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.

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.

Possibly related posts (auto-generated):

1. How Marketing with Meaning Can Save Pharma — Part 2
2. How Marketing with Meaning Can Save Pharma — Part 1
3. How Marketing with Meaning Can Save Pharma — Part 3

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?

Possibly related posts (auto-generated):

1. Healthcare and Pharma Social Media: It’s All About E.V.E.
2. Social Media: More Questions Than Answers?
3. Patients WILL Have the Final Say on Pharma Social Media

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.

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?

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.

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.

Possibly related posts (auto-generated):

1. How Marketing with Meaning Can Save Pharma — Part 2
2. How Marketing with Meaning Can Save Pharma — Part 1
3. Gaming To Save Healthcare Marketing

When you last left this blog, I outlined some of the big issues facing pharma marketing and provided a pretty striking example of how the lack of trust in pharma by many in the general public manifests itself. As a recap, I outlined three big problems that I think can be addressed by changing the way pharma companies market their products.

1. Horrible PR and public perception from  marketing tactics perceived as questionable
2. No public belief in the cost to value equation for pharma products (i.e., people don’t think they should cost so much, which means they think the products aren’t worth it)
3. Falling sales and profits

Sure, that doesn’t capture every issue, but whatever the issue, it likely fits somehow under catch-all issue number 3: falling sales and profits. My assertion was that a concept called Marketing with Meaning could improve all of these. For those who closely follow this blog, you’ll know that Marketing with Meaning is a concept developed by Bob Gilbreath, our Chief Marketing Strategist here at Bridge Worldwide. So, yes, I’m a little biased in thinking this is a really important concept that every industry and every company should understand and implement, but I’m also one of the biggest skeptics out there and if I didn’t think it was a fit for pharma, I wouldn’t be writing about it. Now…on with the show.

First, a little background for those not familiar with Marketing with Meaning. It’s pretty simple really. Marketing with Meaning is two things: marketing that people choose to engage with and marketing that itself improves people’s lives. It’s the opposite of interruptive, broadcast advertising. Simple enough, right? So, why is the first part important? Let’s look at some numbers, shall we?

• Do you like using TV ads as a marketing tactic? Well, IDC Research has shows that 2/3 of DVR owners skip commercials all or most of the time. For the most popular shows, Nielsen Media Research reports that 20% of ALL television viewers (not just those with DVRs) are skipping commercials.
• Remember telemarketers? Probably just a distant memory for you. That’s because 76% of Americans signed up more than 150 million phone numbers on the Do-Not-Call List within months. What’s the next list?
• How about Flash banner ads? Heck, our company makes them all the time for clients. Are these working? Well, 6 million Firefox users have installed AdBlock, which eliminates every one of these ads. (Even the Cannes Gold Cyber Lion winners like our “Can Hands” ad. Sorry, couldn’t resist.)

Not a pretty picture. You’ll notice that digital marketing isn’t immune. People are just as frustrated with digital marketing that isn’t meaningful as they are with any other channel. So, what do we do? Well, the good news is that some companies have already figured out what to do. And while they may not be calling it Marketing with Meaning (yet), that’s just what they’re doing. “So what,” you ask? Our research at Bridge Worldwide shows that “the more meaningful people find your marketing, the more they’ll be willing to pay for your stuff, the more of an investment they’ll make in it emotionally, and the more motivated they’ll become to spread the word.” (from “The Next Evolution of Marketing: Connect with Your Customers by Marketing with Meaning“)

Sound like what you’re trying to do with your marketing plan every year? More people buying your products. More people creating deeper emotional connections with your customers. And more people talking to others about your products. You’re probably spending millions right now to deliver some of these goals right now.

You probably want an example of Marketing with Meaning by now. First, let me tell you what it’s not. It’s not cause marketing and it’s not marketing that is somehow against conspicuous consumption. Meaning in this case means “personal value.” It’s what you find meaningful. That’s going to be different for different people. A cause like saving the rainforests might not be important to your average teenage boy, but a funny, viral video he can share with his friends might be. He’s also not interested in a program that improves high cholesterol, but his father might be. Because everyone’s a bit different, there isn’t a one-size fits all approach. Like anything, you’ve got to match you meaningful marketing program to the needs of your customers. But, there are also many ways that you can be meaningful.

