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ICANN Released New gTLDs – Now What?

On June 13th, ICANN (the Internet Corporation for Assigned Names and Numbers) approved a slew of new gTLDs (generic top level domains) that potentially create new web suffixes ( or, more technically, strings ) to supplement the existing stable which includes .com. .net, .org, .gov, .mil, .edu, .biz, .info and .int ( country specific gTLDs also exist ). The full list, which can be found here requires a $185,000 application fee, plus a yearly service fee of $25,000 paid directly to ICANN. Needless to say, that’s some serious
coin.

The requested gTLD strings included applications from some major pharma companies, with some applying for brand trademarks and program names. I may have missed a few combing through the list, but at last tally they included:

  • Abbot ( .abbot .abbvie )
  • BMS ( .bms )
  • Boehringer ( .boehringer )
  • Eli LIlly ( .lilly .cialis )
  • Johnson & Johnson ( .jnj .baby )
  • Merck ( .merck .emerck .merckMSD )
  • Pfizer ( .pfizer )
  • Sanofi ( .sanofi )

Also interesting to note that several of the bigger pharma companies opted to pass on securing a new gTLD string, including Roche, GSK, Novartis, AZ and Bayer. Pepsi, along with a few other mega-brands, have been very vocal about their decision to stay on the sidelines of the gTLD land rush, while Google and others have applied for multiple strings. So who’s going to come out ahead? Those who acquired the domains now, or those who waited? Given the expense involved and the lack of a road map to implementation, the answer isn’t a clear one.

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Pharma Marketing with Meaning Pecha Kucha

A few months ago, I innocently agreed to speak at the E-Patient Connections 2009 Conference. I say “innocently” because I didn’t know what I was getting into. It turns out that I somehow agreed to do a Pecha Kucha presentation. How hard could that be? Well, it was one of the most difficult presentations I’ve ever had to prepare. This is despite the fact that a Pecha Kucha presentation is only 6 minutes and 40 seconds. Minor detail though, you get only 20 slides and each slide is on screen for 20 seconds. After that, it advances automatically. No mercy. You don’t get to control it. If you want to see more about this format and see some great examples, check out the website dedicated to Pecha Kucha.

My topic was Marketing with Meaning as it applies to pharma, which I’ve talked about here before in a three part post ( 1, 2, 3). After much preparation, I felt I was finally ready. I was the last to go and, because it would have been too easy otherwise, there was a major glitch with my slides. Instead of seeing the slides I supplied them and checked the day before, I saw “slightly” edited slides that had all the titles cut off or otherwise misformatted. Sometimes this resulted in nonsensical statements and, at other times,  the results were quite amusing. Either way, I had to improv my way through not just this difficult format, but also the additional challenge of a little mystery every time a new slide appeared.

If you want a copy of the ACTUAL slides, as they were supposed to appear, you can download them here. You’ll see the titles and, therefore, slides make a lot more sense this way. This also includes my speaker notes as well..

Pharma Marketing with Meaning Pecha Kucha (974 downloads)


Without further adieu, here’s my presentation:

In the end, it worked out fine and I was told my presentation was even better because I had to fight through the slide format issue. Of course, I think I should be insulted by this because no one saw my presentation the “right” way so they couldn’t actually make this comparison. But, hey, I’ll take it.

You can dig through the Twitter hashtag feed for the conference to see everything discussed and you can find the feedback that I received as well (I’m afraid to look). The hashtag was #epatcon and I’m @jonmrich.

Here are a few photos from my talk as well. (Photo credit to E-Patient Connections/Kru Research)

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Here’s the presentation on SlideShare. Click through to see the notes for each slide.

How Pharma Overcomplicates Social Media

I just finished a few days at Digital Pharma this week and it was a great conference. One of the trailblazers in pharma social media, Shwen Gwee, was the chair for the conference and, as an advisor, I got to watch him push for the best of the best content and format. It worked. If you want a great recap of what happened, head off to Twitter and pour through the stream for the conference’s hashtag, #digpharm.

