PhRMA showed off two versions of its recommended search ad, one with a universal symbol that’s easily recognizable as a link to risk information (the sample one showed the FDA symbol). The other ad includes a short-form version of the adverse event warning, such as “All drugs have risks, click here for more information.”

The two versions of the search ads also include some form of warning information on the actual ad. Pharma marketers originally thought they could have risk information provided on a separate landing page linked to the ad, but FDA shot down this “one-click rule” last year.

Social Media has become a necessary evil for pharma in the past few years. Once upon a time, news took days to spread through media channels; now someone can post an article on a blog or social network site and millions of people view it almost instantly. While some pharma companies have taken advantage of social media, creating their own networks and blogs, others are taking a wait-and-see approach toward such technology.

And with good reason. Last April, the FDA released 14 warning letters to pharma companies for improper use of search link advertising. The agency expressed the opinion that pharma companies which listed the brand name of a drug and included health information without safety information were in violation of pharmaceutical marketing regulations.

Many companies were stunned, and called for a proactive response or guidelines from the agency.

“PhRMA remains an active participant in this discussion, and our goal is to help FDA create standards that will allow truthful and accurate discussions about medicines online, by the companies that research, develop, and manufacturer them,” said Jeffrey Francer, PhRMA’s assistant general counsel.

PhRMA’s final recommendation pertained to Twitter and other microblogs that allow users to post brief statements and link to other Web sites. PhRMA thinks FDA should allow pharma companies to provide news and information about drugs on these sites, along with topics related to regulatory events.

Last November, in a massive public hearing, FDA asked for input pertaining to pharma’s use of the Internet as a promotional tool. Hundreds of speakers gave their ideas, and FDA promised to reconvene with answers later this year.

Google just showed off mockups of its fancy new pharma ads at FDA’s social media hearing, on November 12. A few months back, the big G mentioned that it was working on ads to appease both pharmaceutical marketers and FDA, but this is the first time most people got to lay eyes on the new ad units.

According to Mary Ann Belliveau, Google’s director of healthcare advertising, the new ads will include both brand name and healthcare information, as well as a brand URL. To make the ads FDA compliant, each unit will include an abridged warning notice that links to the full risk information. The lead subject line will link to the brand site, so each ad will have two different URLs linking to two different locations.

As it stands right now, pharma companies cannot use brand names and brand URLs in link ads without risk information. This is pretty much impossible to achieve since the risk info takes up too much room on the tiny ads. The other option is to only include the disease state and a generic URL, but Belliveau made it clear in her presentation that this isn’t a practical option.

In April, FDA sent out 14 warning letters to pharma companies that were mixing brand and health information without risk information in the actual search ad. Many of the pharma companies assumed that as long as risk/benefit information was within one click away, then they were in the clear. They assumed wrong, and many were forced to pull their search ads.

Earlier in the day, Yahoo said that it was testing new rich links in text ads to try to appease FDA requirements. The new ads would allow risk or company information to appear when a user hovers over a logo.

FDA is taking in all the suggestions from the Big Two search firms during the two-day hearing, but made it clear that this is just an information gathering process and that a formal decision on guidelines or actions would be down the road.

Image Courtesy of Google

More than 250 people were in attendance for the two-day event, which included pharma marketers, brand managers, and patient education specialists who shared a common interest: The desire to connect and engage an educated, digital savvy population of e-patients and their caregivers.

Some attendees came to hear keynote speakers such as Dennis Urbaniak from Sanofi-aventis, Joe Shields from Pfizer, and Marc Monseau from J&J share their expertise on driving change, patient adherence, and the art of tweeting, respectively. Others like Derek Rago, vice president, strategy and marketing, McKesson Patient Relationship Solutions, traveled to Philadelphia from Arizona for the opportunity to understand how social media and networking influences his clients.

“How will pharma embrace and use social media appropriately? I’m thinking it’s part of a broader marketing strategy and building an appropriate relationship with my patients and social media can play a part of it,” said Rago.

Urbaniak, vice president of innovation and new customer channels at Sanofi-aventis, kicked off Tuesday with a presentation on shifting to a customer-centric approach. “The first mindset shift is the term around patient. We need to stop thinking patient and we really need to start thinking people,” said Urbaniak. “At Sanofi-aventis, we learned that when you’re a person who is first diagnosed with cancer and given the news that you need to undergo chemotherapy, it’s a tremendous impact. We look to see what hospital and grant programs are out there, but then build a program for patients that they want like bringing chemo therapy into their homes if that’s what fits their dynamic.”

Joe Shields, product director, consumer marketing and strategy integration, Pfizer, followed with new ideas for patient adherence. “For me, success is a healthy patient,” said Shields. “The empowered patient will be a collaborator and an active participator. It’s less about the sticking to something, and more about the ‘I want to do this for my health and my family.’ Adherence is starting to elevate the role of everyone in the community, and like health care, is a team sport.”

