksgiving dinner because of the drugs our industry provides and being allowed to do what is best for our customers is reward in itself. Happy Thanksgiving everyone !





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This recession hurting media a lot more

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This recession is digging deep into media unlike any other recession and it's going to get worse before it gets better. What has happened is that now every dollar that is being spent is being scrutinized like never before. GM and Ford have pulled out of the Super Bowl and now a lot of advertisers are rethinking their overall allocation of ad dollars. Could it be that we'll only see DTC ads on TV next year? Well considering that DTC marketers are way behind the curve I guess that's a possibility.

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Social media for marketers

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Conventional marketing is dead...

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Only 18% of proportional TV ad campaigns generate positive ROI, 56% of people avoid buying products from companies they think advertise too much on TV, TV ad cost have increased 256% in the last decade, a 100% increase in TV ad spending is needed to increase sales 1-2% and it takes 117 prime time spots to reach 80% of the TV audience. These statistics have marketers scratching their heads looking for new opportunities and one area that is becoming really hot is social media. But is social media right for you and your company?

The Internet is evolving but one fact remains clear: the Web is part of consumers lives and has given consumers new ways to research products and information like never before. Marketers at first started to put up Websites and push information in Web 1.0 then they integrated a variety of interactive tools as they transformed their online strategies to Web 2.0 but just when you think you have a handle on what's happening comes Web 3.0 better known as the semantic Web.

What is the semantic Web? Well think of it this way: when you do a search on a generic term like cancer or diabetes you might get upwards of 5 million sites with information. Where do you start and who has the time to check out all these sites, thus it has become a game for marketers to get their sites listed higher and higher on search engines. This has led to escalating costs in search marketing because you are bidding on the popularity of the paid search terms. The semantic Web, on the other hand, is going to know a lot about you when you query a search and try to provide only relevant search results. If, for example, you are a 29 year old woman living in Chicago conducting a search on birth control you are only going to get results that are targeted at your demographic and location. In other words relevancy based upon who you are and what you do online. Yes there are some privacy issues that need to be worked out but once people find out how Web 3.0 works it's going to provide a boom for consumers and marketers.


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Conventional marketing is dying but for some reason marketers are still trying to use conventional methods to reach consumers


Among all this is the suddenly social media strategy. If a marketers job is to go where people are then social media has to be in your plan. But what we are finding is that more than 50% of all company social media strategies are going to fail even though 75% of the Fortune 1000 companies are implementing some type of social media strategy. Why is this?

Well, first marketers don't fully understand that the job of the brand now is to act as aggregators. They still feel that they need to use interruption to serve messages to consumers who don't want to be interrupted. Along with this comes an understanding that we don't control the brand anymore, consumers do. This is probably more frightening to marketers than hearing the dreaded term ROI.

Second, marketers are not set up to listen to what's being said on social media so that they can leverage the tone in communicating with people on social media. This means that someone within marketing has to listen to what's being said and has to determine what the tone of the people are around the brand, product or disease state. Remember consumers do not have to adopt to you; you have to adopt to them. Marketers above all have to support community goals and encourage member interaction.

Third, they have no clear business objectives when formulate their social media strategy. What is it we exactly want to do and how are we going to measure the program. When they finally do have a business objective they act too slowly to successfully implement a social media program. Velocity, Viralness, and Spread are key along with offering community members value.

If the relevancy of the Web were compared to the speed of a train it would be a train that is moving at over 400 MPH. For marketers standing on the platform this means that this "whole Web thing" is just a blur, but for those that have a ticket founded in a good strategy and an organization that can implement with speed and has the resources to support an ongoing strategy it could mean success, a lot of success.


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Is your marketing campaign sustainable?

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American health care is asking for help

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According to this weeks Time Magazine, If you're like 67% of Americans, you're currently overweight or obese. If you're like 27%, your blood pressure is too high. If you're like a whopping 96% of the population, you may not be able to recall the last time you had a salad, since you're one of the hundreds of millions of Americans who rarely eat enough vegetables. And what you do eat, you don't burn off — assuming you're like the 40% of us who get no exercise. Most troubling of all, if you're like any parent of any child anywhere in the world, you may be passing your health habits to your children, which explains why experts fear that this generation of American kids may be the first ever to have a shorter life span than their parents do.

