The article was just published today as an “In Focus” article, which they do twice a week. That means you can see my mugshot right on the homepage of iMedia Connection if you head over there right now. If you missed it, here’s what you missed…not too exciting, I know.

The article is entitled: “10 Sneaky Marketing Tactics You Need to Avoid.” Suffice it to say, if you work for a pharma or healthcare company and you’re doing any of these, you need to stop immediately. I think the industry is already lacking enough in the trust department that you don’t need anything else to cast you in a negative light. The 10 sneaky tactics include: AstroTurfing,lucky guesses, anonymous cleanup, image manipulation, trapping visitors, an inability to cancel, stealing credentials, bundling, pulling the switch and, crafty SEO. Clickthrough to the full article to see what all these mean and to ensure you’re not doing any of them: “10 Sneaky Marketing Tactics You Need to Avoid.”

<Play along and use your best infomercial voice to read this first paragraph.>

Do you find yourself frustrated that you can’t take action when you see something bad said about your product on Facebook? Do you find yourself secretly logging in at home to see what bloggers are saying about you? Do you fret that bad things are being said about your brand on WebMD, but you can’t go and check? Do you have a passing interest in Twitter, but don’t want to spend hours figuring out how it works? Well, then social media monitoring is NOT for you!

<Okay, you can stop the voice now.>

That’s right, for most pharma and healthcare marketers, you should just forget about social media monitoring. I know, I know. Didn’t I tell everyone that one of the principles of pharma and healthcare social media participation was “Monitor and Get Involved.” I did. I’ve had this in  presentations for a while, but now I’m wondering why. Why is it such a big deal to monitor social media?

I’m certainly not the first to suggest that monitoring is a good first step into social media. It’s included as the first step in so many lists, that I can’t include them all here. I know you’ve all heard it before in many different places, so it’s almost a rule. The first step to getting involved in social media is monitoring. Right?

Are you sure?

Of course, there are a lot of benefits to monitoring and the rationale for doing this as a first step appears pretty sound. While you’re trying to figure out how best to leverage a certain social media channel, say, Twitter, why not start just by seeing what others are saying? You can use this information to get a sense for how your brand is perceived in the market and what people are saying. Is it all good? Are they consistent? Are they actually saying anything or do they not care? Is there one thing that you didn’t know? Does it even really pertain to your brand or is incredibly general (e.g., just took my Lipitor)? You might find some informative information and you’ll get a little sense for what people say about you when they aren’t in a focus group saying what they think you want to hear. Great. At the same time, while your monitoring, you can also learn a bit of the etiquette of the channel. Using Twitter as an example, you’ll see how the @ works and what the # is and how to use it (and how not to).

There you go…two reasons to monitor just like that. So, why would I tell you to forget about monitoring? It’s simple really.

Since we’re talking about pharma and healthcare here, I thought I’d use this healthcare analogy. Doctors and other healthcare professionals have a pretty simple rule when it comes to ordering tests: do the test only if the results are capable of telling me to change my treatment decision. That is, if I’m thinking I should do surgery and I have one more test I could do, would the results of the test, no matter what they were, convince me not to do surgery? If the answer to that question is “no,” then why do the test? You already have done tests and some sort of examination that said surgery was the right choice, so why do another test if it’s not going to change your recommendation?

Social media monitoring in pharma is just like this last test. Is monitoring, namely what you find out, going to change what you do? Is it going to change your marketing approach? Is it going to spring you into action? Are you going to actively respond? The answer is probably “no.” So why subject your patient, I mean you, to an unnecessary (and potentially invasive) test?

“But wait,” you say, “we are going to do something different. This will give us some insights into our products and  it’ll give us a great marketing idea.” Really? Here’s how this could go wrong: you could actually do this this. Change your marketing plan based on something you see via your monitoring efforts. Let’s say for a moment that you notice time and time again that people are something as clear cut as, “I know they say that Drug X works really well, but I was shocked how inexpensive it was.” (I know, a stretch, but stay with me.) You notice this a few times in a few places. At what point do you see it enough to change your marketing message? At what point do you focus on the cost a bit more in your communications? 10 tweets? 100? 1,000? Maybe 50 Facebook updates? 15 blog posts? At what point do you know it’s something real and not some sort of anomaly?

You can’t. At least, you can’t by yourself. In order to actually use monitoring to inform you about marketing decisions such as brand messaging, you need something much more robust than you doing a Twitter search and making a few notes. It’s a big commitment. Still think you can do it alone? Great. Here’s what you need to collect:

• number of brand mentions and the content of each (make sure to include links from the mentions)
• the tone and sentiment of EVERY mention (positive, negative, or neutral)
• context of the mention (you’ve got to filter out everything irrelevant like spam mentions)

Okay, that’s a good start. There are a few more, but let’s go with that. There’s still more to do. Do you like Excel? You’d better. Love statistics? You’ll learn to. Because now you’ve got to take all the information you gathered and start to look for patterns, trends over time, and where changes occurred. You then need to correlate this with market events and your brand communications. I’d use about a year’s worth of data to get started. Go ahead…I’ll wait.

