Digital Pharma

Collecting ideas and thoughts slightly too big for @digital_pharma Subscribe via email (no, I won't spam you). You can reach me on Google+.

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My guest blog post over at ExL. 

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Pharma Is About To Have a Google Problem

If you're reading this post, there’s a good chance it’s because someone mentioned it on Twitter, Tumblr, Quora, Facebook, on another blog. And if you are aware of these kinds of social tools, you're probably already aware of measurement tools like Klout and Kred (I assume Kwality and Kwant are just around the korner). Even if you don't check your Klout score, you’re aware that someone who has a high score is indicated to have a larger and more robust network than someone with a low score.

Yay! So what? Well, what if there was a tool that measured not just the value of a network, but that also determined the value of content depending on the scores of those who wrote it or read it? For example, when someone with a low-scoring network (a "nobody," to use more earthy language) writes a post, it would sink to the bottom of the rankings, unknown and unloved, because that person hasn’t built a robust network for themselves. However, when a higher-ranking person (a "mover and shaker") writes something, many people comment on it and share it., Why? Because being a part of such a high-profile post confers some status on the commenters and sharers. Perhaps even enough to nudge their scores higher.

This new measurement tool concept isn't fantasy, this is something that is about to happen. And it represents a serious shift in the marketing landscape for pharma.

Part of what Google Plus is doing is allowing all authors, bloggers, commenters, posters, commentators and social-network “talking heads” to collect their total body of work in one spot. This spot, called a G+ profile, allows Google to figure out who's writing the best content and give that person a score (much like how PageRank scores web pages based on their connectivity to other pages).

Very soon, Google will start adding a person’s G+ score to its complicated search algorithm as a means to weigh the value of that person’s page. Thus, the page by a "nobody" will move way down in the search rankings compared to one by a “power networker.” In fact, Google's intention is to place a higher value on pages written by authors it can find on G+.

Can you see where this is going? Can you see how someone who has a solid network of fans and friends, who writes a lot and engages in a lot of online conversation, has more clout with Google than a faceless, authorless corporate page? Suddenly, Google has opened the door to someone who doesn't work for your brand to rank very highly in a Google search on your brand. Your brand's top search results are no longer guaranteed to be your page, wikipedia and the NIH. Someone who’s very motivated and connected will have a very good shot at making the top ten (or five!) of your Google search results. And there’s no guarantee the content they’ll be generating about your brand will be positive, or even accurate.

This search-scoring approach is called Google Authorship. It aligns with how Google sees the web. It wants an internet filled with hand-written content, built by people, not corporations. It wants more personal perspectives and fewer "talking points," because it believes that's how we create more authentic content for the world.

How serious is Google about all of this? Well, if it knows that you wrote a post, it will attach your name and picture to that post within its search rankings. That kind of visibility shows where Google is trying to take its idea of authorship. However, if you attach authorship to a company, Google will reject it. For example, if you try to attach authorship to your corporate page, where the avatar is a logo, it won't show up. Google is using facial recognition software to verify that a "person" is being attributed as author.

Right or wrong, Google is a serious part of your marketing plan, and any change it makes is something you need to consider.

But how? In an industry where comma placements involve protracted Medical, Regulatory and Legal discussions, how can we let "regular people" talk about our brand? The fear of AE reporting alone is enough to make a mortal pharma marketer quiver in terror.

Well, one idea is to personalize your brand. Much in the same way Steve Jobs was the face of Apple and Howard Schultz is the face of Starbucks, you can designate someone in your company to be the “face” of the brand. Sadly, the second that person leaves, you're in trouble.

Another idea is to build a G+ page for your brand, and select the caretaker of that page to be the face of the brand. Should they leave, someone else can simply take over the account.

You can ignore Google authorship at your peril, or you can see this development as the sea-change that motivates your brand to get serious about social communication. After all, what's more social than having a “brand face” that people can engage with?  The time of playing ostrich is over, folks. The time to finally figure out how to get our brands engaging socially is now.

Thanks to Andy Crestodina of Orbit Media for doing the legwork on Google Authorship. http://www.orbitmedia.com/blog/google-authorship-author-stats

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Every Word Of This Is True

Last night, Clint Eastwood spoke at the GOP convention, mostly by pretending to talk to an invisible President Obama, sitting in an empty chair next to him.

If you got a good night's sleep last night and missed it, let me assure you that this happened and that every single word I write here is true.

Regardless of your political beliefs or like/dislike of Romney or Obama, this is something that will be remembered for a long time. Why? Well, let's see what happened next.