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The biggest problem with the U.S. health-care system is that it has long been designed to respond to illness rather than prevent it. According to an analysis by the Commonwealth Fund, a foundation that funds health-care research, half of American adults in 2005 did not receive recommended preventive care, which includes vaccinations, cancer screenings and blood-pressure checks. Not only is this a deadly way to practice medicine, but it's also a breathtakingly expensive one. In 2005 Americans paid out a record 16% of our gross domestic product for health care — a cool $2 trillion — making us the world's top spender on health care per capita. You might think we'd be getting some bang for those bucks, but our leading killer remains what it has been every year since 1900 (with the exception of 1918, when influenza claimed more lives): heart disease, which kills nearly 650,000 of us each year. "The reason we rank so poorly is that we don't provide a basic-wellness infrastructure," says Dr. Mehmet Oz, director of the cardiovascular institute at the Columbia University Medical Center and a host on the Discovery Health Channel.

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There are a lot of ways to measure the effects of America's after-the-fact health-care philosophy, but the most telling might be what epidemiologists call preventable deaths. Certainly, plenty of deaths due to illness are not preventable, but there are many other conditions that a decent health-care system should be able to detect and fix well before they become life-threatening. Most of the leading killers in the U.S. — including pneumonia, diabetes and stroke — fall into this category. According to a Commonwealth Fund report issued this year, 101,000 deaths from 2002 to 2003 could have been avoided with access to timely and effective health care. This rate places the U.S. 19th — last — among industrialized nations.

Behind the news

As a marketer I always try and ask "why is this happening". Well I have some pretty good ideas of why this is happening:

1. The biggest segment within our population is aging, as they age they are gaining weight as their metabolism slows down and they start to enjoy life. How many times have you seen a movie or TV star from the 80's on TV and said "wow has he/she gained weight".

2. Time: who has the time to take care of yourself anymore? Go to a gym? Make a healthy meal? I am more worried about paying the mortgage and making sure the kids get picked up after soccer practice.

3. There's a pill for that. One thing I learned while selling supplements and herbs during the growth period of the 90's; if I can take a pill and make it go away for compensate for that cheeseburger I had at lunch that I'll do it".

4. Preventative care? It takes too long to get an appointment and then a half day off from work to go to the doctor and I'm OK anyway.

5. Finally, food portion sizes in this country are huge. Maybe it's time for restaurants to tell customers how many portions are on that steak platter they just ordered. Nah..the restaurant lobby would never allow this, better that America's health care system absorb the costs.

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What could be done to fix the problems? Well how about America's pharmaceutical companies coming together on a national program to give people more information on what they can do to lower their risks. I'm not talking about disease awareness programs, according to Time people ARE aware of health threats, I'm talking about informative programs that start small and get bigger over time to decrease the risks for disease. Maybe it's also time to have a fitness and nutritionist available at physicians offices. If someone is overweight their insurance company should mandate that they meet with this person at least once a month or more often.

Above all this problem means that people are not taking personal responsibility for their health. I'm not sure that any program can change that but we had better start some initiatives soon because the best endorsement from a pharma company maybe "we hope you never have to use one of our products to stay healthy". Oooops, there goes the ROI model...

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Costs per patient in the US

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Will DTC marketers learn from the Internet President?

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President Obama's plan to create 2.5 million jobs was broadcast on the Web and his videos on You Tune have been viewed over 100 million times. This is a President that understands the power of the Web to connect with people, the question thus becomes "will DTC marketers learn from Mr Obama or continue to ignore the Web?"

Mr Obama wants to move the White House into the Internet age more and more and have an Internet presence that guarantees a certain level of transparency. This is a man who obviously understands what the public wants and how to integrate the Web into his Presidency. He didn't need to do a tons of market research or focus groups he understood that the Web reaches a hell of a lot of people and that this is now THE mass media channel of choice.

In the health area pharma marketers seem afraid to embrace the Internet for fear of angering the big bad FDA. This tells me that in fact a LOT of pharma marketers don't believe their own hype that DTC ads benefit patients and consumers. The other excuse, we're a regulated industry and can't do social media stuff on the Web, is also an extremely weak excuse that belongs with the "weapons of mass destruction" excuse as the biggest charades in history.

Think of this for a minute: you have millions of people going online to get information on health topics, everything from drugs to disease treatments, and reaching out to each other to get information. And where are the drug companies? With the same old product.com websites with maybe some video or actor portrayals. If marketing is about going where your customers are then DTC marketers have missed the boat big time !