If you chose to actually do this by yourself and now are coming back to read the rest of this post, it’s probably October 2010. Most of what you figured out is probably outdated. Sorry about that.

My point with all of this is to say that without a formal plan of what you’ll do with your monitoring efforts, it might just be a waste of time. There are a lot of companies out there that would be happy to help you with this. Some of these tools are free and some are very expensive. This is definitely a category where you get what you pay for. Most expensive isn’t necessarily best, but expect to pay big to do a robust analysis that is going to give you solutions and not just more mountains of data. You do have a budget for this, right?

One other reason why monitoring might not be for you…you’re not allowed. Your company may restrict the sites you can access at work and chances are these include some (if not all) social media sites. Why? I’m not sure, but two possible  reasons. First, they think that you’re going to waste your time all day playing with Facebook. They do this despite the fact that at least one study has shown an INCREASE in productivity when these sites aren’t blocked. Second, they don’t want to know. If you go out and look what other people are saying about your brand and uncover someone talking about an adverse event, you’ve got to report it to the FDA. If it’s not reported directly to you, then you’re not responsible for reporting it. That is, if someone posts an adverse event on WebMD, then you don’t have to regularly go through WebMD and report all of these. But if you see it, then that counts the same as if it were reported directly to you. I’m not implying that pharma companies are trying to sweep this information under the rug, but there’s a reason why more pharma companies aren’t using social media. Dealing with all these reports could be a major pain. For those adverse event mentions that don’t have all the criteria required for submission, you’ve got to try to find the other criteria. When you do have all the criteria, you’ve got to catalog, eliminate duplicates, prepare a submission, send it to the FDA, and prepare to answer their follow up questions (if they have any). There are processes already in place at companies to do this, but they’re not capable of handling this on a giant scale.

If your company doesn’t want you monitoring, then that’s a good indication that you shouldn’t. I’ve heard that a lot of pharma marketers simply log onto these sites at home where they have access to take a look. Of course, as an agent of the company, whether at home or not, they still have to report what they find. How much they’ll actually find is a matter of debate, but you’d should be prepared. Most adverse event mentions won’t have all four criteria (actually only 1 in 500 will), but each company has a different policy about whether they try to find the other two by attempting to contact the person who reported it or if they just gather it all and try to submit it as is. Either way, before you jump in, make sure you’re ready to handle what’s out there.

Just so you don’t feel alone, few companies actually permit social media monitoring according to a poll Len Starnes put together. The poll found that 29% of respondents said there was no internal policy. 7% said monitoring was strictly prohibited no matter what. The rest were shades of “yes” including “yes, but.” See the entire poll here.

The final reason why you shouldn’t monitor is because you might do more harm than good. You start a company Twitter account with the idea that you’re just going to see what people are saying, but you figured you may as well have an account too. Great. Now what happens when someone contacts you? They send you a DM or an @ and want an answer. Do you answer them? Are you allowed? What if you’re on WebMD looking through the forums and see a post that says something like: “If someone doesn’t tell me a way to get this drug for less, I can’t refill my prescription next month.” Now, you know from looking at the rest of the post that this person would be an ideal candidate for your assistance program and would probably get their drug for free. Do you say something? What if you do it anonymously?

If these are hard questions to answer, then you shouldn’t even be looking. When people discover that you’re online and available (and they will), they’re going to come to you looking for answers. If you ignore them, then you’ll do more harm than good, as people will only be annoyed with you.

Okay, so have I talked you out of monitoring yet? No? You’re still going forward. <Gulp> In that case, let’s set a few ground rules. You’ll have to agree to each of these in order to be allowed to monitor social media (on the honor system):

• I will develop a plan of what to do with what I find BEFORE I monitor.
• I won’t make any marketing decisions based on my own “analysis.” I’ll find an outside partner who will do this for me.
• I’ll figure out if my company has a social media participation policy. If so, I’ll follow it, so I don’t get fired and blame this blog. If not, I’ll see if we have any rules about adverse events I may uncover and I’ll help fight to get some formal rules set up.
• When I do participate, I’ll actually participate. I won’t just be a “lurker” on the sidelines, ignoring everyone that wants to talk with me.

Agree? Okay, good. Now go forth and monitor. Try the two below to get started…and be careful. There’s a lot you’ll find out there that will surprise, bewilder, delight, confuse, frustrate, and annoy you. That’s normal. No need for me to order another test. You’re just monitoring social media.

This one is called: “Emerging Media in Healthcare and Pharma.”

Here’s a brief summary:

“There are a significant number of emerging media areas that will affect healthcare and pharmaceutical marketing campaigns in the future. Some will have an enormous positive impact on current marketing practices, while others will have devastating negative consequences on these same practices. The good news is that there are alternatives to the way many current campaigns are conducted that leverage the best in consumer understanding, interactive technologies, and solid marketing strategy (all while staying within DDMAC rules).”