For the duration of the conference, participants had the option of using Twitter to ask questions and continue conference discussion with tweeters near and far. The live Twitter footage was projected on a flat screen monitor for everyone to follow in the ballroom. It was only natural that J&J’s Marc Monseau was on site to discuss the popular virtual space that the company mastered under his direction.

“We saw the Twitter feed as being a news gatherer and information provider as a starting point,” said Monseau. “When we established the Twitter account, I did not want it to be a bunch of press releases.”

Here are six quick tips for getting started in Twitterland straight from the source himself:

1. Create a business case
2. Connect with other initiatives
3. Establish a personality
4. Set guides
5. Gain legal and regulatory support
6. Tweet, tweet, tweet

In addition to Twitter, Eileen O’Brien, a former digital agency veteran who led a 1:1 coaching session on SEO/SEM during lunch, said that Google’s Sidewiki was the hot topic of conversation among pharma folks. She demonstrated the tool to me, located on Google’s tool bar, by posting her own comment about the drug Allegra on www.allegra.com.

“It’s having a side conversation by posting comments,” says O’Brien, who was a fan of today’s tweeting scene. “It’s really great to see everybody here tweeting in questions and answers.”

“Clearly, people who are used to abusing domain naming system for drug names are doing it for the Swine flu as well,” said MarkMonitor chief medical officer Fred Felman. “They are using the brand Tamiflu to try and gain some credibility to sell products from pharmacies that are uncertified. It’s predicating sales on the fear and concerns of people.”

Typing Tamiflu in Google returns a number of sponsored links to online pharmacies, mostly claiming to be in Canada. None are official sites of the drug’s manufacturer, Roche. More than half make reference to swine flu.

MarkMonitor, authors of the annual “BrandJacking” report, track the existence, content, and brand use of a Web site. The company does not have access to transactional data, nor can it account for the credibility of the drugs being sold.

“Based on previous buying experiences—we have bought drugs in the past—the drugs are rarely real, and most often the product is never shipped,” Felman said.

Who’s Watching Who
So who should be responsible for taking down these sites—FDA or the pharma companies? At the moment, it seems the Web-hosting companies and search engines are taking the lead. Both Google and Yahoo are quick to take down problematic and/or illegal paid search ads, and hosting sites such as GoDaddy have been authorized to remove infringing sites without notification (if they fall on a banned list).

FDA, in the past week, has issued at least a half dozen warning letters to companies claiming to sell a cure or prevention medication for H1N1. However, if the Web site isn’t created on US soil, it doesn’t have to abide by FDA’s rules.

“The important thing for the pharma company is to have tools in place to identify abuse so that they can take action, because the brands that suffer worst are the ones that don’t do anything,” Felman said. “If you let this fester, and let the criminals think your brand is an easy target, that’s who they’ll target. If you enforce, you see counterfeiters move to another brand.”

Roche could not be reached for comment by deadline.

Three pharmaceutical companies recently took big steps into the world of social media, launching Facebook applications that give consumers the ability to download and interact with health information material.

For those having a hard time keeping up with the rapidly evolving world of Web 2.0, a Facebook application (“app” for short) is an online program, game, or service that consumers can add to their Facebook homepage by giving the app permission to exist on their site. Most apps are simple and free to use.

Last week, Shire announced that it had teamed up with the Crohn’s & Colitis Foundation of America (CCFA) to launch “Virtual IBD March on the Hill,” a Facebook application that provides health information about the disease. Shire will donate $1 for every person who installs the online program. The way the program works is that once the app is installed, users can choose a virtual shoe from a handful of designer styles, and virtually take part in CCFA’s seventh National Advocacy Conference “IBD Day on the Hill.” 

“We wanted to launch this program on Facebook to give people the opportunity to gather in one place to support the cause,” said Victoria Noble, product director for Shire’s ulcerative colitis treatment Lialda (mesalamine). “So much awareness is driven by walks, but folks are left behind because they can’t actually walk.”

The application is branded with Shire’s name, but no product is associated with it. At this time there are no plans to add an interactive tool or a forum, but Shire does intend to tie the site in with its sales force detailing material and professional marketing assets.

Asked how Facebook marketing differs from buying an online ad on a Crohn’s disease Web site, Noble told Pharm Exec that the application reaches a different audience. “The people involved in Facebook are looking for patient support and community, as opposed to someone that searches Google for treatment information,” she said.

Shire, however, wasn’t the first company out the door with a Facebook app. In March, Pfizer and EMD Serono partnered to release “MS Champions,” a much richer application featuring a unique map that shows the location of every registered user who is volunteering, walking, or riding in support of multiple-sclerosis treatments. The site also provides information about the disease and a link to a branded site for Rebif (interferon beta 1a), EMD Serono, and Pfizer’s MS therapy.

