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Using Digital to Address the Needs of Caregivers

As pharma and healthcare companies become more sophisticated with their digital offerings, it starts to become much simpler to provide individualized content. Before there was digital, printing a thousand versions of the same educational brochure simply wasn’t a practical option. Now, digital technologies make the task of providing customized materials simple (and no printing required). The wild card in all this is that you have to have quality content that’s also the right content for your audience. Let’s assume for now the content out there is quality. I’d like to address the second part: figuring out if it’s the right content for your many different audiences. At the end of this post, you’ll find six tips for using digital to influence caregivers.

Every healthcare company knows that patients and healthcare professionals (like physicians, nurses, and pharmacists) are important audiences, but who else? Sure, you can add in managed care, government agencies, and even employers (who pay for a lot of that insurance). A few companies with certain products add in one more important audience: the caregiver. It’s a pretty broad term, but for the purposes of this post, I’m talking about anyone who has an interest in a patient’s treatment. This could be a spouse, friend, child, parent, sister, cousin…well, you get the idea. It’s all the people in life who make sure that we actually go to the doctor when we’re sick and that we take our medications when we’re supposed to (at least they try). The level of care they actually provide varies a great degree.

You might be a caregiver right now. It doesn’t mean that you’re with the person you care for 24/7 or that you prepare their meals or change bandages. If you have someone in your life with whom you take an active role in their medical care, then you’re a caregiver.

As I mentioned, some companies already recognize the important role of the caregiver. For example, J&J created an iPhone app that’s completely designed to help caregivers called Care Connector. It’s designed to help caregivers to keep track of appointments, prescriptions, and to connect with other caregivers.

Care Connector

Other companies have placed the caregiver in the center of their promotional efforts. Consider the case of the Exelon Patch from Novartis for the treatment of Alzheimer’s disease. Their entire campaign is built around what the caregiver of an Alzheimer’s patient goes through each day. It’s fitting since the caregiver might be the one who ensures that the patient first gets treatment based on the nature of the disease. In addition, Novartis created a support program specifically for caregivers called My Caregivers Connection.

As an aside, someone recommended I take a look at the Exelon Patch site a couple weeks ago. I must say it has some very striking visuals. It’s a well done campaign in my opinion.

Exelon Patch Website Visuals

Today’s post isn’t about reviewing caregiver programs, but rather to get you to take a different look at how you target the messages for your products and to consider who the critical targets really are. Yes, they’re doctors and patients, but caregivers can play a major role in helping to choose a patient’s initial treatment and also influence whether or not they stay on treatment. When we talk about a product for children, it’s a no-brainer that the parent should be the main focus of communication. Where might this also make sense? Alzheimer’s, as Novartis did, seems like a pretty good fit.

But it doesn’t have to be either patient or caregiver, there’s a balance. This gets to why digital is so important. You can’t afford two TV campaigns, two print campaigns, two websites, and two iMedia plans. Digital technology makes this much simpler. First, by really understanding where your patient’s and their caregivers spend time online, you can focus your message. By using some simple segmentation features, you can individualize content depending on whether they are a caregiver or patient. You can even customize your website based on the search terms that got the person to your site. If they searched for “caring for Alzheimer’s patient,” then you can probably assume they are a caregiver and your site should automatically reflect that. If you’re not using customized landing pages like this, you’re missing something. People expect that when they click on a search result that the page they land on is relevant to their search. If it’s not, they’re gone for good.

One other critical aspect I just mentioned involves understanding your targets’ digital behavior. This is partly driven by age as it relates to whether they are a digital “native” or “immigrant.”  Consider the case of Gardasil, the HPV vaccine from Merck. The patient for this treatment are teenage girls. Where better to have a presence than Facebook? So, that’s what they did and created the Take a Stand Against Cervical Cancer page on Facebook. Some look at this page (including me) and say that it’s not a great use of social media since there is no commenting or discussions on the page. On the other hand, I say, “so what?” All this page serves to do is bring your content to where the brand’s target spends a lot of time. It’s essentially a portable version of the drug’s main website. Put the content where your customers are. Makes perfect sense.

So, if caregivers are your customers, you have to tailor your approach. We were asked to come up with a digital strategy for a chronic pain treatment as part of a pitch a few months ago. The key target was older women (55+) with arthritis. Along with a few other demographic details, we were told that the target had children (either teenagers living at home or who just left home). We came up with some solid ideas and a simple strategy. The plan was to communicate with the patients, but to use the caregivers to help drive additional awareness and compliance once the patient started the treatment. Since most of the caregivers were in their late teens or early twenties according to their research, we proposed building a caregiver educational page on Facebook along with many other tactics. In the end, we didn’t win the pitch and the feedback we got was that we didn’t consider the target audience with our tactics particularly when we suggested the use of Facebook. They told us that old women didn’t use Facebook. Clearly, they didn’t listen (or we didn’t explain it clearly enough). It’s not all about the patient, but also the caregiver. You’ve got to tailor your communication plan to the caregiver with as much thought as you put into the patient.

Assuming caregivers are a critical piece of your communication strategy, then here’s how you should be using digital to ensure that you’re giving them the right information, in the right venue, at the right time.