President Obama probably will drive more people to the Web and make them hyperaware of sites like You Tube. Once again a door of opportunity is opening to reach consumers in a new and innovative way..but pharma marketers will probably turn a dead ear as they have done since DTC was permitted by the FDA.
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Time for women CEO's in pharma

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I recently received a phone call from a colleague at a pharma company complaining about the "old boy mens club" at her company. It seems that she went to a high level meeting to review the status of her product and she noticed that not only was she the only woman in the room but that when she said something some people seemed to challenge her more than others in the room. I have heard this before in different companies and given how screwed up most pharma companies are right now maybe it's time for a woman to assume the head role at one of America's pharma or biotech companies.

What I found most challenging working in the industry was the belief that customers and patients came first. After all with company credo's like "answers that matter" I really thought my job was to provide my customers with answers. Silly me; the credo should say something like "answers that matter, provided we have excess money to give you those answers and it provides an ROI and you can have endless meetings to justify those dollars. My business guidebook from the movie "The Godfather" has told me many times "it's not personal, it's business" and after all the business of pharma companies is to make money.

Carly Fiorina, the ex head of HP, found about what it was like to work in a mans world and when she started to make waves she was quickly shown the door with a very nice golden parachute. To this day I believe she is still bitter, and frankly who wouldn't be at being shown the door. I have worked for women in the past and I have to say that I find them to be more direct but also more willing to engage with their feelings when making decisions and thus not all decisions are based on cold hard facts and numbers. The woman that I worked for at Eli Lilly has made Lilly into a DTC powerhouse with escalating DTC dollars and shows no signs of slowing down.

Change is needed at pharma at the highest levels of the organization if the pharmaceutical industry is to grow and continue to deliver new products that extend the quality of life. There are some CEO's who are doing a great job but for the most part the model of just buying companies to get your hands on the pipeline is going to expire really quick. The change that is needed within pharma are the kind of people who can inspire people and make them proud that they work in pharma, the kind of leader who knows that transparency across the whole organization is not an option anymore and the kind of leader who can attract talent back to pharma, the kind of talent that could find the next great big drug or deliver a DTC campaign that is so dynamic it blows everyone away.

Of course a women as CEO of pharma may not happen anytime soon as most of the board members also tend to be men. Come in talk about laying off people to make numbers, have a Scotch and cigar and then fly back to their jobs in private jets.
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Social media bible

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I am have prepared an in depth presentation to answer all of your questions on social media. This presentation has all the latest statistics on social media from eMarketer, Forrester, and all the social media sites among others. If you want a copy please eMail me here.
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Where are DTC marketers when social media is on fire?

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The perfect storm and why pharma and medical device makers may need someone like Peter Rost as FDA Commissioner

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The Department of Justice is investigating the off-label use of a Medtronic Inc. implant for promoting bone growth, bringing government scrutiny of such unapproved uses to the heart of the $189 billion medical-device industry. "While the law establishes that doctors can prescribe any approved treatment, but off-label promotion by manufacturers is not allowed, there's growing concern that the line is being crossed, and a Justice Department review is the right kind of response to those questions," said Sen. Charles Grassley (R., Iowa) who has been looking into whether inducements by Medtronic have led doctors to use its products off-label.

Last year, after news broke that the diabetes drug Avandia was linked to a high risk of heart attacks, reports that the drug's maker had tried to stifle safety questions from a prominent Duke University researcher years earlier provoked a furor. Now it turns out that the Duke researcher wasn't alone in suggesting a tie to heart problems. A doctor from a small Maryland hospital linked Avandia to congestive heart failure in 2000, but the drug's maker, GlaxoSmithKline PLC, rejected her warning and tried to make her stop talking about it with other doctors and hospitals, according to documents and interviews. Glaxo defends its effort, which it says was an attempt to correct "inaccuracies." The head of the doctor's hospital says he ignored Glaxo's overture.

The Senate and House in 2007 began looking at whether Glaxo suppressed information and threatened the Duke researcher, charges that Glaxo has denied. Now the Senate probe, led by Chuck Grassley of Iowa, is investigating whether Glaxo's efforts to defend Avandia's safety led to intimidation against other doctors who were suggesting possible links to cardiac dangers. Mr. Grassley, the ranking Republican on the Finance Committee, has demanded documents from Glaxo and is expected to release a detailed report on Avandia soon, according to staffers.