Now for the examples…

Samsung could have put more billboards all around airports that no one would have noticed, but instead, they paid to install charging stations for travelers like me who can never seem to find an outlet. And, by the way, they get to show me, a very grateful traveler who is charging up a bunch of electronics (which eventually are going to need to be replaced), some of their latest gadgets.

When Adidas bought Reebok in 2005 and threatened Nike’s domination in athletic shoes, Nike didn’t react like they always have by doing a massive media blitz. Instead, the reconnected with their core audience, die-hard runners, and created Nike+. In case you don’t know, Nike+ is a chip that fits into your Nike running shoe and syncs with your iPod allowing you to track your runs and get a little verbal encouragement along the way. It all connects back to a website that features a giant community of runners that now numbers in the hundreds of thousands. 30% of Nike+ users come to Nike’s site three times a week. That is, they CHOOSE to come to Nike’s website…three times a week. Is anyone choosing to do that with your website? Oh, one other thing, Nike CEO Mark Parker credited an 8.1% rise in quarterly profits just 6 months after introducing it to Nike+. Remember, that’s in the face of millions spent on media by the Adidas/Reebok behemoth to capture Nike’s share. It didn’t come close to working.

More? No problem. I’ve got hundreds of these. How about one that fits under entertainment? Yes, entertainment can be meaningful to some people and it can come in many different forms. If you haven’t seen the charging stations or used Nike+, I know you’ve seen this next one. Instead of spending millions on TV and print advertising, in 2006, Dove took a different approach. It created “Evolution” (credit to sister agency Ogilvy Toronto). A “simple” video all to support a campaign that would later be called “The Campaign for Real Beauty.” This concept was borne out of research the agency did that showed that 50% of women say that their body “disgusts them.” 50%. “Disgusts them.” Clearly, there was an opportunity to change that. So, with little hype (and no mass media buying), “Evolution” was launched. If you haven’t seen it, watch it. If you have, it’s always worth watching again.

If that doesn’t stop you for a minute, I’m not sure what will. That video, thanks to a massive viral spread, has been seen more than 500 million times. How much would it cost you for 500 million impressions? How about 500 million impressions on people who WANTED to see your commercial? $500,000? $1,000,000? $3,000,000? Nope. Try $50,000. That’s how much “Evolution” cost to create. Sure, not everything is “Evolution,” but you probably don’t need 500 million views of your video. However, you probably want more than the few hundred or few thousand it has now. “Evolution” launched an entire campaign around improving women’s self-esteem. Meaningful, right? Effective too. The Dove brand, which was previously flat, grew by double digits during this campaign.

I’m not going to list every example here. We’d be on Part 9,381 of this post if I did. If you want more examples, then you’ll have to check out the Marketing with Meaning blog or, even better, you can download a chapter of the book, which describes a lot of these examples and many more. It’s a free trial (Hint: also can be a form of Marketing with Meaning). Download chapter two of the book here.

Well, maybe just one more example would help. Since I know my readers, I know that you’re all saying, “That’s all well and good for Dove or Nike, but we’re not selling shoes and soap. We’re making medicines here that save people’s lives and we’re pretty restricted in what we can do.” Both true. The products you sell prevent, treat, or cure diseases. What’s more meaningful than that? So, shouldn’t your marketing be just as meaningful? If you’re saving someone’s life with, say, a chemotherapy for breast cancer, does it somehow reduce the meaning of the product if you’re promoting it in a simple print ad? Doesn’t that cheapen what it does just a bit? I think it might. It almost certainly does in the eyes of your average consumer who sees almost all advertising as interruptive and irrelevant. And, yes, you’re in a regulated industry, but some pharma companies are already doing Marketing with Meaning.

Meet Aralast. Aralast, marketed by Baxter, is a treatment for alpha-1 antitrypsin (AAT) deficiency. It’s a pretty rare condition in which there are low levels or no levels of AAT in the blood. AAT is an enzyme that protects the lungs from neutrophil elastase (NE), another enzyme that is produced by white blood cells. Without AAT, the NE can attack healthy lung tissue. The result can be early emphysema and liver damage. Here comes the “good” news and bad news. Only 100,000 people in the US have this condition. So, it’s a good thing that it’s not more widespread. However, the bad news is that no one has ever heard of it, so no one knows (including your average primary care physician) to look for it. 95% of people that have the disease are undiagnosed. The result is late diagnosis oftentimes when there’s not much that can be done.