I identified eight emerging media trends that about which I think every healthcare and pharma marketer should be aware:

• Medical Social Networking: Beyond Facebook and MySpace, patients are now connecting with one another online and taking each other’s advice, sometimes over their physician’s advice.
• Live and (Almost) in Person: YouTube is fine for delivering content, but it is instantly outdated. Consumers want to use video to interact with a real person to get the freshest information all from the comfort of their homes. This includes their doctors.
• Secure Communications: People will begin to trust more of their confidential information online, but will expect that it be protected through constantly secure channels.
• Micro-targeting: Targeting consumers has evolved dramatically in the past 10 years to the point where it is possible to find and communicate with a small group of brand supporters in a highly cost effective manner.
• Instant, Dynamic Content: Online content must now immediately change based on user inputs. Providing the same content for everyone regardless of what they do on your site is a losing proposition.
• Mobile Grows Up: Typically seen as a marketing platform that could only reach teenagers, older users are beginning to adopt some of the same habits as younger consumers, opening up a range of new promotional options.
• Managing and Leading Word of Mouth: Tracking down everything that someone says about your brand was impossible without Internet-based technologies. Now brands are expected to track, and where appropriate, join in the conversations that people are having about them.
• Print Goes Interactive: Print isn’t dead, but it needs to leverage interactive technologies to stay relevant and match consumer behaviors.

If you want more information on each of these trends, then you can download my full white paper on this topic: Emerging Media in Healthcare and Pharma  (1687 downloads)

As an added bonus, I want to share a copy of an article I had published in Pharmaceutical Executive last year called “Exercising Your Brand.” This paper outlines these rules healthcare marketers must follow to help ensure a successful digital program. I’ll share the link with you via DM on Twitter if you send this tweet about today’s post (PS: make sure you’re following me, so I can DM you). Deal?

If you want to be informed of any new white papers I publish, just fill out the form below. Your information will only be used for this purpose and will never be shared under any circumstance.

Note: Stay tuned for an updated version of this paper in the coming months. Emerging media changes quickly, so it’s difficult to stay current no matter how often you’re updating.

I just couldn’t resist this post title after the response I had to my post (both positive and negative) called: What Pharma Can Learn from Pringles. Without going into too much detail, the takeaway message was supposed to be simple. Pharma and healthcare can learn a lot about the approaches other industries take in their marketing. Yes, pharma in particular is heavily regulated and limited in what they can do or say, but too often the best practices of other industries are ignored instead of us figuring out how to apply what worked well elsewhere to what we’re doing in pharma. It’s a big missed opportunity that I’ve been working on fixing for a long time.

So, in keeping with this theme, I wanted to share a concept that we call “The Selfish Consumer.” It was created by our Chief Technology Officer, Michael Wilson, here at Bridge Worldwide. Here’s the basic idea:

“TiVo, iPod, and blogging have something more in common than the right technology at the right time. They provide the same old media in new and interesting ways. This not only changes consumer behavior, but forever shifts consumer attitude. Greedy for content and equipped with almost magical abilities to control media delivery, we have armed a very intelligent consumer.”

View Michael’s presentation on “The Selfish Consumer” here:

We’re not saying that your consumers are “selfish” in a bad way, but that digital technologies simply make it easy for them to be when it comes to digital content. As marketers, we need to accept this as the new reality. But what does it mean for us? There are actually three implications, which are all closely related:

• Quality: We need to ensure that we’re creating great content and giving access to it in ways “The Selfish Consumer” demands
• Competition: Everything online is potentially a competitor when we understand that we’re all competing for the same consumers’ time and attention
• Expectation: What “The Selfish Consumer” gets from one industry when it comes to digital, he expects from every other

I’ve done a couple of presentations and blog posts about the first two: quality and competition. The most recent was my presentation “If You Build It, They Will Come…Or Will They?“, which addresses “Competition,” you can find on SlideShare. So, today, I’m going to address “Expectation.”

“Expectation” is a pretty simple concept. If a customer is used to getting a certain service from one company, he expects it from all that company’s competitors. This is why new innovations and special offers get duplicated so quickly and so readily. This happens within industries and it’s very common. However, it’s rare that a special offer from one industry gets carried over to another. Just because Subway is offering buy one, get one free sandwiches doesn’t mean the Hilton down the street is offering buy one, get one free rooms. When it comes to digital technologies, it’s a whole different story.

If one industry offers a certain digital technology, then “The Selfish Consumer” expects every industry to offer it. This concept (and example) was first explained to me by my colleague Bob Gilbreath, Chief Marketing Strategist here at Bridge Worldwide. What Bob pointed out is that if people now can track their package online thanks to FedEx and UPS, they expect this same thing in other industries including those industries that have nothing to do with packages. So, here’s what “The Selfish Consumer” says: “If I can track my package online, then I should be able to track my pizza online too.” And, thanks to Domino’s, now you can.

Yikes. If you’re bringing something to “The Selfish Consumer,” there had better be a way for them to track it. That’s now the standard…the expectation. What does this all mean for pharma? It means that pharma needs to look at what digital technologies and tools its consumers are getting from other industries. Once you know what they are, take a look and see which might translate well to pharma. Need a hand?