The perfect reasons for Congress to step in and "over regulate" the pharma/medical device industry. Peter Rost is right ! This industry consistently shoots itself in the foot and then backs off and shoots itself in the other foot ultimately leaving it crippled. The logic of trying locked doors in hopes of finding an open one to market products is beyond me and obviously something needs to be done to ensure that they get the message LOUD and CLEAR.
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Is the FDA ready for someone like Peter Rost?

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A response to my post from Peter Rost;

Hi Rich,

When I become FDA Commissioner I will excuse myself from any Pfizer-related issues during ongoing litigation, since it is important to avoid even the appearance of bias.

Key here is that this is an opportunity to serve American citizens and that the Commissioner serves at the pleasure of the President.

Settling "old scores" is likely a good way to cut any such appointment short.

But change at the FDA is important, I've given John Mack my thoughts on what needs to be done.

I appreciate that you write about this issue.

Regards,
Peter


So Peter is ready to take the post of FDA Commissioner but is the FDA ready for someone who can shakeup a government agency and install a sense of order when Democrats are likely to examine every move the FDA makes? Well maybe the FDA needs someone like Peter to shake the tree and just maybe those vibrations will trickle down to pharma who has a habit of continually shooting itself in the foot.
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Why pharma does not embrace the Web

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Top 10 Online Healt Sites (10/08)

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New hope for Type 1 Diabetics

Could drugs already on the market send Type-1 diabetes into remission? A new study, only in mice, showed that Gleevec sent Type-1 diabetes in mice into full remission and when the medication was stopped the disease stayed in remission. For the 1 million Type-1 diabetics this could be the beginning of the end to painful injections and infusion sets. Although the trials are only in mice researchers could have results in people within a year.
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Social media sinks new Motrin ad

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OK, so you think that social media doesn't have too much influence? Well the brand people at Motrin woke up with the type of headache that can't be cured with any pain reliever: an advertising campaign that backfired and caused an uproar via social media to the point that the ad had to be withdrawn. Ooooops ! Guess what Twitter just maybe the new primary market research channel and marketer from all industries had better pay attention because once again consumers have flexed their muscles.
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The answers suggest change is really needed NOW

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My friend John Mack over at Pharma Marketing Blog is running a poll to see who visitors think should be the next FDA commissioner. Since Peter Rost came out to number one I wondered how many people who took the poll were in pharma. Johns reply was "You wondered how many pharma people voted for Rost for FDA Commissioner in my survey. The answer is that looking just at US pharma respondents, Rost was their #1 choice (21.7% favor Rost). Susan Wood, Robert Califf, and DAVID KESSLER are tied for #2 (17.4% of respondents favor each of these contenders)." How's that for a surprise?

While this is a bit of a surprise I like to think what data might tell us and in this case there are two things it possibly tells me; first, that people are not completely familiar with the background of Dr Rost and second that a LOT of people feel that senior executives at pharma and biotech companies need to be spanked and Dr Rost is the person that just do it. Read More...
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Retaining and attracting talented marketers

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In March 2007, Circuit City came up with a plan to confront softening sales and competition from online and offline retailers: fire the most talented, experienced employees. Of course, those workers were the retail chain’s single most important point of difference from the legion of Internet retailers and general merchandisers, but in a single stroke, Philip J. Schoonover, the chief executive of Circuit City, wiped out that future. Could the same be happening in pharma and biotech companies?

For Circuit City this move turned out to be not so great. The “wage management initiative” erased morale, both for employees and the folks who shopped there. Sales sank after the one-time gain from the layoffs. And last week, the company sought bankruptcy protection.

Mr. Schoonover joined his former employees in the discard box in September, a nice bit of symmetry until you factor in his $1.8 million in severance, $50,000 in outplacement services and a two-year cushion on health benefits. (The clerks axed in Wichita and Tucson got a bit less.) I
n the digital age, we’re told, the critical difference between success and failure is human capital — those heartbeats and fast hands that can make a good business great but what happens when new talent and current talent decide to leave pharma to pursue other opportunities ? The result could be another reason that DTC budgets are going to be down significantly next year. Read More...
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Peter Rost: An axe to grind?