A critical marketing objective for Aralast is creating awareness of the disease and encouraging physicians to test for it. If we followed the traditional pharma approach, we’d consider a massive TV or print campaign to inform people that they might have the disease and to get tested. Sure, for most people that see the ads, it won’t apply, but perhaps it’ll reach those precious few where it could help. Of course, we’ll annoy and further distance everyone else, but that’s the price we pay, right? Maybe instead, Baxter should spend a fortune lobbying Congress and health insurance companies to make the tests mandatory. Again, more annoyed people than satisfied people.

What Baxter does is totally different. It gives away the tests (and the lab processing) to anyone who requests them. Concerned consumers can request the test and have their doctor administer the simple blood test and physicians can also request a supply for their offices. The test themselves are, of course, marketing the awareness AAT deficiency (just like our commercial would have tried to do). They’re also branded with the Aralast name. Marketing the product right on the test package?!? Isn’t that exploiting the importance of detecting the disease? Aren’t doctors turned off that the test has been commercialized? No and no. Why? Because the test is Marketing with Meaning. Once again, Marketing with Meaning is marketing that people choose to engage with and marketing that itself improves people’s lives. When it comes to these tests, check and check. Yes, people are choosing to engage with it. Doctors and patients alike are ASKING for the test either through the brand’s website or sales representatives. And, these tests are improving lives. Without access to the free test, many people wouldn’t have thought about getting checked and many others wouldn’t have received it because of pressures within our healthcare system to try to reduce unnecessary tests. (Thanks to Bob G for his post about Aralast, which I borrowed heavily from for this section)

The marketing of Aralast, which comes in the form of free tests for AAT deficiency, improves lives. The product itself clearly improves lives by saving people from early emphysema and liver damage. But the marketing does also. It increases awareness of the disease, it reduces the costs to our healthcare system, and it makes it easier for physicians to diagnosis a difficult to detect disease. It does all of this at the request of customers. People seek out Baxter’s marketing for Aralast (in the form of free test kits). Who’s seeking out your marketing?

So, if a modest-selling product like Aralast can do it, why can’t a top-selling drug like Lipitor do it?

In part three of this post (yes, there’s more), I’m going to tell you how Lipitor can do it. I’m also going to tell you how several other drugs from big sellers to niche products can do it too. Free Marketing with Meaning advice. Stay tuned for Part 3.

(Warning…here comes some commercialism, so if you’re easily offended by that sort of stuff, you should skip this. If you read on, you don’t get to complain later.)

Since you’ve made it this far, I do have to add one more thing. This is going to be a commercial, but I think it’s also Marketing with Meaning. One of the ways we spread the word about our agency, is via this blog. You won’t see an ad for Bridge Worldwide in your latest trade journal (though we did one once a couple years ago though) or at an exhibit booth at a convention. Instead, we invest in this, Dose of Digital (among other things). The Marketing with Meaning blog is, of course, another way we market our agency. We think the information we share in these blogs is valuable and is an example of Marketing with Meaning. You’re choosing to engage with it, right? And it improves people’s lives. Not in the way Aralast’s marketing improves lives, but it makes your job as a marketer easier (we hope). That’s improving lives. There are different degrees, to be sure, but you can always achieve even a modest improvement.

With that, I’d like to tell you about something we’re particularly proud of here at Bridge Worldwide. Last Friday was the official launch a book written by Bob Gilbreath, our company’s Chief Marketing Strategist (and my boss, so be nice). The book is called “The Next Evolution of Marketing: Connect with Your Customers by Marketing with Meaning.” While Bob was the author, we’re all really proud of the book and we have made it the cornerstone of what we do here at Bridge Worldwide. If you have read Bob’s blog or find what you’re reading here pretty intriguing, I encourage you to go get a copy of the book. Not only is it full of great examples, like the ones in this post, but unlike other business books, it tells you exactly how to bring Marketing with Meaning to your company. Step-by-step, internal and external.

Intrigued? How about a sneak preview? You can download chapter two of the book here. It’s a good place to start because it’s the first chapter that really sets up the concept of Marketing with Meaning and also gives some great examples.

One more offer…

Use Twitter? Then I have a request/offer. However, only do it if you’re buying into the Marketing with Meaning concept or read the chapter and liked it. I want you to tweet this only if you really think people should get book. It’s not supposed to be spam.