The companies are now gearing up for phase two of the project, which will include some form of interactive conversation, though the details are still being ironed out.

“One of the key things about Facebook is the ability for users to blog and express themselves on the site,” said Carole Huntsman, vice president of marketing for US neurology at EMD Serono. “We are working on our social media policy overall, and we have been looking at how we can evolve the site going forward.”

The plan is to allow users to blog in real time, but have comments reviewed before they are posted in order to make sure that all content is compliant with regulatory guidelines.

Today was Day 2 at Health 2.0 in San Francisco, and the overwhelming theme for me at the conference was this: it feels a lot like it did eight years ago.

In many ways, I am impressed with the number of companies that are all focused on the same goal of improving the way people consume healthcare and related information. Many more start-ups and early stage companies presented again in the standard, rapid-fire demo mode, where each company has less than four minutes to make their pitch. While this does allow for greater awareness of some of the new companies out there, it all starts to sound the same after a while.

A lot of companies talked of significant traffic to their sites or to their communities – but I had to wonder if in fact all of this traffic is coming from the same people, continuing to search many websites, hoping to find the answers or feedback that they want to hear.

A colleague of mine had an interesting insight: that the experience for a consumer to search for information online happens as a very intimate moment. If you or a loved one was just diagnosed with a serious disease, you will likely then turn to many websites to find answers and seek hope.

So where do you place your trust?

The thing is, there is no trust yet of a significant scale. As I said yesterday, Google is doing a great job to build that trust – they are the go-to place to start almost every search query, health-related or otherwise. This points to the great opportunity ahead. It is a wide open space now with many companies trying to create a brand, and become integrated into people’s lives when it comes to helping them understanding healthcare.

And that’s why it feels like it did during the Internet boom of 2000 – lots of companies, all chasing the same dollars, trying to carve out ownership of a vertical or space, each offering the same type of service solution. In time, most companies went out of business, there was a lot of consolidation, and a couple of big players paved the way.

Chances are, history will repeat itself. The reality is that the ad-driven revenue model just can’t sustain all of these new companies, and just about all of them depend on ads to survive. Furthermore, click through rates will continue to be extremely low such that companies will need to find alternative revenue streams to stay afloat.

One company did stand out for me today. Wellsphere has a Google-like interface that makes search really user friendly. Results are organized according to type, so it is easy to see if results from your search on a topic come from a blog, a journal article, a community, etc. It is one of the nicer user experiences I’ve seen to date, and worth checking out, and possibly the site that earns our trust.

Amidst all of the hype of what’s to come from Health 2.0 tools, I was a bit surprised that few companies spoke directly to the pharmaceutical companies, offering solutions for them that matter. With so much emphasis on the improvement of patient lives, it was odd to me that more energy is not being spent from these smaller start-up-like companies on building meaningful partnerships with large manufacturers by offering unique value.

I’m heading back home to Boston tonight and look forward to seeing how the vibe differs at the Eye For Pharma conference on Friday.

This is the 2nd year of the event, and there are close to 1,000 people here, with representation from pharma, biotech, VC firms and investors, agencies, and reporters.

The purpose of the conference is to showcase the evolution of the healthcare space in general, thanks to the proliferation of various web 2.0 tools available.

There were plenty of demos from big players and small ones, and everyone in general is quite bullish on where things are headed. There seems to be a general consensus, however, that these are still early days, with much innovation and greater adoption ahead.

Clay Shirky gave a great keynote address, helping us all see the power that can come from individuals and their web-based tools of empowerment. His book “Here Comes Everybody” looks like it is worth the read.

Google Health is clearly on a path towards success. They outshined Microsoft, Aetna, Yahoo, and WebMD with what they are building, and the smart money remains with the big G. Look to them to make the personal health record a reality – and soon – and it will be a tool that finally makes sense for the consumer to use with ease. Of course, this will also make sense for Google, as they will figure out the right way to monetize this with the series of other free tools that they offer. Which is why they are Google. And which is why they will win. They have the creative license to succeed where the other guys will fall short.

Sermo and PatientsLikeMe stood out as leaders in the pack of Health 2.0-companies, both are now a couple of years into their business model, and both doing well. They are challenging the status quo, and should be applauded for their good work thus far.

Much discussion centered around patient communities, The Long Tail, and search. Organized Wisdom proved that they are on to something, and I suspect they will remain a strong player in vertical search in the coming years.

Edelman released a new report today that explores consumer attitudes towards healthcare and information. You can access the full report here. Of note, friends and family rank as the #1 source for health information, more than a physician (69 percent vs. 65 percent). Amazing…

Stay tuned for more highlights from Day 2, coming tomorrow.