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In reading John Mack's BLOG this morning I was surprised to see that a majority of people who are taking his poll want Dr Peter Rost as the new chairman of the FDA. Now I am not going to go into his short fallings but it would be interesting to know how many people who took the poll on John's site work within big pharma as I believe Dr Rost has a personal ax to grind with pharma especially Pfizer. Here is an interview from Guernica in June of this year with Dr Rost.

Four years ago, Peter Rost was vice president of marketing at Pfizer, the world's largest drug company, when he posted a book review on Amazon.com. The review was for Dr. Marcia Angell’s The Truth About the Drug Companies: How They Deceive Us and What To Do About It. Rost wrote: "Drug companies are their own worst enemies. They have antagonized grannies all over ... with their work to stop reimportation of cheaper drugs into the US, a practice that has been in place for many years in Europe."

The review changed Rost's life. USA Today was the first to take notice. A slew of newspaper stories were followed by appearances on 60 Minutes and before Congress, where he attacked the drug industry’s claim that re-importation (buying less expensive pharmaceuticals from other countries) was unsafe. But it wasn’t just controversial practices like re-importation that Rost began speaking out against. He also spoke out about illegal practices, filing Qui-Tam suits (also known as False Claims or "whistleblower" suits) against Pfizer for the off-label marketing of Genotropin, a human growth hormone, and Wyeth, his previous employer, where he alleged tax fraud.

In just months, Rost went from anonymous corporate executive to Big Pharma’s number one whistleblower. But his speaking out proved to be an act of self-immolation, banishing him from an industry he had worked in for almost 20 years. According to Rost, Pfizer retaliated by removing all of his responsibilities and isolating him before finally cutting him loose six months after his 60 Minutes segment aired—which prompted Rost to file another suit, this one for wrongful termination. Jobless, Rost turned to writing.

In 2006, he published the first of two books critical of the pharmaceutical industry. The Whistleblower: Confessions of a Healthcare Hitman was an autobiographical expose that recounted Rost's days at Pfizer and his attempts to speak out against the illegal and unethical behavior he says he witnessed there. In 2007, he released Killer Drug, a novel about a fictional drug company called Xenal, which develops a biological weapon for the military. He also keeps a blog and has done stints as a blogger/columnist for both The Huffington Post and Brandweek. And he recently launched another career as a litigation consultant on drug marketing issues. While Rost's critics have attached selfish motives to his whistleblowing—he seeks to make a fortune through litigation, he's a publicity hound—his allegations continue to be proven true. One industry insider summed him up this way: "Rost is a bit of a carnival act, but he's not a liar."

—Jake Whitney for Guernica

Guernica: Take us through your last days at Pfizer.
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Is pharma afraid of DDMAC and fighting for DTC ads?

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There is no doubt that change is in the air in Washington DC. A new administration and a Democratic majority in Congress mean that pharma is going to come under a lot more scrutiny than ever before. However, is pharma and biotech ready to defend DTC and ask for latitude to do more or are they going to play it politically safe and hide in a shell like frightened turtles?

DTC marketing and advertising, when done well, leads to more informed health choices by consumers and does NOT add costs to drugs. That is not an opinion it is a fact. With the hundreds of millions of dollars that drug companies spend to develop new drugs they should have the right to advertise them to a public that is aging and looking for new treatment options. Those in office however like the attention of saying that DTC ads cost consumers more and lead to patients getting Rx's that they might not need. That statement is an insult to physicians and is an ignorant point of view but it's much easier to become the center of consumer anger and seem like a champion than to act on facts.

If you look back at DTC ads over the last year there are not many that really stepped out of bounds and made bad choices. Vioxx was not a DTC issue it was an issue with clinical trial data and side effects. The same can be said for Avandia. Bayer recently did an a letter to pull their ads for Yaz but only because the ad may had insinuated that the product can control outbreaks of acne. DTC marketers have done a good job of not making outrageous claims while keeping ads informative.

Now that everyone is predicting a decline in DTC ad budgets it's a real good time for pharma and biotech companies to come together to discuss the future of DTC advertising and marketing. If senior management really believes that DTC is a necessary tactic to meet business objectives and help consumers than they need to approach DDMAC now to amend the outdated regulatory framework for advertising drugs. DDMAC, for example, has never acknowledged the Internet with a full set of guidelines. For marketers it has been trial and error. Specific guidelines are necessary for paid search, organic search, online Rich media ads, product and unbranded Websites as well as social media. When DDMAC guidelines were established the Web was still in its infancy and social media was still in development.