  • Create custom content. Just don’t copy and paste the same content you have for patients and put it in a “Caregiver” tab. Caregivers have unique needs that are completely different than those of patients. If you don’t want to go through the expense of creating content yourself, look for some that you can license or that is available for syndication.
  • Buy caregiver search terms. Don’t just focus on what patients search for and buy those keywords. Think about (or do some research) about how caregivers search when they are looking for information they need to take care of someone else. Maybe “caring for <plus condition>” or “administering <plus treatment>.”
  • Develop custom landing pages. If a caregiver comes to your site from a source that you know makes it highly likely that they are a caregiver (e.g., one of your caregiver targeted paid search ads), then make sure they land on a page that has caregiver specific information. Don’t just dump them on your homepage.
  • Reach them where they are. Chances are that caregivers will be found on completely different sites compared to your target patients. Remember my Facebook example above.
  • Choose the right technology. Caregivers might be comfortable with different digital technologies versus your patients. Your caregivers might prefer to get new information via RSS, while your patients might have no idea what RSS even is.
  • Consider connecting caregivers with other caregivers. Facilitating the conversation between caregivers would be a useful service. You can only learn so much about caring for a person with Alzheimer’s by reading about it online. You learn the little details that make all the difference from talking with others in your situation. One of the features of the iPhone app that J&J created is a way for caregivers to connect to one another and share what they’ve learned. Nervous about social media and open discussions? Consider how the Connect to Conquer Epilepsy program is set up. Instead of allowing discussions on a company-sponsored site, the program instead matches people with similar situations (like a dating service). Once you are matched up, you share your personal contact information with your match and then you talk off the website via email, phone, or whatever you feel comfortable with.

Caregivers can be an important influencer not just on which treatment a patient chooses, but also on whether or not they continue the treatment. There are plenty of opportunities to use digital to reach this important group in a simple and cost-effective manner. If you aren’t using them, count on your competitor to do it.

Bringing Digital to Pfizer’s Drug Giveaway

First, I would like to applaud the folks at Pfizer for their new MAINTAIN (Medicines Assistance for Those Who Are In Need) program. Yes, it’s a little bit of stretch to get to the acronym, but pharma’s got to have them. For those not familiar with the program, basically, it provides one year of free drugs if you’re unemployed at no cost. A couple of important caveats: you have to have been on the Pfizer drug for three months prior to losing your job and  have no other healthcare coverage for drugs. Essentially, this is the Hyundai Assurance program for pharmaceutical products. 

As we all know, big pharma could always use a bit of good PR and this is some of the best it’s had in a while. Some cynics might mention the limitations of the program or that it’s tied to losing your job instead but does not include those with jobs who still can’t pay for their medications. You could also note that higher cost (and higher profit) oncology products aren’t included in the program according to Ad Age’s review of the program. However, the cynics seem to not be making a big splash this time around as most of the buzz is positive. 

Overall, this has got to be a positive PR coup for Pfizer. At the same time, I’m going to guess that they’ll actually not have that many people who fit the requirements for the program. You need to be on branded Pfizer products for three months and then lose your job. Yes, many people have lost their jobs recently, but the employment rate is still (historically-speaking) relatively low and job losses seem to have slowed. The other piece that limits the number of people who might qualify is that patients have to have been on treatment for three months. Assuming people tell the truth, with adherence rates dropping dramatically in the first three months, most patients never make it to month three. My point? This program might not cost Pfizer that much at all. Compare that to the PR value that they are getting (and could never have bought) and overall it seems like  pretty smart move. 

Let’s also remember, Pfizer has a lot to gain from this program. People who lose their job may cut back on medical treatments along with everything else. Those on Lipitor may ask their doctor for something that’s almost as good but much cheaper and they end up on generic Zocor. Pfizer gets nothing. However, when the patient gets his job back, he’ll probably continue with what was working. Pfizer would rather make sure that their drug is the one the patient is taking when they get insurance coverage once again. So, instead of losing them forever, Pfizer basically loaned them some money until they can get back on their feet and start paying once again.

As an aside, Ad Age included this in their article: “A former high-ranking pharmaceutical company executive said the cost to Pfizer for this new push may not be as high as people think. ‘Most of the money [drug companies spend] is in [research and development],’ said the former executive, who asked not to be identified. ‘It doesn’t cost a lot to manufacture the pills or package them.’”

Perhaps this comment explains why he/she is a “former” executive. If this were the pharma business model, then they could be selling every pill for 3 cents. Technically, I guess they’d have to sell the first pill for $800 million and then the next one could be 3 cents. The point of the higher prices is to re-coup the investment in development throughout the life of the product. Giving them away doesn’t have a high costs of goods sold, but it has a tremendous opportunity cost (or sacrificed revenue “cost”). So, seriously with this quote? But, I digress…

The point of this post isn’t supposed to be a Pfizer-lovefest, so I’ll get to it. My challenge to Pfizer is how they could have (can?) bring digital (and relationship marketing) into this program to make it even more valuable and actually turn a profit on it later on. It’s pretty clear that this program isn’t going to be advertised (which also keeps the number enrolling down) and I’m not suggesting that Pfizer advertise it. There also are some rules around offering enticements for getting someone to use your products and free samples (which is what this basically is) can fit in that category in some cases. So, I know that they have to be careful with how they tie this program to current and future sales and marketing.