If I can track my exercise progress thanks to my shoe company, I should be able to do the same with my healthcare company. Of course, you can. There are quite a few trackers out there, so this is a perfect example of one industry’s lead moving over to pharma. No, Nike+ didn’t create the first health tracker, but neither did a pharma company (bonus points for anyone who knows who did). Nike+ is a health tracker in the end, so that’s not a big leap. But what’s next? Here are a few common digital tools and technologies that consumers get from other industries and might start demanding from pharma:

• Product reviews — I’ve already talked about product reviews a lot (with more to come later this week). Consumers get them everywhere online now and use them to make purchase decisions on everything from very low to very high involvement items.
• Online customer service –I wrote about this a while back in a post called “Providing Meaningful Customer Service in Healthcare.” According to a recent Manhattan Research study, “More than three-quarters of ePharma Consumers report that they “expect” online customer service from a pharmaceutical company.” EPharma Consumers are “those who use the Internet to research prescription drug information. In past five years alone this group has tripled to about 95 million U.S. adults.” Why? Because they get online customer service from every company they interact with online from shoes to books to vacations. Everything you can buy or think about buying has some form of online customer service. Why not pharma?
• Privacy — Nothing is more private than someone’s health. Yet, we pharma marketers ask people to tell us an awful lot about themselves before we give them something of value. More and more other marketers are moving away from this and allowing people to register with limited or no information. They use technologies like OpenID, so that visitors don’t have to register (and give out more personal information) for yet another site in order to get access to a website. That means you don’t even have to share an email address to get access. Most marketers are also very careful with the information they capture online. For instance, if you’re not going to use someone’s home mailing address for a certain promotion, then you really shouldn’t be asking for it for two reasons. Number one, asking for less increases the chance that someone will complete the enrollment process. And number two, it’s none of your business. Yes, you might say that you’re going to use it later for something different. Well, that person didn’t register for “something different,” they registered for one particular thing. They gave you their information only for that purpose (PS: using fancy opt in choices with pre-checked boxes or double-negative language doesn’t really entitle you to use information later).
• Aggregation and deferment – Two related ideas here. First, there are many sites out there that simply pull together all the content related to a specific topic and put it one place for you to review at your leisure. They are called aggregators (see: Netvibes or Pageflakes for an example). Pharma companies might just find that using aggregators is the simplest way to create a disease awareness portal that works the way “The Selfish Consumer” expects. The folks at S&R Communications Group just had a great post on this very topic. Today’s consumers can set up an iGoogle page with everything they want, why not every new piece of information about their disease on one page? Aggregators would pull content from the best sources, the leading experts, bringing together the best of the best information instead of relying on a single source (i.e., you).  Deferment is related to aggregation because it too involves turning to outside experts in the areas where you are not the expert. In the case of a pharma company, you might be the expert in high cholesterol since you make one (or more) products to treat this condition. A key part of the treatment for high cholesterol is diet and exercise management. However, a pharma company is not an expert in diet or exercise. There are plenty of people who are though and whose names and experience are far more credible than yours in this area. For example, perhaps you turn to the people from Weight Watchers for the diet portion of your content. They are recognized as experts in this area. This works for two reasons. First, it frees you up to focus on what you know best: high cholesterol. Second, it also tells your consumers that you have their best interest in mind. You’re not trying to do everything yourself, you know when someone might know more than you. You are essentially providing your consumers with referrals to other experts. This is the “Enlist” part of my four tenets for best in class digital strategy in healthcare.

While it may seem really challenging and a ton of extra work to connect with today’s “Selfish Consumer,” it’s worth the effort. First, and most basic, this is what your customers are demanding. If you remotely subscribe to the notion that “the customer is always right,” then you should get on board with this as well. Second, the most “selfish” of consumers aren’t selfish at all. In fact, they share…a lot. They share things they like and things they don’t. So, if you do your job with them, they’ll help spread the word for you about your product and company. If you don’t do your job, then they’ll still spread the word, but you won’t like what they have to say.

UPDATE April 6 (original post follows):

Seems like the times have changed already. In the week after I wrote this, the FDA has cracked down on paid search ads. On Friday, April 3, the FDA sent letters to 14 companies specifically about misleading search marketing ads. As you saw in this post, no one was really quite sure how to interpret FDA rules for search, but they made it pretty clear in these letters. If you have have the drug name and an indication, you’d better have fair balance. Same as every other promotional medium. The story of these letters broke on April 3 and included a few examples. One such ad was for Biogen drug Tysabri. The quote from the article:

“Biogen received a warning letter for its multiple-sclerosis drug Tysabri. The ads say ‘A Multiple Sclerosis Treatment That’s Different from the Others’ or ‘Satisfied with your MS Medication or Looking for Something Different?’ but don’t include any risk information.

“Their casual approach to Tysabri treatment is extraordinary in light of the potentially lethal risks of the drug and the stringent controls over its distribution,” the FDA said in its letter to Biogen on March 26. The letter was posted on the agency’s Web site Friday.”