The real question though is "are the senior executives from pharma and biotech ready to take on the FDA and DDMAC or are they going to stay under the radar?" To date this author has not seen any movement by anyone to try and update DTC guidelines. Nobody seems to want to challenge the FDA or work with them for fear it may hurt them in other areas like approval time for new drugs. I personally know of one company that wanted to challenge a notice from the FDA for a print ad but did not for fear it would "rock the boat" on an important drug awaiting approval. That is not a working relationship; that is a relationship based on fear and power.

If DTC marketing is to continue to provide information to consumers then it must evolve to go where consumers are going. This means a change from push messaging to engagement. It also shows that pharma believes that DTC marketing is a valuable tactic in the organization and that maybe the biggest challenge of all for DTC marketing people.
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Is DTC going to decrease in 2009?

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I keep reading how an industry trade magazine, if that's what you want to call it, is predicting a decline in DTC spending next year. Well with the current environment it doesn't take a genius to figure that one out. I decided to do an informal survey of several of my colleagues and although their budgets are going to be less don't expect to see less ads on TV. They are finding ways to cut dollars from the budgets by doing with marketing tactics that don't make them superstars. You know, stuff like Online and The Web. After all it's not like people are going online for health information.

The reason that there will less DTC in the coming years is that some drugs, like Lipitor, are getting ready to come off patent and that the effectiveness of DTC is being questioned internally among executives and externally by a changing political landscape. This author has said many many times before that the days of hundred million dollar DTC product launches are over. Marketers cannot count on reach and frequency to drive new Rx's and awareness has become a very small part of the marketing puzzle.

Pharma and biotech companies have also been on a purchasing spree lately and the money to purchase other smaller companies has to come from somewhere and marketing is usually the first to get cut. But let's be honest here, there are no big name blockbuster drugs in the near future that are due to be launched with the exception of Amgen's osteoporosis drug. Allergy, statins, diabetes and blood pressure medications are already generic. When Viagra comes off patent in 2012 it will take Cialis and Levitra sales down with it. Weight loss drugs have all failed in clinical trials so that leaves what? Cancer drugs? I don't think you'll see DTC ads for a lot of cancer drugs anytime soon.

Another reason that DTC advertising may decline is that the industry is losing a lot of great marketing people. They are leaving for greener pastures and to work in an industry that appreciates great marketing. Recent MBA students ranked pharma way down on the list of businesses they want to work in and with the industry laying off people left and right.

Now about the informal survey that I took, well most people already have substantial DTC budgets for next year but there are also going to be triggers to get more funding. A trigger is a milestone, such as reaching certain sales levels, to get more dollars. It also means that market research people will be working closely with DTC marketers to show ROI for every initiative. The consolidation of the ad agencies and digital marketing shops should also save some dollars and some agencies are going to be held to quantitative measurements in order to continue working as the "agency of record".

DTC is going to have to evolve if it is going to continue to be an integral part of brand marketing for pharma. The one area of course that is lagging is Online which requires a lot of support in people, analytics and dollars to be successful but the dollars are still far less than a national TV campaign. Let's see which pharma/biotech company is the first to make negative headlines in 2009 and bring the weight of Congress down on the whole industry. It's going to happen it's just a matter of who and when?
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Doing what is best for patients or the bottom line?

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At a time when health care costs are rising and payers are looking to cut costs comes this story from todays Wall Street Journal. A group of labor unions is launching a campaign that accuses CVS Caremark Corp. of violating patient privacy and improperly pushing doctors to prescribe a costly prescription drug. Change to Win, a group of unions that represents about six million workers, said CVS's pharmacy benefits management business has been urging doctors via a letter to add Merck & Co. diabetes drug Januvia to specific patients' treatments. The letter, obtained by the union group, said CVS identified the diabetes patients through a review of prescription-drug claims processed by its Caremark unit. A line at the bottom of the letter says Merck paid for the mailing. Neither Merck nor CVS would say how much Merck paid, and the drug maker also declined to say whether the mailing boosted Januvia sales.

First let me say that I personally would consider it a violation of privacy if my pharmacy sent me information from a drug company based upon my current prescriptions. Second, you really have to wonder what was the motivation here? I am sure that Merck paid a LOT of dollars to do this and if it is in the patients best interests. Then there is the issue of coming between the patient and his/her HCP. If I were a physician and a patient came in with a letter like this I think that I would be pretty upset.