That said, there’s an opportunity here. On the application form, Pfizer asks for the patient’s email address. I would guess that people would readily turn over this piece of personal information because they feel that they are getting some value in return (my take on this value exchange). But the question is: what can/should Pfizer do with these email addresses? Again, keep in mind that they’ve offered something very valuable in return for information and have people who are likely to be willing to accept some offers in exchange for these free drugs. So, is Pfizer asking each of the people in the program to opt into one of their product-specific CRM programs? For example, an applicant who is taking Lipitor should be offered the chance to enroll in My HeartWise, the product’s CRM program. If Pfizer believes in the value of these programs, then why not try to get more people enrolled?

Since those who get accepted for program are likely to have a very positive attitude towards Pfizer (and rightfully so), why not leverage this while you can? Perhaps they’ll agree to share their story for use on your website. Maybe they’ll write a blog post about you (or send a tweet). Maybe they’ll tell their friends about how great of a company you are. You can help them do all of this by providing them with simple talking points about the program and the company. Let them be your ambassadors while they’re willing and have a great opinion about your company. 

Maybe now’s the time to start collecting product reviews for inclusion on your site later on (when you can sell it to your regulatory team). Surely, these people would be more likely to give you a positive review (or any review at all). All of this is very common in other industries where they do a much better job at finding, energizing, and supporting their biggest brand advocates. They look for the right people through a variety of channels (social media being the big one now). They get them excited about what they can do and the difference they can make. Finally, they give patients simple ways to spread the word to others. It’s not a quid pro quo, as you’re not making their participation in the program contingent on their agreeing to help. Pfizer can follow this same model: find, energize, and support. 

How? The find part is really easy. They’ve got the names, street addresses, phone numbers, and email addresses of those that should be the biggest advocates for the company (i.e., those that were accepted into the program). Energizing is hard regardless of the industry, but it can be done here for sure. Let those in the program know the value of what they are getting, how the drugs are going to help them (i.e., they made the right choice to find a way to stay on treatment), and how many other people could benefit, but aren’t. Yes, a little bit of a guilt-trip, but I think fair. Support is the final part of the model and that could be as complex as mailing a PR kit to every member of the program who is interested or as simple as adding a ShareThis button to every product site. Either way, you have to make it very easy for people to share your story otherwise they won’t.

So, hats off to Pfizer for taking on this ambitious program, it’s a 7.5 out of 10. My challenge to you is for you to figure out how you can make this even better and bring it to a 10 out of 10.

The Ante of Quality Assurance

As part of my regular research, I’m constantly checking out websites all over the Internet. I’ve even had the chance to be a judge for the WebAwards. Point is, I’ve seen a lot of what’s good and bad online. There’s stunning creative with terrible content and there’s amazing content with lifeless design. Occasionally, the best of these combine to create a site that both looks beautiful and has tremendously valuable content. They’re rare, but they exist. Unfortunately, this isn’t all that it takes to have a website that customers engage with and changes their minds. In the end, the number one requirement is that is works.

When I say “work,”  I don’t mean that it must “work,” as in move people along the adoption spectrum, purchase funnel, or whatever you call it, I mean that it actually functions correctly. You’d be surprised how often this doesn’t happen. Links are broken, videos don’t play, fancy iframes don’t quite load, and sites are down. All of these (and many, many more) are completely unacceptable. But, for some reason, these major errors seem to be fairly common. I haven’t noticed that they occur more often on pharma or healthcare websites and I’m not going to call out any specific sites (to protect the innocent and guilty), but I am going to cover a few very specific things you need to ensure happen as you’re developing your new site and maintaining your old one.

I’m going to focus on something I call “The Ante of Quality Assurance.” That is, you have to pay a bit before you can even get started just like an ante in poker. Everyone has to pay it and it ensures the game (i.e., your site) goes as planned. If you don’t have money allocated for quality assurance (QA) in your budget, then take money from somewhere else for it. If your site doesn’t work, does it matter that you have one more flashy graphic? As a client, you should have zero tolerance for errors in the final product. I can guarantee that they are going to happen during development, but once the site is live (and out of beta if you have one), then your site should work flawlessly. F-L-A-W-L-E-S-S-L-Y. Anything less should be fixed immediately. However, if you employ the right QA staff, you should never have this problem. So, do you have money budgeted? Do you have dedicated QA professionals who are trained to find errors and not just people at your agency who need billable time? It makes a tremendous difference.

The best analogy I can give to people who aren’t digital experts is this: Imagine if you completed your TV commercial and during it’s first airing, it simply when black after 20 seconds. Would you stand for that? No, you’d probably have someone’s head on a platter. Now then, how come it’s all right if your shopping cart or your product demo video doesn’t work?