The most critical part of all these letters for pharma companies is as follows: “Biogen’s ad includes a link to the Web site for the drug, which does contain the relevant risk information. The FDA said the link ’does not mitigate the misleading omission of risk information from these promotional materials [bold added].’ “ That is, the one-click rule is dead. Just because you have the risk information on the page your ad links to doesn’t mean you don’t have include fair balance. So, for all the complaining I do about the FDA not being clear on digital promotion guidelines, this seems pretty clear to me. Check out my original post, which contains some more things for pharma marketers to consider when placing paid search ads.

Original Post

I’ve been meaning to write this post for a while and haven’t gotten around to it. Someone at work today reminded me of it when they asked me a very simple question (or so it would seem) about FDA rules regarding paid search marketing. (For the sake of today’s post, I’m referring to search engine paid search such as Google AdWords.) The question was this: “Since you have to include fair balance when you show the drug’s name and what it is used for, how come there are all these paid search ads that do both with no fair balance?” Here’s an example of one of these:

There you see a paid ad (in the tan box) from Femara along with “Breast Cancer.” Femara is indicated for breast cancer, so by including the name of the drug and what it is used for without fair balance they are in violation. Right? Wrong?

The answer is I have no idea and neither does anyone else for sure. The FDA has never formally issued guidance here (a pet peeve that I’ve blogged about before). The rule that many companies seem to use is the “one click rule” (good review here from Catalyst). Many companies use this rule almost like it’s a formal FDA policy, but it isn’t. Basically, the rule is that if the fair balance information is one click away from the ad, then you’re okay. Or are you?

At the end of last year, Diovan received a warning letter for a banner they used that contained no fair balance (hat tip to John Mack’s post about this issue). They were applying the one click rule. The FDA didn’t care. Two things to consider though: this was a banner and not just a simple text ad like AdWords and Diovan has a black box warning meaning it’s got a whole set of special promotional rules to follow. So, you can’t really say this is the end of the story. Fact is that thousands of pharma ads are served up on Google each day that, by letter of the law, are in violation. The FDA has to know this and lets it go, so there has to be some informal nod of approval there…maybe.

Enough of that. In this post, I want to do two things. One, convince you of the value of paid search and two, show you some examples of what to do and what not to do. 

One: Why You Should Care About Paid Search

I’m going to use Google AdWords throughout this post, but know that the same rules apply to Yahoo! or MSN or any other network that wants to serve your text ads. If you have no idea what AdWords is, you can start with this primer from Google.  Very few pharma marketers I know really understand paid search and why it’s important. Typically, the buying and planning for paid search is relegated to the “e” team or is completely outsourced to a media buying agency. While this may be fine, you still need a working knowledge of what’s going on. Here are a couple of bullet points on why you should care about search as a channel for marketing:

Big numbers, right? Here’s why search marketing is so important and why it works: Many people go online with a problem. Problems need solutions. This is what Google’s results, both paid and organic, are supposed to be. Solutions. If you search for “hotel in San Juan,” we can reasonably assume your “problem” is that you need to find a hotel in San Juan. The solutions might be organic results of some major hotels in the area and the paid results that might include something as simple as “Cheap hotels in San Juan.” Consumers are looking for Google to provide a solution and Google is letting you help them provide it (at a cost, of course).

Clearly this is how patients use the Internet. They have a problem (e.g., a condition they are managing) and they want solutions. These solutions can come in many forms and you need to be sure that you’re part of the list. Here’s an analogy for you: paid search similar to someone who goes to a grocery store looking for diapers. They already know their problem (out of diapers…a major problem), but they may not know their solution. This person gets to the shelf (Google’s search results page) and then picks out a solution (a specific brand of diapers). If your brand is not appearing in paid or organic search results on the first page, then you’re not “on the shelf.” It’s hard to be selected when you aren’t on the shelf.

Okay, so by now you’re convinced. Paid search is good. One more thing to consider, it’s highly cost effective. With AdWords, you only pay when someone clicks on your ad. So, you’re only getting people that found some appeal with your ad. They’re interested in your solution. So, you’re not wasting money paying to display ads for people who don’t care about your solution. You pay when they click. That’s good news and bad. You pay when they click. Each time someone clicks, money comes out of your budget. The question then is “did you get your money’s worth”? Here’s how you can ensure that you do.

Two: What To Do and What Not To Do

I’m going to be as diplomatic as I can here in providing some constructive criticism. When I show an example, know that this is just one of probably hundreds that are making this same error, so if you’re site or campaign is here, know that you’re in good company. Paid search is still a new skill for many pharma marketers, so mistakes are going to be made. Let’s just figure out some ways to ensure that they don’t keep happening. I’ve broken the areas you should focus on into three sections.

“Fulfil the Promise”

This means that when you promise something in your ad, make sure you deliver it. If you don’t, the patient will simply leave immediately and you wasted your money at best. At worst, you can create someone who has a very poor perception of your brand…not something any pharma brand needs. Here are the first paid and organic search results for “breast cancer” again. You should know that each time someone clicks on a paid search ad for “breast cancer” it’s going to cost between $1 and $7. It all depends on what the competition is bidding at that time. $7 a click is quite a bit to have people leave as soon as they arrive.