I had seen and heard a lot of what was discussed at this meeting before simply because I get to spend a lot of my time thinking about it. For others that have a different focus in their day-to-day jobs, I’m sure they took away even more than I did. For me, the best part of the conference was the informal, “unconference” discussion that took place for the last two hours of the final day and was lead by Brad Pendergraph from Novartis. There was no stage, no slides, no official speakers, just a bunch of people really interested in digital pharma marketing talking to each other. It’s perhaps not surprising that the conversation almost exclusively focused on social media, as it seems like THE thing to talk about right now (and has for a while). The upcoming FDA hearings on this topic naturally make it more relevant and top of mind (PS: I’ve been invited to speak at the hearing and can’t wait to get in my two cents).

The participants of this final discussion were a good mix of pharma employees and agency/consultant types like me. I mostly listened to the conversation and took a few notes. At some point, I heard one of those simple statements that suddenly helps it all make sense. The “ah-ha” moment.

With constant debate of can we?/can’t we? in pharma companies when it comes to social media, I’ve been saying for a long time that we’re making it too complicated. While there are a lot of objections and concerns within pharma companies when it comes to social media, the one I hear most often and that really bugs me is about the internal regulatory/legal process. There are a lot of other objections that come up, but this one seems to particularly bother me. Here’s what I’m talking about. Let’s say your company starts a corporate blog and (imagine this) allows people to comment. Sure, moderate the comments if you’d like. No problem, just let through the legitimate ones.

Now, here’s where I get frustrated. Let’s say one of the comments is something of a question…something like this: “Great point, but don’t you think that [insert whatever ending you want]?” Clearly, it’s something that the person would like an answer to. They want to engage with you and have a discussion. It’s a great opportunity, right? You know that, so you decide to respond…and that’s when the wheels come off.

Since you’re going to create a response to publish, you have to send it through your review process. It takes a solid two weeks to do that using your normal channels. Or, maybe you’re lucky, you have an expedited process for this type of thing and you can get something out in a couple of days. Of course, by this time, the commenter probably has forgotten all about you. You likely missed a chance to make a major, positive impression. But why? Why did your response have to go through your whole process? “Well,” you say, “you know the answer to that Jonathan. If we post something online, then it has to through our regulatory process. Same rules as if we created a printed piece. What’s wrong with you…have you forgotten everything you learned working at a pharma company?” Okay, so maybe you’d leave out the last part, but you’d say the first part pretty much exactly as I wrote it.

“But, why?” I ask again. I have actually struggled to come up with a simple response to why you could justify NOT putting something like this through your official review process, but hadn’t come up with something yet. As pharma expands its social media efforts, at some point, this becomes a major issue. Are you going to review every tweet, every Facebook status update, and every “Hi, welcome to our forum” comment? You must either really love those regulatory meetings or you really have way too much spare time. Clearly, this isn’t going to be practical. At some point, you have to trust that people will do the right thing and follow the rules without reviewing every single thing they say before they say it.

Crazy…I know. Or is it? As I said, I struggled for a way to simply explain why this isn’t pure madness. It came to me while in the discussion at the conference. My epiphany came courtesy of Brad, who I mentioned earlier. He had the perfect analogy. I’m going to paraphrase just a bit, but here’s the gist:

When someone calls your company’s call center with a question about your product, do your representatives answer the question or do they tell the person that you’ll get back with them in 2-3 weeks?

Not to be outdone, Steve Woodruff, added to this (again paraphrasing):

When your reps are talking to a doctor and the doctor asks a question about your drug, does the rep have to pre-clear a response and get back with the doctor 2-3 weeks later?

Think about both of those statements for a minute. Obviously, we don’t make our call center representatives or sales reps wait for our regulatory process to review their answers before responding to a customer’s question, so why would we have to do this to respond to a customer question on our company blog? Do we trust our sales reps more than the person responsible for our blog? Do call center people get a special set of rules?

I don’t know the answers. I really don’t. You might argue (especially if you’re a lawyer), that the blog response  is “on paper” and therefore, more discoverable while the two analogies are just conversations that aren’t recorded. I suppose it would be harder to “get in trouble” if they aren’t recorded. Of course, this doesn’t put too much faith in your representatives to follow the rules and, the last time I checked, we had these things called voice recorders. If someone really wanted to get you in trouble, they could. Does anyone know the answer to this? I’m not saying that you should let every Tom, Dick, and Harry at your company respond to blog comments, but shouldn’t someone be allowed to do this without having everything approved before they say it?