Top Web Browsers

Most companies do a good job with the basics. Links all work, Flash elements play as they should, pages render as they are supposed to. At least they do a good job when it comes to one browser. It takes a little extra effort and also some extra development smarts to ensure that the site works correctly in every browser. I’ve seen too many sites from giant companies work fine in one browser and fall apart in another. This isn’t a one browser world. Market share of web browsers is split between basically six browsers that account for 99.6% of browser usage. They are, in share order, Internet Explorer, Firefox, Safari, Chrome, Netscape, and Opera. What?!? Only heard of two of these? You’re probably in good company. Internet Explorer (IE) accounts for 66% of the market. I’ve found most IE users don’t know (or care) much about the other browsers out there. But, if you don’t consider the others when you’re developing your site, you’re basically saying “sorry about your luck, but you can’t see my stuff” to one third of all Internet users. Not good, but common. 

Without too much technical detail, each of the browsers interpret code differently. Some are very close to one another, others are not. For example, Firefox (22% share) interprets code very strictly and literally. This means that pages that contain coding errors are rendered in such a way so as to leave them looking or working incorrectly in the browser. However, to be sure, it’s the site’s fault, not the browser’s fault. Firefox strictly interprets the W3C standards for coding. IE tends to let you get away with a few mistakes and “hacks.” Some developers have little shortcuts they use when they code and others are just sloppy. The result can be a perfectly functioning page in IE, but one that barely loads in Firefox.

To add a little more complexity to this, let’s not forget that there are currently three versions of IE that people are using right now: IE6, IE7, IE8 (in beta). Each behaves differently than the other two. So, that means you’ve got to test opposite multiple browsers and multiple versions. While you’re at it, you need to check different operating systems as well if your site loads or installs anything outside the browser (like a widget or gadget). 

By now, you’re probably seeing why you need QA included in your plan and the value of ensuring that it’s properly funded. You’ve got to do the basics right in order to communicate with your customers. Remember, these people usually don’t trust pharma and healthcare companies, so when they do extend themselves and come to your site, make sure your house is in order.

Do You Really Need Your Digital Agency?

As someone who works for a digital (and relationship marketing) agency (Bridge Worldwide), I was a little hesitant to write the title of this post. It’s a fair question though: Do You Really Need Your Digital Agency? I’m addressing this question not just to all the pharma and healthcare marketers out there, but also to all the agency folks that are regular readers. Your question is just slightly different: Does Your Client Really Need Your Digital Agency?

The inspiration for this post was a fellow Bridge colleague, Jason Bender. He writes the blog Famine City along with Marty Boyer, another Bridge-ian. Earlier this week, Jason wrote a post called “Howard Stern schools digital agencies w/ facebook.” I really should just re-blog Jason’s post because he pretty well sums it up. I’m going to add a little pharma/healthcare commentary to his thoughts though. Here’ the background from Jason’s post:

“He [Howard Stern]  (the “client”) had a relatively simple request for the folks who run his website (his “digital agency”). He wanted to post a video to his site. He made the request live on the air, and waited.

“After a few minutes, his producer claimed “they—the guys who run the site—can’t post a video on the site.” In other words, the “agency” told the “client” that it wasn’t possible to do what he wanted to do with his site.

What did Howard say?

 “Get back to me with a plan?” No.
“Let me know when that’s possible?” No.
“Can you explain why we can’t?” Nope.

He didn’t ask them anything. He solved the problem himself.

His solution? Forget the website, then. Create a Stern Show page on Facebook and post the video. “We’ll have it up in less than 5 minutes.” 

Jason ends his post quite simply: “So the question for digital agencies and the people who work at them is…what do you offer your clients that they can’t do themselves with 15 minutes and a Wi-Fi connection?” [bold is his]

For all you agency folks reading this, take a moment and really answer this. For you “clients,” ask yourself if you could do what your digital agency is doing on your own. 

As someone who takes great pride in the quality of work and depth of thinking we bring to our clients, I’m hoping, for the industry’s sake, that most agencies have a good answer for this question. You have to because if you don’t there’s an agency right behind you that does.

So to take Jason’s observation and apply it to healthcare and pharma (and really any industry), I put together a little list of what you should expect from your digital agency. If they’re just tweaking your website or uploading content for you, you don’t need them. If they’re doing more than this, great. But how much should you really expect? Here goes:

Your digital agency should…

  • be able to occupy a seat at any table where any marketing strategy, tactic, or channel is discussed. In other words, they should be able to add value beyond just digital.
  • provide strategic recommendations and not just tactical executions. Your agency shouldn’t simply take orders and do just what you say. They should be partners who are helping define your digital strategy and not just updating a little copy on your site.
  • be creating systems that allow you to make simple updates without redoing things from scratch. In other words, if you request a change to one word in a Flash piece and your agency sends you a bill for $50k, you need a new agency. Same for updating site content (not design, content). Frequently updated sites should have a content management system (CMS) or some other simple procedure that allows this to happen.
  • tell you “no.” They should tell you “no” to ideas that they believe are not good ones. They should say “no” when they know that you’re about to waste your money. Part of any agency’s job is to talk you out of doing things.
  • know if you’re making your numbers. Are you over-budget? Are sales behind plan? Every agency should know this including your digital agency. I don’t know why some clients don’t share this with agencies and I don’t know why more agencies don’t ask for this. How can you recommend what a client should do next if you don’t even know where their business stands?
  • cooperate with every other agency. More and more, digital is the hub of communication with customers. If your digital agency doesn’t know what everyone else is doing, you’ve got a problem.
  • know healthcare/pharma. Yes, even your “tech” people should understand the market. They might be the ones who can come up with an elegant technology solution to a big problem (like adverse event reporting)  if they understand the market, regulatory rules, and brand strategy. If they only know “tech,” then you’re not getting your money’s worth. 
  • know other industries as well. They should also know industries like consumer packaged goods (CPG) or consumer electronics or any other industry where some of the newest digital strategies and tactics are being tried. This will allow them to reapply these lessons to healthcare/pharma. If your agency only knows healthcare/pharma, then you’re missing something and probably doing the same thing as last year.
  • do some thinking for “free.” Not your entire brand plan mind you or an entire website. I’m talking about leading your thinking. This might be as simple as sending you an article they found along with some of their own commentary. It might be a presentation they created on social media principles that they share with you (kinda like mine that I’m sharing).
  • be making you smarter on digital…everyday. When was the last time your agency taught you something about digital that you didn’t already know? When was the last time they put together, say, a small training program for you that made you better?

