Jacky Law

Online physician communities are like sweet shops for brand managers.
Or are they? asks Jacky Law.

For as long as pharma has been around, it has been trying to engage with doctors. Recently, that has meant following them onto the web into a range of physician-only communities. These cater, at one end of the spectrum, for large general medical communities such as Sermo and Physician Connect in the US, DocCheck in Germany and doctors.net uk in the UK. At the other is a long and growing tail representing smaller, often international, communities catering for specialist medical interests.

It is now three years since Pfizer famously partnered with Sermo to explore how it could use one of the first communities to build a strong (30,000+) US physician base. In that relatively short space of time, new networks with new business models have been vying with each other to entice doctors and pharma companies on board.

In the process, both parties are finding interesting ways to engage with each other while the networks build up their businesses. Len Starnes, Head of Digital Marketing and Sales, General Medicine, Bayer Schering Pharma, is convinced these networks will change marketing and estimates there are around 30 sites in the US and 30 in Europe, that started later and are now starting to catch up. “But it is in the Asia-Pacific where the statistics are most mind-boggling,” he continues. “China’s top site, dxy.cn, has 1.7 million members, Japan’s m3.com another 177,000.”

Some of these numbers should be approached with caution, however. In China and India, for example, doctors are rarely authenticated, making the figures rather less useful. Even where doctors really are doctors, it is one thing to sign up for a network, another to actually use it. Nevertheless, all the evidence suggests doctors are gravitating towards them in growing numbers.

The networks are doing everything they can to sign up doctors. That means, among other things, constantly improving the news and journal content, helping to keep conversations interesting and, often, offering money to take part in market research. If the doctor is with doctors. net.uk, that money can take the form of surfing points for simply staying on site. Pharma companies, meanwhile, find themselves confronted with a number of digital universes all filled with doctors talking about difficult patients who could be taking their drug, disease areas that could be swung round to discuss their drug, and everything else that doctors talk about. It is hardly surprising that the first activity to take off, in the US at least, was strategic listening — literally eavesdropping in on what doctors do actually talk about.

Efficient eavesdropping

Strategic listening quickly led to active market research and a gradual deepening of appreciation of the advantages of the digital world. For example, no-one ever knows for sure how many doctors see an ad in some obscure medical journal. Online communities take that kind of metric for granted and routinely give page view numbers and time on page for any aspect of a promotional campaign. Moreover, their business heads are constantly grappling with the same questions and with the same intensity as a typical brand manager: how can this community in its daily activities make doctors see and take notice of a particular product?

The result is a fast-evolving landscape of physician-only networks, fuelled by greater chunks of pharma’s promotional spend and apparently being lapped up by doctors. “The danger,” says John Mangano of comScore, a company that measures activity on the web, is that “it is a slippery slope as to how sites are monetized. From the networks’ perspective, it is important to ensure the actions to provide access don’t drive the visitors away as the relationship can be jeopardized if it is too overtly commercial.”

This financial dynamic, along which doctors and pharma companies will eventually diverge, also provides the best pointers as to how the landscape may evolve. From the networks’ perspective there are already various degrees to which they welcome pharma involvement. Ozmosis in the US, for example, separates its community of physicians from its business activities, using insights from running the former to inform the latter. And the largest UK site, doctors.net.uk, allows no direct pharma access while at the same time encouraging companies to use its community as an ideal promotion platform.

The reason the sites give is their belief that doctors value trust above all else — that and the click-of-a-button ease with which they can move from one site to another. If pharma companies share this belief (that doctors want to be seen as more than just potential prescribers), and use such sites accordingly, then the commercial tone is turned down and their integrity preserved for longer.

Conclusion

Potentially important new insights are emerging all the time that suggest new ways of engaging doctors. One is how online dialogue is revealing a whole new kind of key opinion leader, not necessarily the consultants or academics pharma has traditionally engaged with. Rather, they are the doctors who are listened to and have the most followers. Finding these people and really engaging with them means using tactics designed for the digital age. That, in my book, probably means supporting sites that fiercely protect their communities and instead sell their insights into how doctors engage with each other and may like to engage with pharma.

Click here for the FirstWord report, Digital Doctors: Marketing to Online Networks.

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.”

The brands in the study were given a social influence marketing (SIM) score that measured two attributes—the total share of consumer conversations a brand has online (share of voice), and the degree to which consumers like or dislike a brand (net sentiment). The SIM score combines the two attributes to measure the favorable impact of a brand.

In the pharmaceutical category, Razorfish measured the SIM scores of the top five brands with the most consumer media spend in 2008: Ambien, Lipitor, Lunesta, Plavix, and Rozerem. Of the five medications, Ambien captured a majority share of voice at 58.8 percent. However, its net sentiment was one percent lower than Lunesta, which received 64 percent net sentiment (but only 9.3 percent share of voice).

“We did conversation monitoring with our partner, TNS Cymfony, and we [analyzed] the online conversation for the last six months of 2008,” said Lisa Flaiz, vice president, group director, national pharma practice lead at Razorfish. “We then established a benchmark index for each industry using the brands we chose to analyze.”

The data does not include conversations that are not publically viewable, such as forums that require registration or private Facebook accounts. However, that still leaves a ton of data from sources like Twitter, YouTube, and comments on blogs.

“The beauty and the curse of these open forums is that you give up control of the brand, and you have to be willing to accept that there will be some negative comments for the greater good of elevating the conversation around the disease state,” said Flaiz. “Elevating the conversation online is now [like a] funnel—it helps create awareness and preference and I think we can be encourage by this.”

Interestingly, Rozerem’s reputedly popular Abe Lincoln ads do not show much traction online, with only 0.6 percent share of voice and a total score of 0.5. That can’t feel good from a campaign that cost Takeda $91 million in 2007.

“That’s share of voice over the total industry conversation,” Flaiz pointed out. “From a volume perspective, you just aren’t seeing that much traction in conversation around Rozerem. I think most of the conversation around the beaver came from industry people.”