One final comment that was said around this discussion came from Xavier Petit from Shire. His point related to the fact that we simply can’t ignore that people want to talk to us, so, basically, we have to respond when they come to us. We can’t just ignore them. His analogy was something like this (again, paraphrasing because I can’t write fast enough):

When we realized that people were going to call us on the phone when we gave out our number, did we suddenly decide to cut all the phone lines?

Of course not, but isn’t that what we’re doing when we don’t respond when someone asks us something via a social media channel? We create places for people to comment, but when we realize that they’ll actually do it, we cut off the communication. Actually, it’s exactly the same thing.

So, why are you still here? Shouldn’t you be calling your IT group and telling them to turn off the Internet?

How Marketing with Meaning Can Save Pharma — Part 3

This is part three in the series, so you should probably read part one and two if you haven’t yet.

We’ve now established what the concept of Marketing with Meaning is and how it might relate to pharma. I gave the example of Baxter’s marketing for Aralast as a perfect demonstration of how it can work. I’ve also offered you a few  other examples from healthcare and other industries, which can be found on the Marketing with Meaning blog and in the free download of chapter two of the book.

Some people have told me that sometimes I oversimplify concepts like these. That is, they interpret my posts sounding as if I’m saying, “But, this is so simple…why in the world are you standing around doing nothing?!?” But having worked in pharma for many years, I realize, it’s never that simple. But I like challenges like that form my readers, so to show you that this is an important concept for pharma and one that they can and should embrace right now, I’m going to give you a three of examples of what Marketing with Meaning could look like for a few big pharma brands. I’ve somewhat randomly picked these brands, but if any of you skeptics think I “cherry-picked” these, just leave me a comment and let me know for which brand you want me give an example. (PS: I’ll take up that challenge for any brand in any industry, by the way)

Two disclaimers before I get into these. First, you’ll probably look at a few of these ideas and think that no one would want to engage with a pharma company in the ways I’m suggesting. You might be right. At least, you might be right today and I probably agree with you. But, if people won’t participate in my program because they don’t trust me, is the solution to never do a program ever again? No, the answer is to do the program and show that you are trustworthy. It won’t happen instantly, but if you do it consistently over time, then it will happen. These first programs might not have huge participation, but they’ll show the world that pharma can do it differently and in a way that they can trust and find very valuable. Second, I don’t have in depth knowledge of the marketing plans for these products. So, these ideas might be off equity and probably not in line with the brands’ marketing objectives. Not much I can do about that. The concept is what’s important, not the specific tactics. In addition, these ideas will certainly be controversial and difficult to get approved, but that’s sort of the point. We’re just going for a demonstration of the concept, not a comprehensive marketing plan. So, here goes:

Gardasil/Cervarix

I mentioned in part one of this series the controversy stirred up by anti-pharma people people regarding Natalie Morton’s unfortunate death. The anti-pharma people tried to blame it on the vaccination for HPV she had gotten hours before. It turns out that a massive undiagnosed tumor is what killed her. A sad story to be sure and one for which pharma companies got unfairly clobbered. I mentioned that a lack of trust of big pharma (no surprise to most of you) is one of the things that makes situations like this impossible for pharma to defend. It’s hard to listen to anyone telling you that all is well when you don’t trust them. That was the point of this Marketing with Meaning series. I think it’s the best way for pharma to get back that trust. As I said before, it won’t happen overnight, but it will happen if we’re consistent.

These vaccines are to prevent the spread of HPV, which causes most forms of cervical cancer. HPV, of course, is usually spread by sexual contact. As you probably know, we’re a little uptight about sex here in the United States. Discussing the need for the vaccine also requires discussing sexual activity. To some degree, this is related to the debate about whether you give teens free condoms. Does it encourage or condone them having sex or is it simply an acceptance of the reality that they will have sex, so you might as well help keep them from catching and spreading sexually-transmitted diseases? I’m not here to answer that debate.