It’s a pretty long list, but I don’t think it’s anything too complex or too much to ask. So now I’m curious if you’re getting this if you’re a marketer and if you’re giving this if you’re an agency person. Let me know what I’m missing or if I’m asking too much.

Now…I’ll sit here and  hope I’m not firebombed by some of my industry colleagues for letting out all the secrets and making their jobs harder.

Pharma Search Engine Rankings Need Fixing

Dose of Digital Mini White Paper

An anonymous pharma friend recently asked me to do a simple analysis. He asked, “how do we rank in search engine results for our important keywords?” Answer: terrible. I was pretty surprised by my basic analysis and really didn’t understand how a site so rich in content (and built at such great expense) could perform so poorly in this important metric. Question is…why should you care about search?

A couple facts to get started: 80% of all online sessions begin with search. Google has a 63.7% share of all searches. The point? Most people find things online by sitting down and using a search engine. It’s the first thing that happens 80% of the time. Two thirds of the time, these people are using Google. That means that just over 50% of the time when someone starts an online session, they open to Google and search. In other words, if your site isn’t showing up on Google search, it may as well not exist. Moreover, it had better appear pretty high up in the results.

(Note: I know that I’m about to simplify some search engine principles here, so for all you professional search marketing folks, give me a little slack. This isn’t an SEO blog, but do leave your comments if anything is grossly inaccurate. That said…)

It turns out that the top three listings on a search engine results page (SERP) account for 62.6% of all clicks. That is, about two thirds of the time, people look no further than the first three listings before clicking. So, clearly that’s the place to be. To give some added detail to this, you’ve got to be in the top two in order to really be seen. The number three result gets only an 8.44% click through rate compared to  a 42.3% click through rate for the number one listing. After number three, the numbers drop dramatically. Result number 11, the first result on page two of your search results, has a click through rate of 0.66%. Number 21 (top of page 3): 0.29%. Number 31 (top of page 4): 0.12%. Number 41 (top of page 5): 0.07%. I think you get the point. If you’re off the first page, you pretty much don’t exist.

Now, consider your average pharma brand manager who may not know all the details about search marketing and certainly wouldn’t know these numbers. When her agency comes and tells her that the site shows up as the number 11 result for one of their important keywords, she’s probably pretty satisfied. For all the billions of pages out there, our site is showing up pretty high where it counts. No one tells her that this means that this means we get a measly 0.66% click through rate.

I think I’ve made my point. People are using search engines (particularly Google) as their first stop online. You’ve got to be on the first page (results 1-10) to be seen. The results on page one get ~90% of all clicks. Got it.

So, how do pharma companies do against this?  I took a look at the top five selling, branded, prescription drugs for 2007 to see how they handle this. The drugs were (in order of sales) Lipitor, Plavix, Advair, Enbrel, and Nexium. (If you’ve got 2008 data, let me know).

We currently don’t work with any of these brands, so I’m not privy to their website keyword strategies. So, I had to use some judgment as to what keywords they’d most likely want to own. To determine this, I went to each of the brand’s website’s source codes and found their meta keywords. It’s a line that looks like this (from this blog, for example):

<meta name=”keywords” content=”e-marketing, marketing, healthcare, advertising, digital, internet, pharma, pharmaceuticals, health care” />

Now, a bunch of people are really upset right now. They are yelling that Google (and most other search engines) don’t consider meta keywords for search rankings. I know this. What I’m saying is that these keywords have to be important otherwise these companies wouldn’t have gone through the trouble of including them in the website’s code. True? Perhaps there are other keywords in addition to these, but I think it’s safe to say that these are important.

Methods: I used a tool available from SEO Book to rank everything on May 5, 2009 at the same time. In addition, to the Google rankings, I’ve also included the Yahoo! and MSN Live rankings. These are US-based versions of the search engines, results may differ in other countries. Keywords were taken from the meta keywords code for each site, except for Enbrel. There were no meta keywords, so I selected several keywords based on what I saw on the homepage. I also added each brand’s generic name when it was not included in the meta keyword list. The main website URL was used to come up with the rankings. The number represent the search rank of each term. A dash (-) indicates that the main website URL does not rank in the top 500 listings.

So, how did the brands do?