Okay, here’s the offer: I’ll send EVERYONE that tweets the following message an awesome Marketing with Meaning sticker (or 10…whatever…just share with your friends). There are going to be as cool as the Apple sticker someday, so get in on the ground floor. It’s not a massive token of appreciation, but if you’re a believer in the cause, you’ll want one.

Okay, here it is (please copy and tweet it EXACTLY like this or I won’t know you did it.):

Download a free chapter from the new book, “The Next Evolution of Marketing” Please RT http://bit.ly/twitter_bww

I’ll DM you and to get your mailing address after your tweet goes live.

Of course, if you’ve seen enough and are ready to buy some copies of the book, here’s the link to the book on Amazon. If you buy the book, I’ll send you stickers too. I could require you show me the receipt, but I’d rather it be on the honor system. Just use the contact page to let me know you bought a copy and where I can send the sticker (or stickers if you are going to share them with friends).

Okay, thanks for listening to my little commercial and for supporting the cause. Hopefully, you see how it’s Marketing with Meaning as well. If you’re interested in talking with others who are getting behind the cause, you can join the community. We’re just getting started.

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1. How Marketing with Meaning Can Save Pharma — Part 3
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There’s no question that pharma is in trouble. There seems to be a scandal a minute (whether real or created). Billion dollar fines seem to be the norm instead of billion dollar products. Sales growth has stalled for many and workforce cuts seem to come everyday.

That’s all pretty bad, but it doesn’t even capture the number one problem and it won’t come as a surprise to anyone: public opinion of pharma is terrible. Not just bad, terrible.

As a regular user of Twitter, I use Tweetdeck and one of my columns shows every tweet with the word “pharma” in it. Today, I noticed this tweet:

I thought it was maybe just one anti-pharma zealot. Then I saw it again. And again. And again. In fact, after searching, I realized there were hundreds of this exact same tweet (see for yourself). Hundreds of tweets all with the same message: a pharma conspiracy. Pharma conspiracy theories aren’t new, but this one stood out for me.

For those not familiar with the story, Natalie Morton was a 14 year-old in the UK who received a government-mandated injection of the cervical cancer vaccine and died hours after receiving it. In the UK, it’s mandatory for all teenage girls to receive the vaccination. For good reason too, it prevents a leading form of cancer, cervical cancer. A vaccine to prevent cancer. Imagine that. Back when Nixon declared a “War on Cancer” in 1971, how thrilled would be to know we had a vaccine to prevent one form of cancer? Instead today, it’s not seen that way at all. It’s just another pharma conspiracy to get more profits.

Back to Natalie’s sad story. Immediately after Natalie’s death, several news organizations jumped on the story. Here’s what Huffington Post ran. It appeared to every anti-pharma person that they’d finally been vindicated. Here was big pharma’s vaccine killing a perfectly healthy girl. Of course, none of them mentioned that 1.8 million girls had already received the vaccine without a single death similar to Natalie’s reported. Of course, the anti-pharma outrage should have stopped today, when an autopsy was performed and found that Natalie died from complications of an undiagnosed tumor. The medical examiner reported the following: “The heart was heavily infiltrated by a tumor which extended to the left lung. It was so severe death could have arisen at any time. The role of the immunization appeared to be minimal.”

End of story, right? Wrong. That’s when the tweets started. Rather than concede that the vaccination didn’t cause this girl’s death, she was used to infuse a little emotion into the anti-pharma zealots’ rhetoric. Yes, it’s really easy to fake a massive chest tumor during an autopsy.

Why is it like this?

Instead of praising pharma companies for potentially eliminating the approximately 11,000 incidences of cervical cancer each year and preventing about 4,000 deaths in the United States alone, “big pharma” gets beaten up. Why?

No doubt there are countless reasons, some of which the industry has brought upon itself with some questionable marketing tactics and scandals followed by massive government fines. But this isn’t the only reason. People are very passionate about the cost of the medications (but not very passionate about the costs of the other aspects of their helathcare). Since most people don’t know what an MRI costs and many don’t pay for a dime of the cost of one, they don’t get upset when their insurance company gets the bill. But when you pick up your prescription at CVS and have to shell out your cash, it’s a different story. That makes people mad.

Clearly, I’m not going to be the one to solve that problem. I’m not going to tell you I know how to completely fix all the PR issues pharma has. But I think we can make a dent.

