Those issues (adverse events, off-label discussions, fair balance presentation, no meaningful FDA guidance) hardly need rehashing here, and despite the barriers, progress has been made on the digital front, as evidenced by – if nothing else – pharma’s willingness to invest in smaller-scale social media efforts not directly tied to product sales. In the digital sphere, ROI means “hitting the primary endpoint,” and that endpoint could be data collection, engagement with widgets or functionalities on a page or within an app, or the number of visitors (or likes) on a Facebook page. “The ROI of social media is that your business will still exist in five years,” a quote from Socialnomics author Erik Qualman that surfaced in one of the presentations, speaks to the accepted necessity – in some quarters – of social media participation and customer engagement.

“Advertising has already largely shifted to what people say about your brand,” as opposed to the magazine, television and radio ads that people consume, said Martin Husar, customer strategy and innovation at Sanofi Canada. In Canada, DTC isn’t allowed, but last October Sanofi tapped the Toronto-based agency MediResource for an interactive Facebook campaign around atrial fibrillation (A-fib). The business objective, said Husar, was to “own the primary venues for Canadian patients and caregivers to learn about AFib.” By his measure, the company’s Afib at Heart | La fibrillation auriculaire à coeur Facebook campaign has been a success – one need not “like” the page to access the content, and thousands have clicked on tabs like “Ask the Expert,” or “Don’t Skip a Beat,” a Simon-inspired memory game.

A Janssen Canada educational campaign around psoriasis goes a step further, offering a list of available treatments, and a dermatology locator that returns only those dermatologists who “agree that they will use biologics” – Janssen markets Stelara, an immunomodulating biologic – and who have voluntarily signed up to be listed on Janssen’s Living Well With Psoriasis website, according to Spilios Asimakopoulos, director of marketing technology, Janssen Pharmaceuticals Canada. The site also offers a shareable psoriasis “severity calculator,” which is available online or as an app for download.

South of the Canadian border, others agree that the educational/disease awareness space is a good place for experimentation. John Patten, a sales rep for Facebook, told ePharma attendees that “Facebook makes sense in terms of initial support groups [for rare diseases], and locating others with the disease.” He also singled out Bayer’s Walk for Hemophilia and Sanofi Pasteur’s Voices of Meningitis as good examples of Facebook educational campaigns. “Pharma is more powerful in the unbranded, open wall pages” on Facebook, said Patten. Whitelisted brand pages, or pages with the comments function disabled, will be “de-prioritized in the news feed,” and they go against Facebook’s model, which Patten defined as “a distribution platform that promotes authentic sharing.” Perhaps as an added nudge to discourage whitelisted pages, Patten announced that by the end of February, “admins can drill down into individual commenters, and message them directly,” to help deal with “your drug turned my arm blue” adverse events comments.

A couple of hours before Patten’s presentation, however, a regulatory affairs director from a major pharmaceutical company was on a panel griping about the fact that while Facebook allows blocking of comments on the wall, “we can’t turn off sharing or commenting” on the actual brand image. Asked whether the company responds to such comments on the branded Facebook page, the panelist said no: “once you do that, where do you stop?”

Bill Drummy, founder and CEO of Heartbeat Digital, said the difference between a traditional and a digital-focused agency is that digital is an interactive medium; it’s not interruptive like an advertisement.

William Martino, vice president, digital strategy, of Saatchi & Saatchi Consumer Health + Wellness, took an opposite prospective: “I think traditional agencies have a significant advantage over pure digital [agencies] because of a deeper understanding of the audience or the consumer. However, the traditional agency has to evolve, so they are not labeled.”

Eli Lilly would, ideally, like to have the best of both worlds. However, Lyndsay Younce, the company’s marketing consultant, said that Lilly hasn’t yet found one agency that can bring everything they need to the table.

For e-marketing space, Eli Lilly relies on digital agencies. “I don’t care if they have an integrated offering. But I want them to integrate well,” she said. “A lot of this has to do with the brand. It’s hard as an e-marketer to move away from the traditional advertising mentality, but you have to be able to speak that language in order to move. I have yet to see an agency come in with a specific measurement about their digital work.”

Both types of agencies have their pros and their cons. For example, according to Martino, a digital agency has the tendency to recycle ideas across brands with no understanding that audience and therapeutic areas are different.

“At the end of the day, a really good integrated plan is all about vision,” said Dorothy Wetzel, chief marketing extrovert of Extrovertic. “It really takes the brand team to consider all ideas and options and then put it together. The worse thing you can do is put agencies together and say to them, ‘Come up with a good integrated plan.’ The new school of thought is about building the number of brand advocates.”

On day two of the conference, I got the opportunity to sit down with Shwen Gwee, lead business analyst, health informatics and new media, business solutions for Vertex Pharmaceuticals, and get his thoughts about AZ’s recent launch. Specifically, we talked about why, despite having a Twitter account, the company chooses not advertise its YouTube presence on it.

Gwee gives several reasons for the company’s hesitance. First, Twitter is a two-way engagement tool, meaning, as soon as you post something people can access it. Furthermore, space is limited to 140 characters, so a company’s standard press release would not fit. Finally, nobody has a full policy yet for how they want to use this online medium.

Also Twitter accounts come with adjustable settings. For example, you can set one so that people can only follow you. This doesn’t mean that messages are private, but rather that certain individuals cannot message you directly—what they send you could be viewed by anyone. “The biggest challenge people face with corporate communications is its standardized-process type of review. Twitter is a new medium for putting a template out there; unlike a press release, you will get responses—it’s not a broadcast.”

Gwee noted Novartis and Boelinger Ingelheim’s transparency on Twitter: “The important thing is that they are on there,” he says. “I definitely see a trend for pharma adopting Twitter, and I think it will come from corporate communications. First, pharma has to remember that it is not just another broadcast mechanism, it’s a conversation.”

One tip Gwee has for pharma companies is to start internally. There are several Twitter tools that a company can try within its organization before opening up to the rest of the world.

For a review of 19 enterprise-level microsharing tools (aka Twitter!), check out Yammer at www.yammer.com or the Pistachio consultant blog at http://pistachioconsulting.com