I was working on Prozac when Lilly got raked over the coals for sending letters who had Rx's for Prozac to get them to try and switch to the weekly form of the product but that was essentially more convenient for the patient as well as a good business decision. To get patients to try and switch to a branded product over a generic has a lot of negative implications. Januvia is as much as eight times more expensive than many other diabetes treatments, according to a recent study. Some medical experts say patients may not need the drug and may respond just as well to older, cheaper treatments.

Of course Merck is saying that they did not have access to patient data and private information but this trend still raises disturbing questions about shady marketing practices and sheds additional light on pharma marketing at a time when they need to get out of the spotlight.
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Physicians becoming more digital

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The number of physicians who use the internet and other digital technologies to access pharmaceutical, biotech, and medical-device information has jumped 20% since 2004 and accounts for 84% of the total US physician population, according to the ePharma Physician v8.0 study from Manhattan Research. The research also finds that 36% of physicians now communicate with patients online (up from 19% in 2003), and that physicians are more active than the average consumer when it comes to new media.

Google is the most popular search engine among physicians, with 91% reach among physicians searching for health and pharmaceutical information online. 83% of physicians watch video clips online, as compared with 34% of all US adults.
Physicians using online communities - such as Sermo and Medscape Connect - are more likely to be primary care physicians, be female, own a PDA/smartphone, go online during or between patient consults, and be slightly younger than the average physician.
Online Media Consumption for Professional Development.


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Physicians are increasingly using emerging technology channels to enhance their professional development and shifting their learning online. When it comes to product and treatment information seeking, physicians on average conduct 41% of their pharmaceutical and medical device research online. This number is expected to reach 50% going forward.

Live Video Detailing:

Though physicians have traditionally relied upon personal interaction with sales reps to build relationships and stay abreast of the latest product updates and news, live video detailing through the internet has emerged as an alternative to traditional face-to-face meetings.
About 45,000 US physicians met online with a sales rep over the past year, and more than 300,000 more show interest in interacting with sales or other company representatives, the study said.


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Physician Customer Service Portals:

While most physicians still want to be able to talk to a sales rep during a new product launch or when they have a question, they prefer to
conduct more routine activities online at their own convenience. Physicians often turn to customer service portals, which include access to journal reprints, the ability to order samples, patient education information, links to continuing medical education, and sometimes live online video conferencing with a company rep. Though portal visitation actually declined from 2007 to 2008, interest in using a service portal increased over the same period. This indicates an unmet demand for relevant content that exists today, according to Manhattan Research.

Product Websites:

Product websites are often one of the first places physicians visit when researching treatment and prescribing information and updates for a particular product. In 2008, the diabetes brand sites of Januvia, Actos, Byetta, and Avandia all ranked prominently in terms of primary care physician visitation to pharmaceutical product sites.

Online Medical Journals:

The New England Journal of Medicine, American Family Physician and the Annals of American Medicine are the top three online journals among physicians. Reading online medical journals has been one of the fastest growing professional activities for physicians, growing at a double-digit rate over the past three years. Physicians in the study say that they will devote even more time to online journals in coming years.

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Online Conferences:

Online conferences offer physicians the ability to attend medical events and network with colleagues from the convenience of their own office or home computer. Like online journal visitation, attending virtual conferences is a professional activity that has grown at a double-digit rate over the past three years. Physicians report that they expect to increase their attendance at online conferences, and these types of events are expected to grow in terms of quantity and variety. These emerging digital channels give professional sales, marketing, and service teams new ways to better align their efforts and facilitate cohesive relationships between physicians and brands if they can determine the optimal channel mix, Manhattan Research said.

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Clicks on ads don't mean anything anymore

roibl
Clicks on internet ads don’t measure all of a campaign’s sales impact nor the cumulative (latent) impact of ads. They also don’t tell you anything about brand building effects and the Internet ads as we once knew them may be a relic of the past.

It used to be simple to develop Internet ads and match them with your target audience online to determine the online media plan. However if you look at your Website metrics at the top exit page and the time spent per page it can tell you a lot about what's happening and what maybe happening is that people click on your ad, come to your Website and leave because either they are not in the target audience or they are not interested in the brand/product.