Lipitor

Lipitor Search Results

Plavix

Plavix Search Results

Advair

Advair Search Results

Enbrel

Enbrel Search Results

Nexium

Nexium Search Results

I’m going to focus on Google for my analysis of this. Here are a few observations:

  • All brands hold the number one ranking for their brand name. Good.
  • None of the brands hold the number one position for the generic name of their brand. Enbrel does the best with a #3 ranking for “etanercept”. Advair does the worst, as it doesn’t even rank in the top 500 for either of the ingredients in the product.
  • Condition-specific (e.g., heartburn relief) keyword performance is poor across the board. Lipitor.com is the 63rd listing on Google for “high cholesterol.” Advair.com is the 198th listing for “asthma.”
  • “Treatment-related (e.g., acid reflux treatment) searches are perform slightly better with several results at least in the top 50 (but still getting less than 0.001% of all clicks for the specific search term.

Why is all this important? I think we can all agree that additional traffic to your site, especially among people searching about your disease state and solutions for their diseases (e.g., acid reflux treatment), is a good thing. I’m not saying traffic for traffic’s sake, but improving with the right people is critical. Simply improving for one key search term can make all the difference.

Here’s an example:

There are 1,500,000 searches for “asthma” each month on Google (use their estimator tool to see for yourself). Advair.com gets approximately 105,000 visitors in March according to Compete. Currently, Advair.com gets no visitors (or virtually none) from the keyword “asthma.” Their site doesn’t show up until the 20th search result page. When was the last time you looked this deep for something? So, what if Advair managed to move itself to the first page of Google results for “asthma.” What impact would that have?

The 10th listing (last result on page one) gets approximately 3% of clicks. 3% of 1,500,000 searches per month for “asthma” equals 45,000 clicks (i.e., visitors). This would instantly translate to a 42% increase in monthly traffic for Advair.com. What if they became the number one listing? That would mean an additional 630,000 visitors per month, a six-fold increase.

I’m not saying that this is necessarily even possible. The number one listing for “asthma” in Google is for Wikipedia, which will be impossible to displace. Many of the sites on the first page of results will also be hard to displace, but it might be possible. So, is it worth the investment?

I think there’s no question that many of the positions for these keywords can be improved. They all won’t make it to the number one result or even on the first page, but they can all improve. The closer to the first page the better. Here’s how to consider whether an investment in this might make sense. If you buy keywords, simply consider the cost to buy these clicks/visitors versus getting the same amount for free. I checked the costs and expected clicks for “asthma” specifically. Paying the maximum amount for this keyword in Google Adwords will likely cost ~$2.25 per click. Google estimates that you’ll get a maximum of 14,000 clicks per month. Cost…$31,500 a month…forever, or at least as long as you want this number of clicks. Here’s the ROI part…14,000 clicks is 0.009% of the total search volume for “asthma” per month (1,500,000). Instead of buying clicks, instead you invest to move your site up to just the 41st search results for “asthma” (top of the 5th page). This would result in 0.07% click through, which means 105,000 clicks per month. In other words, you can get almost 8x the number of clicks by getting your page up to the 41st search result versus paying for the clicks. Once you’re at this position, your ongoing cost is virtually zero assuming you continue to maintain your site. The yearly cost to buy the 14,000 clicks per month (which Google says is the maximum you can hope to get) is $378,000.

The question is: can you optimize your site by developing more content, improving your code to make it easier for search engines to index, and by deploying a solid linking strategy for less than $378,000. I’d really hope so. If you need help, contact me.

Sorry for all the math today, but I often get tired of hearing that digital programs can’t really show an ROI. So, all the people that say this forced the rest of us to sit through a math lesson. Thanks…

How to Make the Social Media Risk Worthwhile

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There’s no question, some risks just aren’t worth taking. Naturally, the reward should justify the risk. This is especially true in the land of pharma and healthcare marketing. The regulatory and legal folks at these companies really have a simple job at the end of the day: figure out if this promotion/concept/message/etc. is worth the risk. Yes, I recognize their jobs are, in fact, much more complex, but this  is what it comes down to. So, to be sure that the company can answer “yes” to this challenge, the regulatory and legal folks make changes, require new messages, increase fair balance, and sometimes outright deny permission to try something. Many times this is keeping marketers from getting the company into hot water (whether we really believe it is or not). Sometimes, however, we (adding myself in here as a former pharma marketer) don’t understand the reasons and think that some “rulings” just aren’t necessary. 

Unfortunately, this is the name of the game. In a highly regulated environment, this will always be the case. The question then becomes: can we make the risks justifiable? That is, can we create something so meaningful and where the benefits are so clear, that almost any risk is justified? I think the answer is “yes,” but only in certain cases. Now to further complicate things, I’m going to talk about a social media applications and not, say, a print ad. I can sense the regulatory people getting nervous already.

Josh Bernoff, Forrester Senior VP and co-author of Groundswell, developed a report that spoke precisely to this issue. He called it, with all seriousness: “How to create a social application for life sciences without getting fired.” Josh presented the main ideas found in the full report at the recent HealthCampBoston meeting. You can download his slides here. There’s a lot of good information in his presentation, but I latched onto one specific piece and this is what prompted this post.