So, does Femara fulfil the promise? They say they are going to allow you to “Review Treatments.” When you click on the ad, you get to this page. See it for yourself here and below.

It’s the Femara homepage and, right away, I don’t see anything about reviewing treatments. There is a link to “Treatment Options” on the left, but why didn’t I get automatically sent to that page? Rule one: if you promise something then deliver it. Part of this is ensuring that you don’t direct every paid search ad to your homepage. Direct them to the page that matches the information you promised in your ad. 

To give Femara the benefit of the doubt, I checked this “Treatment Options” link to see if this allows us to “Review Treatments.” For one section, adjuvant therapy (one place where Femara is indicated), here’s what was included:

Not exactly “Treatment Options” when your treatment is the only one listed and far from letting me “Review Treatments” as the ad indicated.

Patients Like Me, normally one of my favorites, is guilty of the same rule violation. They have two versions of basically the same ad for the search term “fibromyalgia” (Google lets you experiment which works best, which I highly recommend). Here they are:

Subtle difference, but one offers you a survey when you click and the other doesn’t. This is a great way to see what people are more interested in and what will get them to click your ad and come to your site. However, both of these ads send you to the same generic fibromyalgia landing page. There is no survey. At best, an honest mistake, at worst a bait-and-switch. Unfortunately, this is very common in AdWords, but people don’t like to be tricked. They clicked on your ad for a reason and expect to see what you promised. Don’t waste your money if you’re not going to fulfil the promise.

“Switch-A-Roo at Your Own Risk”

The “switch-a-roo” is pretty common on AdWords. This involves including one URL in your ad and then automatically redirecting the user to a different URL. Here’s an example:

So, I searched for “Cholesterol” and got back these three paid search options. The first one sounds pretty good. I want to know how to do all this stuff…lowering my cholesterol and such. The Site URL sounds good too: GetCholesterolInfo.com. I want to get info and it sounds non-biased. I’ll go with that. But where does the patient go? To the Crestor brand site.

The person clicking this ad may be fine with this or they may scoff at being sent to a pharma brand site when they thought they were going to a third party information site based on the URL in the ad. Again, you might lose someone immediately and you’re wasting money. Let me also say that there is nothing illegal or unscrupulous about using these masked URLs and redirects. They are well within Google’s guidelines. In addition, they don’t violate the letter of the FDA law since the ad doesn’t contain a brand name. So, they are likely “less” in violation than the versions that include a disease state and a brand name. Likely, but who really knows.

Crestor does get higher marks than Femara (disclosure: I used to work for AstraZeneca, makers of Crestor, but they’re getting a little rough treatment, so you know I’m not too biased). They fulfil the promise to a much higher degree. They offer in their ad “ways to lower your LDL cholesterol” and they direct you to a page in the section of their site called “Living a Healthy Lifestyle” with information about diet, exercise, and stress management. They didn’t just dump the patient on the homepage and require him to find his way to this info.

So, I said this section is called ”Switch-A-Roo at Your Own Risk” and I mean it. There isn’t anything wrong with using these masked URLs, just know that some people might not appreciate them. As I said before, Google let’s you experiment. Try different ads and track the bounce rate of those clicking the ads. Bounce rates essentially let you see if people leave your site before clicking anything else. Is the bounce rate really high with the masked URLs compared to the real URLs? If so, you might have a problem with upset people leaving right away when the figure out this is not what they expected. Test, test, test.

“For All That Is Decent and Holy, Buy Your Brand Keywords”

I didn’t include the first part of the rule initially, but added it in my second draft to emphasize the point. I’m not even going to explain this rule, I’m going to see if you can figure out the problem from this picture. This is the search result for “Lipitor:”

Figure out the problem yet? For all the fighting pharma does over Canadian imports, especially Pfizer’s based on its history, you’d think that pharma would take care of this little problem. The two top positions for paid search go to Canadian pharmacies. If someone was just prescribed Lipitor, they probably go online to check it out a bit more even before they fill the prescription. They search for “Lipitor” and find a simple way to buy your drug from Canada. That’s not in the marketing plan.

There might be a really good reason why Lipitor is not buying its brand keywords. They may have exceeded the budget for the day, one of these other companies outbid them, or Pfizer may have chosen to not bid on “Lipitor.” Whatever the reason, it’s still a rule. Always own your brand name on AdWords. Don’t let anyone else dictate the message. By letting someone else have the top spot (you can outbid if you need to), you’re giving them the opportunity to tell your story. You don’t allow that in any other marketing channel, so don’t allow it here.

Those are the rules. Follow them to get started in paid search if you haven’t already or follow them to improve what you’re already doing. As always, if you don’t have anyone at your company or agencies who you feel can do this properly, then contact me. Remember if your company was mentioned in my post about Pharma’s Getting the Message, I’ll help you for free. All the companies mentioned in this post are on the list (hint, hint). 

In programs I’ve lead in the past and in work we do here at Bridge Worldwide, we’re always striving to create a closer connection with customers (patients or doctors,  in the case of healthcare) and make our information more meaningful and relevant. There has been and always will be a lot of debate about the best ways to do this. One of the first things that marketers come up with is personalization.