Discussing sex with your kid is pretty tough for most people. It’s uncomfortable (for everyone). Parents might not be sure how far to go and what level of detail to provide. And they likely aren’t aware how much their kid already knows. When your kid senses this, it makes the conversation even worse, so many parents struggle with this parenting challenge. In many ways, this discussion is like talking to your kids about drinking, smoking, or drugs. These can be uncomfortable as well for parents. But, parents have gotten better at these over the years thanks to some really good campaigns from government agencies, non-profits, and even manufacturers. The free download of chapter two of the book from Marketing with Meaning has a great case study about the Partnership for a Drug Free America (PDFA) on page 42. They’re the people who brought you the “This is your brain on drugs” ads. But, they’ve left these behind to focus instead on educating parents about how to talk to their kids about drugs. Check out what they’re providing for parents on their site.

PDFA Parent Toolkit

While weighing the risks and benefits of the HPV vaccine is an important part of the decision process being able to have a frank and open discussion about sex with your kid is a key part as well. A parent might think they can put off the decision to have their child vaccinated for a few more years because they aren’t sexually active when, in fact, they are. So, here comes the Marketing with Meaning part: why not help facilitate this discussion? Do exactly what PDFA did to help parents talk to their kids about drugs, but make it about sex instead. Help parents with the difficult questions, with the details, and with knowing when you should have the talk. No one’s providing this really well on a national level and it’s a great chance for a pharma company to demonstrate some Marketing with Meaning. This isn’t selling vaccines or promoting a brand. That comes over time when parents trust you more. This is providing something meaningful to parents who are your most important customer for these vaccines. You’ll be able to talk about your product later when they’re actually listening.

Enbrel

For those who don’t know, Enbrel is a treatment for moderate or severe cases of rheumatoid arthritis (RA). It’s also one of the top ten selling drugs in the world. But what would happen if the incidence of rheumatoid arthritis started to decrease? What if someone was helping people slow the progression of or delay the onset of arthritis? Check out this campaign for Tylenol. You’ve probably all seen these billboards by now. What are they doing?

Tylenol Ad

These billboards appear to be showing you a way to avoid taking Tylenol. If there are fewer people with headaches, then doesn’t their demand (and then sales) go down? Of course, what Tylenol knows is that providing this advice helps people create a better connection with the brand. People view these and believe that Tylenol isn’t simply out to make a buck, they care about your health. When you’re about to pick up a pain medication in the store next time, who do you turn to? The company that you know cares about your health or some private label store brand? Of course, this doesn’t create an emotional connection with everyone, but over time it has an impact. These ads are Marketing with Meaning. Yes, they’re billboards that are somewhat inherently interuptive, but you choose whether or not to read the words. When you do, you realize that they give a tiny, but valuable piece of information that can help in the future.

So what does this all have to do with Enbrel? Let’s take the same approach as Tylenol and help prevent those with the earliest stages of RA from progressing into the more serious, latter stages. It’s just like a headache medicine helping you prevent headaches. How can Enbrel do this? Exercise is an important part of preventing the progression of arthritis. Of course, some of the most debilitating effects of RA happen on the hands. They become painful and lose flexibility over time. You can slow this with proper exercise, but how do you exercise your fingers? Well, WebMD has an entire section dedicated to this. Any other ways, just in case you find those boring? Hint: if you’re writing a comment about how there’s no way to do this, you’re doing it. Typing and moving a mouse can be a good way to get some exercise in both the hands and fingers. Not too much to the point that your hands get sore or lead to carpal tunnel syndrome or anything, but enough to get people moving their fingers around everyday. But how do you get people to type? With a game.

The onset of RA typically occurs in middle age and women are disproportionately affected. This group is also big players of “casual games.” Seriously. Here are some stats from two sources ( Pew and ESA):

  • Average game player age: 35
  • 26% are 50+
  • 36% of gamers 65+ say they play EVERYDAY or almost everyday (the highest of any age group)
  • 50% of gamers are women

These are simple, often Flash-based games that can played quickly and might have an interesting rewards system. It’s games like Bejewelled.

Bejeweled 2

You could create a game that requires you to use increasing amounts of finger dexterity (up to the level you can comfortably do) in order to get through puzzles or move onto the next level. Perhaps part of the play requires you to use one hand and quickly press a few different keys in order that are spread in different keyboard positions. The faster you do it, the more impact it has on the game. It doesn’t have to be complex (but it does have to inherently be a fun game and not just an exercise tool). You would make the game open to the public and it would just carry a small Enbrel logo in the corner. If you make the game good enough, you’ll help people prevent the progression of their RA, something they’ll be incredibly grateful for…something that will dramatically build their trust in you. And, if it’s good enough, the game will get played and spread around by people that don’t have RA, but it will also increase their trust in you as well. More trust with more people is just what pharma needs.