Through his research, Josh discovered a couple things. First, no surprise, people with some diseases use social media more than others. This doesn’t come as a major surprise when you consider that certain diseases are more prevalent at certain ages. For example, those with osteoporosis tend to use social media among the least of any disease. This makes sense when you consider that most of these people are older and there are plenty of studies that show they use social media the least of any age group. Contrast this with people with depression or anxiety, which is more prevalent in younger populations who use social media more often. That’s part one.

The second part was a somewhat subjective judgement on which diseases would benefit the most from social media. That is, which people with which diseases would get the most out of connecting with others in a similar situation? Which are most open to talking about their condition and seeking help from others? Josh called this the “Social Benefit.” Consider people with erectile dysfunction versus those with cancer. There are support groups and thousands of online discussions for cancer, but nothing for erectile dysfunction. This was the second part. 

When you combine these two parts together, you end up with this:

forrester social pharma

You can quickly see where the most common diseases end up on the scale. You can also see where the most potential lies; the upper-right quadrant that Josh called “Misery Loves Company.” To relate this back to your regulatory team, if you’re focused on a condition in the upper-right, your argument is simple. There’s a great need for social media applications for these patients and it’s also likely that they’ll engage with something good if you create it. The risk is worth the potential rewards. On the other hand, if you’re working on a drug to treat a thyroid condition that likely won’t benefit patients in a meaningful way and the target patients aren’t likely to use it, why take the risk?

I’ll take Josh’s report one step further and cross-reference this with the Pharma and Healthcare Social Media Wiki that is housed on this blog. In Josh’s presentation, he includes a handful of examples (all of which were included on the Wiki) of social media programs that are already out there. I don’t claim to have every healthcare social media program in existence on the wiki, but there’s a pretty good number. If I’m missing something, let me know. So, based on my research, here are some observations:

  • Looking at the conditions in the upper-right quadrant, only two diseases have any sort of social media applications: obesity and depression/anxiety (and other mood disorders, which I’m including together with depression/anxiety). Of these, obesity is best represented with sites like Obesity Help and also, alli Circles. The entire category of psychology-related diseases covered by only one example, Psych Central.
  • Two of the diseases (diabetes and cancer) in the upper-left quadrant are very well represented on the Wiki. While high blood pressure and arthritis are not.
  • There are multiple sites for diseases in the lower-left, where there should be the lowest overall benefit and usage (i.e., the highest risk). These include programs for “gastrointestinal” such as the multiple programs for Crohn’s disease including Crohn’s and Me. 
  • A number of diseases not on Josh’s list have multiple sites including multiple sclerosis, which has four sites on the wiki.

What does all this mean? If you’re a healthcare marketer, you need to figure out where there are big gaps that you can help fill in and where you should steer clear of social media. I’ve broken the the diseases down to Yes, Maybe, and No. “Yes” meaning do a program now. There’s a big need and also limited competition. “No,” as always, means no. You should avoid these areas. The competition is either too high or you’re likely not to have anyone interested in your program. “Maybe,” means that either there’s a need and a bit of competition or that there’s less of a need, but no competition. You’ll have to figure out if it’s worth it. I included a little rationale with each “maybe.”

So, by disease state:

  • YES: Sleep disorders, chronic pain, migraines, skin disorders, any mood disorder, and/or depression/anxiety
  • NO: High blood pressure, erectile dysfunction, thyroid condition, congestive heart failure (CHF), bladder and urinary conditions, walking disability, osteoporosis, and gastrointestinal
  • MAYBE: Cancer, diabetes (both competitive, but a high need), asthma (limited need, higher social media usage), arthritis (no competition, limited social media usage).

One caveat…every brand is different. For example, if you’re brand is targeted to younger folks compared to the average drug in your class, then maybe you’d be more likely to try something in social media. Also, be sure to take a look at the competition out there. If there’s already a strong community or channel out there for your disease state, instead of competing for patients, can you instead find a partnership? Overall, for you marketers, I hope this gives you a little more rationale when you’re talking to your regulatory and legal folks about why a social media program is necessary. On the other hand, a lot of these regulatory people also read this blog, so they’ll be ready when you come to them and try to sell a program for your thyroid treatment.

Forget Communities, Create Channels Instead

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A few weeks back, I read a really simple, but (to me) really important blog post from Stephen Saber, CEO of CrossTech Group – the parent company of New Marketing Labs, CrossTech Media, and CrossTech Partners. (Like many of my best finds, I came across this on Twitter, so I’ll say it again, if you don’t have an account, get one now.)

The premise of Stephen’s post was simple: should marketers be creating communities or channels in the social media space? Stephen argued for channels and I completely agree. I also think that as far as pharma and healthcare marketing goes, this is the only way to go. So, what’s a community and what’s a channel? Here’s how Stephen defined them:

“Communities, in their truest sense, are made up of a large number of equally important individuals meeting each other, sharing ideas, and communicating with and amongst each other.  While a community might have a community manager and / or a community leader, all people are – for all intents and purposes – treated equal. 

Channels – on the other hand - still have many of the same aspects of community – the ability to communicate, comment, share ideas, and connect – but they are focused on a certain, designated group of content providers who formulate the thought leaders of the group.”