Personalization, for purposes of today’s debate, means adding some personally identifying information to your communications. This usually means putting someone’s name on the top of an email or direct mail piece. It’s remarkably simple to do with digital media and has become very simple (and cost effective) in print as well. Adding someone’s name to an email, for example, is much better than sending an email with “Dear Person” or “Dear Cancer Person.” I only joke because I have seen these before. I assume they were mistakes, but I saw them.

A recent article in eMarketer pointed out that “41% of US Internet users surveyed said they paid more attention to advertising that was personalized. And nearly the same proportion of respondents (39%) said they were more willing to click on such personalized ads.” Personalization does work.

But personalization only goes so far. Consider your email about your oral contraceptive  that starts out “Dear Stacy.” So far so good. You then  give “Stacy” all sorts of useful information about why birth control is perfect for “Stacy” and how simple it is to take and that it might even clear up “Stacy’s” skin. Excellent. Good pitch. The only problem is that “Stacy” is a man. I highlight this extreme example to make a point. Don’t bother trying to make it look like your created something personal for someone when you didn’t. It’s insulting and I guarantee that it does more harm than good.

Individualization is something different. For our purposes,  individualization means creating communications that are tailored for each and every individual person. The test to see if you’re sending out individualized messages is simple: does someone read what you sent and think, “Wow. They wrote this just for me.” If not, then it’s not individualized. This too can be really simple and more and more companies are embracing it. Here’s a great example that my colleague, Bob Gilbreath, wrote about on his Marketing with Meaning blog:

First, Delta included his name. Good. That’s personalization. However, then they go on and apologize for sticking him in a middle seat on his last flight and offer him some miles to say sorry. Interesting point to note, Bob didn’t ask for this or complain to Delta. They just did it. Delta knew the situation and sent an individualized response. Question: if Bob got this email and the 500 miles or another email that simply gave him 500 miles without the individualized touch, which would have more impact? Each results in the same value for him, 500 miles. But clearly the one that talks about his specific situation makes a lasting impression. So, you can’t just give away stuff and expect that to be enough. You have to make the extra effort to make it meaningful.

But just how difficult is that to do? For Delta, all this required was for someone to into their database and write one simple rule: middle seat on last flight, send this email. Period. Probably less than a day worth of work for one person (depending on their system). If you are already collecting personal information about people, you’re on your way to being able to do this. What type of data is in your database?

Part of what makes Delta’s message so special is the fact that it’s a bit of a surprise. Bob has opted into communication from Delta, but doesn’t expect things to come regularly, yet he is open to hearing from them (even more so now). You can create relevant surprises as well. If you have a section of your site that allows people to register, then you should be doing this. Once someone registers, you can follow what they do on your site and send this information back to his or her profile in your database. The rules you set up then generate an email follow up, for example. Consider someone who comes to your site and looks through every page about financial assistance for your product. They linger a long time time on the eligibility section.  Imagine that you send this person an email noting that you know she’s concerned about finances and reiterate some of your programs that are available and then offer her a discount ( like  a rebate coupon) and offer her an 800 number she can call to talk to a live financial counselor (if you have this). 

Obviously, this email would make a huge impact and all it required was a bit better organization of your database and communication system. It is perfectly relevant to her biggest concern about your product and you are there immediately to help answer it. This level of individualization is becoming the norm in many industries. Your message is just one of thousands a given person sees each day. Your “competition” isn’t just the other drugs in the class, but also every one of these other messages. People will only interact with those that are meaningful to them. So, just because your direct competitor isn’t doing this isn’t a reason to ignore it. You need to stand out in a really cluttered inbox, mailbox,and Internet. Do your communications stand out?

I’ve written a fair amount about the use of social media in healthcare (here and here), particularly pharma, on this blog. And, like many other people working to try to enhance healthcare marketing by including channels such as social media, I’ve heard all the same excuses. I was reading John Mack’s post today at Pharma Marketing Blog and it inspired me to write a quick little summary about what I call “The Myth of Adverse Event Reporting.”

Before getting to that, a little setup. Let’s be clear, the reality is that many healthcare companies (or many other industries for that matter) aren’t ready to incorporate social media into the mix. The specific reasons are different for each industry, but they share some commonalities. Here are the big reasons:

1. Afraid to give up control of the brand
2. It doesn’t work/impossible to measure
3. No one in my target audience uses social media
4. Worried about bad reviews

For pharma, these same reasons persist, but they have a little different spin:

1. Same
2. I can’t track it like physician-level prescription data
3. Older people use my products and they don’t use social media
4. Adverse Event reporting 

So, let’s take a look at each of these one at a time. I’ll save the one that kills me the most, Adverse Event Reporting, for last.

1. Afraid to give up control of the brand

Surprise, you already lost control of your brand. Conversations are going on without you already. Don’t believe me? Pull up any discussion board on WebMD. It’s going on without you. Search for your company’s products and see what people are saying. They’re saying it’s great, it’s horrible, it gives me gas, it makes my teeth whiter, it made Aunt Sally turn blue. They’re also giving and receiving medical advice that only a physician should give. So, if you think that allowing people to comment or post information about your product might take control from you, you’re right. However, do you want it happening on WebMD where you have no control and can’t really respond effectively or do you want it happening on your site where you can?