Lipitor/Crestor/or any other statin

I already gave you the Aralast example of providing free test kits for their drug. They have to because the disease is so rare that your average health insurance plan would see it as a waste because it would cost a fortune to find a handful of people with the disease. It would be a tremendous burden on the health system with little wide-scale benefits. So, Baxter takes that on as part of their marketing budget.

If we were in the UK right now, I could simply walk into the pharmacy and pick up a statin off the shelf. Statins are an over-the-counter (OTC) product there. There’s been debate about making certain statins OTC in the US and this debate will likely continue for some time. The arguments for allowing this is that more people will get treated. Presumably, this is because there’s far fewer barriers to getting an OTC product than a prescription one. There’s no trip to the doctor, no passing a slip of paper, and waiting for you pharmacist to fill the prescription…you just walk in and take what you need. The arguments against focus on concern about people managing their own heart disease; something, they say, should be monitored by a physician. I’m not here to declare who’s right and who’s wrong.

So, if the argument for allowing this focuses on giving more people access to these drugs by making it simpler to get treatment, can’t the prescription drug companies do this too? It’s a hassle to go to your doctor and get a blood test, wait for the results, maybe go back for a follow-up to discuss treatment, get a prescription…and on and on…you get the idea. Many people get their cholesterol counts during annual check ups, but not everyone gets one. So, why not eliminate some of the barriers? Take out the first few steps of the process by supplying at-home, cholesterol testing kits to those who ask for it. You already can get them without a prescription for about $15, so this isn’t completely crazy of an idea. Before you panic, let me tell you how it would work. Test kits can be made available through different media promotions, in-pharmacy displays, etc. The person gets the kit, takes the sample and mails it back. They can choose to have the results sent to themselves or to their doctor. You also allow them to request additional information about your company or your products, but you don’t keep their information. That is, you can’t keep the test results to use later on. Sorry, too much room for abuse there.

Here’s the simple math, which I admittedly haven’t done with absolute precision: is the cost of the tests (and processing) less than the incremental sales your product would get from people who would never have found out they had high cholesterol? If the answer is “yes,” then this is a simple decision. Let’s see…a test costs $12 to manufacture and process (I’m thinking bulk discount). Let’s assume that only one in four who take the test would actually be a candidate for statin treatment (based on this). That means you have to spend $48 ($12 x 4) to find one highly qualified and motivated patient (I classify them as such because they’ve had to do a lot to get to this point unlike, say, someone who just visited your website). Perhaps only one of the four actually goes to the doctor and gets a statin. That means, you have to spend $192 ($48 x 4) to get one motivated person a statin prescription. At around $130 per month, each person needs to take their treatment for an average of 6 weeks for you to break even. Of course, you won’t get every prescription, so apply your brand’s market share here as well. This doesn’t factor in the PR benefits and free media placement you should expect as well. Not sure if the math works (I think it’s actually conservative)? You could do this as a small, localized pilot to see what the rates of response are before going national.

Like Aralast, pharma gets to play the hero because they are reducing the costs within the healthcare system by absorbing some of the testing costs themselves. They are getting treatment to people who would go onto have severe heart disease without ever knowing it. But, you say, will people trust pharma to do this? As I said before, maybe they won’t at first, but enough people will. With those people as your proof, you show the world that you are doing this with good intentions and that there isn’t anything underhanded going on. It would be a slow process, but it would work over time.

There you have it. Three examples of Marketing with Meaning for three big pharma brands. These might not be ideal programs for these products, but consider them illustrative. Imagine what the people on these brand teams can come up with as they apply their intimate knowledge of the brand. I guarantee they’d be even better. These examples weren’t meant to say that these brands should do these programs, but more to demonstrate how it’s possible even for pharma to do meaningful marketing. Some already are, but if we can do it consistently throughout the industry, we can change public perception and get back to a place where people are glad pharma companies are around to provide them with life-saving or life-enhancing medications and not as something they need to protest against.