In Rich Media there has been a decline in click through rates of 2.5% in 2002 to 1.12% in 2006. Why? Well there are a lot of basic reasons such as irrelevant messages to the target audience(s) and poor ad designs but probably the biggest reason, in this writers opinion, is that Web users have become more Web savvy and when they go online they know what they want and where they want to go rather than browsing or just randomly surfing the Web. In addition a comScore study of Yahoo and Double Click cookies found that 30% of Internet users delete their cookies in a month and that these deleters do so an average of 4 times a month. This means large errors that could lead to 2.5 times overstatement of unique visitors in server logs and 2.5 times overstatement of reachand a similar understatement of frequencyin ad server logs. The online ads that you sponsor therefore maybe giving you false data and thus incorrect ROI numbers.

So what are advertisers to do? Well first in search marketing we need to move beyond click through to the site and look at cost per targeted action and cost per targeted action within our target market. Why should you pay for a click through to your site only to find that the person who visited your site stayed less than 5 seconds and just viewed the home (entry) page?

For online ads it's time to move from awareness and clicks to engagement. This means engaging your audience online via Rich Media to let them interact with the online ad. In a sense you're creating a mini-site within an ad but the key is to ensure that the content of the ad is relevant to YOUR audience. This means that you need to move away from offline DTC message just because they tested well with your audience for a 30 or 60 second TV spot. This by far is the biggest mistake marketers make when they develop online ads.

Of course to make all this happen you need to a whiz at using Excel and analyzing Web analytics to tell the story. When I talk to people within the eMarketing industry this is often the hardest part of their job; communicating to management, in a way that they can understand, what is happening and what it means to the online marketing programs.

To date pharma has not shown that it is interested in really relevant online advertising development. The ads that have appeared are boring, dull and don't leverage the strength of the Web to engage people. I guess I would have expected this given that pharma tends to spend less than 5% of its DTC budget online. Still maybe pharma will get the message about the conversation that is NOT taking place online.

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Trust has to be earned via transparency and engagement

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“It’s frankly absurd to lay the many dysfunctions of the U.S. healthcare system on the doorstep of pharmaceutical companies … but unless we can restore trust and deliver unambiguous benefits to as many people as possible, the industry’s image and stock values will continue to suffer" This is a quote from John Lechleiter the CEO of Eli Lilly and while I agree the pharma industry has to acknowledge that they have made some missteps that have led to this position.

As I have said many times before the environment in which we market is tough right now. There is a lot of anger out there and it doesn't take much to be the target of consumer displeasure. The pharmaceutical industry has been less than transparent in a lot of ways and continues to embrace dated business models to prepare for the future. Top therapeutic categories will soon be generic including some blockbusters and payers now have options to remove hundreds of millions of dollars in costs by switching customers to generics in heartburn, cholesterol, high blood pressure and diabetes medications. As pharma and biotech companies came out with new and improved products payers asked for head to head studies to show the advantage of new products against generics. Some of the new and improved products failed in clinical trials leaving R&D people scratching their heads to determine what went wrong. This is all coming at a time when the FDA is asking for more data on new drugs thus delaying their time to market and thus the ROI for shareholders.

Perhaps though the biggest barrier to regaining trust with customers has been pharma's inability to embrace Web 2.0 because they are a regulated industry. Customers no longer "want to be sold" , they want to engage with the brand and each other around the brand. Marketers foolishly think that people who see DTC TV spots are going to ask their physician for brands without doing research online. Arguably the sales plateau for Byetta can be directly linked to the negative consumer buzz about the product and the lack of anyone on the brand to engage with people around issues of pancreatitis. Pfizer decided to withdraw from its relationship with another company over inhaled insulin largely because BLOGGERS has communicated the risks of the product to prospects and told them not to use it.

Trust, in any relationship, starts with a willingness to listen to your customers and talk with them instead of at them. Until pharma learns to listen more and put patients first above profits via transparency the road back will be a long one with a lot of hills.
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It's time for DTC marketers to understand how patients make treatement decisions

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Over the course of reviewing DTC marketing materials it's become apparent that either a lot of DTC marketers don't understand how patients make healthcare choices or don't care. They continue to push mass market TV ads and engage in Web 1.5 but when a major pharma company spends $750 million on DTC and only $5 million of that is allocated to the Internet than there is something seriously wrong with the system.

Over the last two months I have sat in on some qualitative research with people of all age groups to determine how and when they get health information. Two things became apparent; first, they only search for health information when they are concerned about a health problem for themselves or family members and