Okay, simple enough. Communities feature everyone having equal weight in what the community is about and what is said, like Twitter. Channels feature a handful of people with a disproportionate amount of weight, like editors and like every newspaper or news site.

Healthcare marketers have struggled to figure out how to effectively use social media without some of the regulatory worries that surely would come by having a completely open community. Some companies have tried (and even been successful) by providing a limited amount of social interaction among site visitors (check out the Pharma and Healthcare Social Media Wiki for examples). But many are still looking for a way to engage with people and create true communities. Many in the industry, including John Mack, have advocated for a public hearing and clear guidelines from the FDA on the proper use of social media (i.e., how to do it without getting in trouble). I’ve even advocated this on a number of occasions. 

But now I’m not so sure. Is it really important to have a completely wide open community where everyone can publish every thought they have on every the topic? Is that really meaningful to people? Do people really look at everyone as providing equal value? No, they don’t. A great example Stephen use is Twitter: “While most Twitter users are following hundreds of people, they are truly only following a select few people and paying much looser attention to the others.  In fact, for new Twitter users – the first questions are always the same – who should I follow – who is worth listening to.  They are readily admitting that while they will follow many, they will only listen to some.”

I know this is true for me. I really only pay attention to probably 30 of the 1500+ people I officially “follow.” I know that these people are providing information that is consistently valuable and provides a real benefit for me. Everything else fits in one of two categories: noise or nonsense. Noise is simply the massive volume of information out there that I simply (as a human with limited time) cannot process. Some of it may be good, but I can’t read everything. Nonsense is just that…the “crazies” that are part of every community and spend a lot of time shouting at the rain. So, to avoid these, I have to focus what I pay attention to. Twitter is officially a community, but for me, I use it like a channel.

I realized from reading Stephen’s post that I really only engage with channels. They are sites where one or a handful of people controls the content and discussion and everyone else can simply add their thoughts if they’d like. A big reason for this is because I know who the people are that are supplying the information. I know that they are credible, have excellent experience, and have things to say that make sense to me and I can relate to. You probably do this too. You read one newspaper (online or off). What are those? Channels. A community newspaper would be a disaster. Just read some of the community-supplied “news” you can find on Twitter regarding the swine flu. You read product reviews. These are community supplied, but you probably look for those where others have deemed the review useful (as they do on Amazon). You also probably read expert reviews first. That’s channel behavior. Even things that appear to be true communities usually aren’t. Take Wikipedia. Yes, anyone can edit Wikipedia, but in reality, what ends up actually staying edited is controlled by a really small group of people who closely monitor changes and are very picky about what gets changed (and rightly so).

I’m not saying that true communities don’t exist, but I am saying that most people don’t use even these as communities. They use them as channels (according to the definitions above). They ignore the vast majority of what’s said and gravitate towards a handful of people that they either relate to or they see as experts. The question becomes can healthcare marketers use this idea to do more social media that’s more closely controlled (and therefore less likely to violate FDA guidelines), but still valuable to visitors? The answer is yes.

Take this post I pulled from WebMD. Here’s someone telling another visitor to stop taking their statin medication:

WebMD Discussion

People don’t want medical advice from catspajamas. Who is catspajamas? I’m guessing he/she isn’t a doctor and probably doesn’t have any medical training. Do you think that the person who initially asked “Is my doctor going to the extreme?” actually taking catspajamas’ advice? I’d say almost certainly the answer is no. It may weigh into their consideration about whether or not to continue treatment, but it’s far from a deciding factor. On the other hand, if this response was from someone certified by WebMD as a physician (which they do), I’m certain that the person who asked this question would find the advice far more meaningful, valuable, and would likely follow it.

Consider the case of how new information gets out to people. Instead of letting anyone post any article or piece of  information that they think is important (like on sites like Digg or Mixx), would it be more valuable if the articles on, say, a diabetes-related site all came from registered dietitians and endocrinologists? Wouldn’t this be seen as more useful to people versus 25 articles submitted by catspajams on the benefits of shark cartilage?

So here’s my new advice on social media for pharma and healthcare marketers. Forget communities and instead make valuable channels. Here’s what you need to do:

  • You need to find neutral (key word) experts to lead the channel and discussion. As soon as it becomes clear that they aren’t neutral (i.e., bias towards you and selling your wares), you’re done. 
  • You need to create a space that doesn’t exist that people have  real need for. Maybe a site that only discusses hyperlipidemia. Not every cardiovascular condition, just hyperlipidemia. 
  • Allow for some discussion of the expert provided information, but manage it. It’s okay to moderate comments. Many, many (and more than you think) sites do this already. Just make it clear that this is the policy ahead of time. Don’t squash the debate, just make sure that it is controlled. That’s what you have the experts for. Catspajamas isn’t going to argue with the leading cardiologist in hyperlipidemia. If he/she does, no one’s really going to listen anyway. 
  • From time to time, you (or your neutral moderators) can promote members of the site to “expert” status. This shows that you’re really letting the discussion happen without your involvement. Promote those that are consistently providing fair, valuable, and interesting content. The content that people came to your channel for in the first place.

Perhaps in the future, you’ll aim towards even more community features, but wouldn’t it be great just to start with a really good channel instead?