So, let’s look at three major pharma problems:

1. Horrible PR and public perception from  marketing tactics perceived as questionable
2. No public belief in the cost to value equation for pharma products (i.e., people don’t think they should cost so much, which means they think the products aren’t worth it)
3. Falling sales and profits

Question: Can Marketing with Meaning improve all three of these?

Answer: Not overnight, but yes, it can.

Question: Does pharma really need this now with all of its other challenges to worry about like patent issues, healthcare reform, and increased government scrutiny?

Answer: Because of these challenges, there’s no better time.

Interested?

In part 2 of this post, I’ll tell you all about how Marketing with Meaning can do all this. In the meantime, you should read up on what Marketing with Meaning is all about. You can also register yourself for the upcoming E-Patient Connections conference where I’ll be presenting this concept (in 6 minutes and 40 seconds). If you do register, use promo code jr500 to get $500 off. Finally, a perk from this blog.

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1. How Marketing with Meaning Can Save Pharma — Part 3
2. How Marketing with Meaning Can Save Pharma — Part 2
3. Pharma Marketing with Meaning Pecha Kucha

As you look through nearly any brand website, you’ll see all sort of content related to the brand. Of course, there’s information about the product including all of the brand messages and, of course, in the case of healthcare, a bunch of fair balance. Most every site in every industry goes beyond this and offers some information about their category whether it be information about LCD versus plasma TVs or, in healthcare, information about the diseases their products treat. That’s all standard.

A few go beyond this, they offer something of a service in the form of an ongoing newsletter to share new content with their customers every so often. It’s a part of many company’s relationship marketing efforts, and these vary dramatically in their value to customers. Some may offer a coupon or special offers only available to members of the program. Of course, the vast majority of these are free to the subscribers. Pharma is no exception, as each of the top selling drugs offer some type of program (whether they’re working as well as they could or not is another story).

And, of course, some companies go even further and offer applications and services at no charge. Some of these are incredibly valuable and others are pretty questionable in their utility. Now it seems like everyone has a free iPhone app for their brand. This includes companies like USA Today, Nationwide, even Chipotle. Healthcare has dabbled in this area as well and have started to offer some iPhone applications. It’s not just iPhone apps either. Other on-site tools offer utility as well from disease trackers to product selectors and even games.

So, everyone is giving more than just brand information on their websites. It makes sense, right? When it comes to healthcare, you need to include information about the disease your product treats, right? You have to include things like diet suggestions, exercise tips, or even relaxation suggestions. Or do you? In many cases, we include this type of information because we think we have to. Our competitors do, so in order for our site to be as “good” as theirs, we do it also.

But think about it for a minute. The non-brand information we provide on our brand sites in healthcare is fairly generic in nature and available from a variety of sources. That is, you can get this type of information from a bunch of different sources; sources that consumers see as more objective than brand sites. Places like WebMD provide countless disease-related articles and tips related to healthcare. Even for specific disease information, third party sites almost always go far deeper than what you’ll find on any brand site. It’s what they do.

Despite this fact, healthcare companies continue to spend a lot of money to create content that can already be found elsewhere. Often, they create applications that don’t offer much value or have limited utility. I’m not picking on healthcare companies. This is common in every industry. We don’t use what’s out there already, we want to create our own version. We don’t link to other resources or syndicate content onto our sites. We want to make our own. But how many exercise tips do we need for people with hypertension?

It’s an ultra-competitive marketplace out there and companies believe they need to “capture” as many people as possible. They want them to stay on their sites and not go elsewhere. So, what better way to do this than try to put everything a person might need on your website? Okay, but here’s the problem with this. If you’re going to make an attempt, people now expect everything they see to be of outstanding quality. You have to remember that they aren’t comparing you to your category competitor anymore, they’re comparing you to everything else they’ve seen online. If your content isn’t of high quality with a lot of in depth information, people will be disappointed. If your application doesn’t work right or is boring, they’re going to be unhappy. Disappointed or unhappy people are not the kind of customers you want.

If you’re going to create your own content, whether it be articles or an application, it had better be good. It’s what people expect. They aren’t happy simply because you made an effort. They don’t need to get it from you, there are plenty other sources. And, that’s where they’ll go if you let them down.