2. It doesn’t work/impossible to measure (for pharma: I can’t track it like physician-level prescription data)

First, social media is no harder to track or correlate with sales than any other online program done in healthcare (or offline for that matter). It is far more difficult in pharma to track the effects of a specific promotion on sales compared to other industries. In consumer packaged goods (CPG), for example, you can do panel match studies where you know who is doing what, what messages they are exposed to, and if it had a specific lift in sales. Our company does this all the time. In pharma, you don’t have this level data and you never will. HIPPA prevents it. So, get used to that. You can’t determine if someone who saw your commercial actually went and got a prescription and filled it. You can ask them, but that’s not reliable. The fact is, you may need to use other measures to determine if the program is effective. You do many programs where the efficacy is measured in clicks or visitors (rightly or wrongly) and you can do the same in social media. In addition,  in social media, you can actually track real-time brand sentiment. Instead of being a tactic to completely change opinions, you can actually use it as the proverbial “canary in a coal mine” to see if your other activities and messages are having an impact on opinion. For example, if you put out a new TV ad (please don’t by the way), you can rest assured that someone is commenting on it right now online. What does that conversation look like?

3. No one in my target audience uses social media (for pharma: Older people use my products and they don’t use social media) 

This simply isn’t the case anymore. You should know this by now. No? Well, here’s the info one more time. Consider just one social networking site for a minute. Facebook. Its share of college age users continues to decline every month. In addition, in the US, there are over 4 million users over the age of 35.

Isn’t 4 million a lot? Sure, it’s not number of people watching American Idol each week, but it’s not a small number. That’s just Facebook. Rest assured that the number of “older” people using social media will only increase in the future.

4. Worried about bad reviews (for pharma: Adverse Event reporting)

So, this is the main reason for today’s post, but since you came all this way, I figured I’d give you a few other things first. No charge. Let’s address bad reviews first. Product reviews are the norm now in ecommerce, but they weren’t always. One of the big reasons is that companies were afraid of negative reviews. It turns out, of course, that simply having reviews can increase traffic, conversion rate, and average order value (see more detail here). In addition, negative reviews aren’t an issue so long as there aren’t only negative reviews.  Consider yourself for a minute. You’re checking out a product online and all the reviews are glowing. What do you think about that? You’d probably feel like the results might not be all that authentic. Instead, when there are negative reviews, it actually can lend credibility to the product (and site) because people know the reviews are actually genuine. Negative reviews don’t turn people off. They read them and consider whether the negative would actually bother them. For example, someone ranks a product 1-star and says “this didn’t work on my Mac.” Well, if you have a PC, you aren’t worried. Simple example, but you see how it works.

Adverse Events are nothing more than negative reviews. If you want people to genuinely talk about your brand, they are going to say negative things. But how often do posts include adverse events? Nielsen decided to take a look at this rather than simply assume it was ” a lot,” which of course is a difficult number to manage. Nielsen looked at Yahoo Health boards and took 500 postings. Of these, only 1 contained enough information to qualify as an adverse event that needed to be reported. That’s 0.2%. Why so low? Turns out that someone simply saying that your drug caused them to have a headache isn’t enough to qualify as an adverse event. Nielsen summed up the pieces of information required to report an adverse event and there are four pieces: “(i) an identifiable patient; (ii) an identifiable reporter; (iii) a specific drug or biologic involved in the event; and (iv) an adverse event or fatal outcome.” (Hat tip to Pharma 2.0 for the summary). The study showed that one or two of these pieces were often available, but not all four. In addition, they found that it would be impossible to get all four even with some effort. In fact, the FDA says, “[Without these pieces] a report on the incident should not be submitted to the FDA because reports without such information make interpretation of their significance difficult, at best, and impossible, in most instances.”

This is because people often don’t register or leave their personal information in a post, so there is no way for a company to follow up and fill in the blanks. Naturally, if there is something significant, every effort should be made, but on the often anonymous Internet, this is usually difficult. Suppose for a moment there were several adverse events that need to be reported. How often do they need to be reported? The FDA is pretty clear on this. For new drugs, reports need to be filed quarterly for three years. After that, it’s annually. For “serious and unexpected” events, these have to be reported within 15 days. However, there’s a pretty high threshold for an adverse event to be considered “serious and unexpected.” Every company already has these reporting channels in place, so it is simply a matter of including adverse events received from social media into the workstream. 

Yes, it’s a balance. The fact is adverse events should not be the reason why healthcare shies away from social media. These risks can easily be mitigated and, if done right, can actually be used in a positive way. So, don’t use adverse events as an excuse anymore. You’ve got the data. 1 in 500 posts include a reportable event. You report quarterly at most (which you’re doing anyway). How much ongoing effort do your other marketing programs require? Probably quite a bit more than this. Next time you hear this excuse, you’ve got the data to dispel the myth of adverse event reporting.