So, the question you have to ask is simple. Is my content seen as valuable to my customers? If it’s not, you need to ask why you’re doing it? Of course, figuring out if your content is useful or not can be tough. It requires complete objectivity and that’s not easy for anyone. I’m going to make it easy for you.

When it comes to the best content and applications, we often pay for them. We pay for them happily because we get so much value from them. So, here’s your question, if you decided to charge for your content or applications, would anyone pay for them? It doesn’t need to be a lot, say, a dollar for your application. Okay, how about fifty-cents? Two bits? Anything? If your answer is no, then your content could possibly be doing more harm than good. People might find your content and get frustrated by its lack of details, limited utility, or because your application didn’t work right.

Here’s the good news, you don’t have to set up a complex payment system on your site. You don’t actually have to charge people for your content or applications. Just use it as a test to see if what you have is good enough.

Much of the content that was once something you paid for is now moving to free. Chris Anderson famously proposed this in his Wired magazine article, Free! Why $0.00 Is the Future of Business. But many of these free things, we would pay for if they suddenly required us to pay. A few examples: if Google suddenly decided to charge for Gmail, would you pay for it? I would. If Nike decided to charge for Nike+, would you pay for that? I would and I bet that I most people that use it would do the same.

“But,” you say, “we’re not Nike. We’re not Google. We’re talking healthcare. I don’t have to worry about these types of companies. I’m worried about my competitors.” Well, they are your competitors. Everything online is you competitor. Everything is competing for your customers’ time, so they’re you competitors. Here’s the thing to remember, people ARE paying for your content. They pay for it with their time, which is both very valuable and finite. When they waste their time, they waste their money.

Is you content wasting people’s money? If so, what are you going to do to improve it today?

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In case you missed it (and welcome back to Earth if you did), Apple is releasing yet another version of the iPhone: the 3GS. In today’s post, I’m not going to tell you why this upgrade is going to dramatically change the way pharma markets its products using digital. Because it won’t.

However, one other announcement from Apple came out at the same time  and went largely unnoticed. This little detail will change the way pharma markets its products in digital. While explaining all the cool features and enhanced speed of the new iPhone 3GS, Apple also told us that the current top of the line model, the 3G, will be reduced in price to $99. $99 dollars versus a current cost of $199 or $299 (depending on memory) is a big difference. $99 is one of the those magical buying points where something starts to look really affordable to people. In fact, in a recent study done by Neilsen prior to the announcement, they noted, “…the second most important factor-noted by 20% of respondents-as to why people did not pick the iPhone was its price.” It doesn’t take a lot of calculations to figure out that there’s going to be a huge increase in iPhone sales because of this decrease.

So, how does this affect you as a pharma marketer?

With more iPhones (and any other smartphone with a browser), more people can instantly get quality information no matter where they are. For you, this means in their doctor’s office, a pharmacy, a hospital. It essentially allows patients to immediately double-check their doctor’s recommendations. Picture someone who was just prescribed Lipitor walking out of their doctor’s office. Let’s say they have an iPhone. What’s the first thing they do when they leave that office? If it’s me, I check out Lipitor on my iPhone and see what it’s all about. This is going to become more and more the norm as these types of phones become the standard instead of just another high-tech gadget.

So, when your patient checks out your site on their iPhone, what do they see? Let’s consider our friend who was just prescribed Lipitor. If he checked out the Lipitor site at home. This is what he’d see:

Not a bad looking site. Front and center patient stories. Clear navigation. Good.

What about on the iPhone? The iPhone browser has one big limitation; it doesn’t recognize Flash. Flash, as you know, is what’s responsible for much of the animation you see on the Web today. Chances are that if you see something moving around on a webpage, it uses Flash. As far as the iPhone is concerned, Flash doesn’t exist. So, your very expensive to develop Flash piece (the patient stories) on the Lipitor site looks like this on the iPhone:

No more patient stories. Everything else still works, but you’re missing your big feature and there’s an ugly blank spot on your page that makes it look like it’s broken somehow.

Who else has the problem? I looked through the sites of some of the top-sellers out there and found a few more plus one that does it right (almost).

One that I found that goes on the “needs improvement” list is Actos. Here’s their website:

Here’s the iPhone version:

So long strange, talking, bacon-man (and the sound as well because he does talk in the Web version, but not on an iPhone).

One other site that I actually wrote about very positively in a recent post about addressing caregiver needs, looks great on a full browser, but not so much on the iPhone. It’s Exelon Patch.

Full Web version:

It includes the engaging visuals that really speak to someone caring for someone suffering from Alzheimer’s. However, when you look at it on the iPhone…

All the visuals are gone and you’ve got a page filled with tiny words.

So, is there a way to fix this? Absolutely. What’s more, it isn’t very difficult to do. Correcting the way your site displays content is critical so that users of smartphones (including the iPhone) can view it properly, but there’s one other even more important reason you need to ensure that you have an alternative to Flash on your site. It’s called Google. Perhaps you’ve heard of it. Turns out that Google doesn’t like Flash all that much either (at least Google’s spiders don’t). Google cannot read Flash. It basically doesn’t exist. This oversimplifies the issue a bit, as Google can see some elements of the “behind the scenes” parts of Flash, but for the most part it can’t. Here’s a good article explaining some of the details if you’re interested. So what if Google can’t see it? If it can’t see it, it can’t index it, which means it can’t consider it in the rankings for search. Bad news.

So, here’s the deal. You’re beautiful website…

…looks like this to a search spider:

Not pretty, but that’s okay. Google doesn’t rank on pretty. However, it’s not okay if all your important keywords aren’t showing up here. If they are buried in the Flash, Google doesn’t see them. In this case, much of the content of the Iams site is contained in Flash and isn’t seen by Google. Interested in seeing how your site looks to Google? Here’s a great tool.

It turns out that there’s a great compromise that is a really simple programming fix and one that you should be requiring your digital developers to do. Essentially, you create two versions of your website. Relax, it’s not twice the cost. All you are going to do is create second version using some programming techniques that ensures all of your content that was included in your Flash piece is visible to search spiders. You can direct which page is seen through a really simple programming technique that allows you to check either browser type or other parameters that ensure the right visitor sees the right page. So, you can show search spiders one thing and regular people another. You can also show an iPhone version to iPhone users. You don’t need to understand the technicalities of how to do this, but if you really want to, contact me and I’ll get you in touch with one of our developers (no charge of course).

Let’s just see what it looks like. Someone in pharma has done it ALMOST perfectly. This is the normal Web version of the Seroquel website (note that I cut the page off a bit):

There’s a big Flash piece right in the middle of the page that feature some patient stories. It’s nicely done and looks great, but as we now know, the iPhone (and Google) isn’t going to like it very much. But, AZ (makers of Seroquel) handled this the right way. Here’s the iPhone version:

What you see is that the site explains that it’s optimized for Flash and gives you directions on how to install Flash if you don’t already have it. You still lose the stories, but at least you don’t have a big blank area on the page that leaves people wondering why your site looks broken.

For those paying close attention, you noticed that I said they did this “ALMOST perfectly.” Here’s the problem with this approach. All of the great content that is in the Flash piece is gone. If you use the simulator like I did for the Iams site, none of the patient stories are seen by search spiders. The stories are even narrated and have some good content, but Google doesn’t know about it. However, it’s possible to take that content out of the Flash file and display it essentially in transcript form only for search spiders. You have the transcripts already (because your regulatory team demanded them), so adding this to your site isn’t a big deal. It won’t mess up the look of the site because you can program it so that only search spiders can see the text. It’s a simple fix, but one that is overlooked pretty regularly. With all the competition out there for important keywords in Google’s rankings, you need all the help you can get. Why leave out big chuncks of content when you don’t have to?

In addition, you could invest a little more and make a non-Flash version of the patients stories that is going to be viewable on an iPhone. That was the point of this post after…optimizing for an iPhone. So simply saying, “Sorry, you’re out of luck because you don’t have Flash,” how about offering an alternative using static images or some other technologies that mimic Flash, but without some of the issues?

The big takeaway…make sure that people who are using smartphones can see your website the way you want it seen. Do a little experiment and find out what your site looks like to iPhone users. If you’re not happy with it, contact your developers and figure out how to improve it. Don’t leave your site with a gaping hole in the middle of it. This doesn’t instill confidence among visitors. At the same time, make sure that you are truly optimizing for search. The two really go hand in hand. If you have an issue with how your site displays on the iPhone then you probably have an issue with how Google sees it too.

So, go out and wait on line for a new iPhone 3GS today (or just ask to borrow a friend’s if you’re not quite that gung-ho).

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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.

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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.

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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

Plavix

Advair

Enbrel

Nexium

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…

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