Well, like with almost everything these days, things turned online. As the place where anyone can say anything and reach everyone in the blink of an eye for almost no money, this shouldn't be a surprise.

First, we got "Eastwooding," a meme where Eastwood pointed at different types of chairs (those of you about to celebrate your 40th birthday might agree that the choice of Pee Wee Herman's chair Chairy was pretty funny). People added funny captions to pictures of Eastwood and the soon-to-be-famous chair. Maybe you saw the picture of a fake newspaper clipping of Abe Simpson was entitled "Old Man Yells At Chair."

People made ever increasingly interesting/funny/pathetic attempts at humor inside the meme and it kept shifting, growing, morphing and evolving.

Then that shifted to old people pointing at chairs. And then anyone pointing to almost anything was "Eastwooding." 

Then, because this isn't weird enough, you got President Obama, who tweeted a picture of the back of his head in a seat marked President and wrote "This seat's taken."

And then, we we introduced to @InvisibleObama, because in this world, you're nothing until someone makes a fake Twitter account about you or your idea.

This all happened while you were asleep last night.

To recap: An idea to get some press, to change the news cycle from "Paul Ryan seems to know what he's talking about though even FOX News thinks he's lying" and "Romney's list of things he doesn't want to talk about keeps growing" is now "Hey! Everyone loves Clint! And Clint loves America and the GOP! Yay!"

But that event shifted the course of conversation not one, not twice, but three times overnight. Overnight.

Now, I'd suggest that a meme like Eastwooding won't much legs and will probably be a "hey, remember this meme" two months from now. But think how these two memes will affect the presidential coverage and thus the election. Memes. Helping us determine who the next American President is.

So if you don't think the internet is serious business, doesn't have the power to change minds, start and destroy careers and businesses, you are wrong. If you think your business's 12-month plan for how to manage social media is adequate, in a world in which the tech changes weekly and the ways to use it changes minute-to-minute, you're in trouble.

And it's only going to get worse/better (depending on how you look at it). What happens if your brand, in an effort to generate awareness or change the news cycle ends up in a similar meme-hole? What can you do about it?

Are you ready for the future? Because it's already here. Just ask the holographic head of Ronald Reagan the GOP was planning on using this year.

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Gamification: They Laughed at Tree Frog Venom, Too

So yesterday, after having poked at Pharma Guy's stance on gamification, I got called out pretty severely by John Mack. Reading between the lines, I feel like he called me out as some sort of gold-digging digital con artist, so that was fun. Maybe it's a case of, "You're nobody in this town until Pharmaguy makes fun of you." Perhaps I should take it all as a weird compliment.

Ignoring the ad hominem attacks, I'd like to dive deeper into Mr. Mack's argument against the likelihood of the FDA ever approving a game as a proper treatment, the likelihood of a doctor prescribing a game, and the likelihood of an insurer paying for any of it.

The truth is, there is no proven science that games can, in any way, treat a patient's condition better than a drug. Mr. Mack drills that point home pretty hard, which is fine because it isn't the point I'm making.

The point I was making is that just because something doesn't work now, it doesn't mean that it can't work in the future. In fact, the entire pharmaceutical industry is predicated on the idea that this particular clump of atoms form an unusual molecule, which when applied to certain people, cause certain outcomes. At one point, penicillin was just mold that grew on bread. It didn't cure anything until we applied some science to it and learned what it could do.

And, like games, the first time we tried penicillin, it didn't work. We learned, through trial and error, applied via the scientific method, the best way to use it to stop infections. I wonder if there was a Mr. Mack in 1928, claiming that no one would ever eat the mold off of bread because no one had ever been cured by it before. Or that no one would pay for moldy bread bits.

This all gets even more interesting in light of Mr. Mack's post today in which he is supportive of the idea that people play games in order to stave off the onset of Alzheimer's disease. You'll excuse me for being confused by his position. Regardless of what the FDA will or won't do tomorrow (as my crystal ball is in the shop), pharma's reason for being is to discover find whatever solutions to people's health care issues they can, no matter how unlikely or unusual the source. They were skeptical of tree frog venom, once. Video games seem obvious in comparison.

Frankly, the day pharma can build a game that treats a disease (in a scientifically-provable manner) nearly as well as a brand, is the day pharma finally realizes how much money can be made from this. That's when pharma takes gamification seriously and issues about the FDA will be figured out.

Also, since games probably won't have much in the way of side effects, does the FDA really need to be called in to do anything more than verify that the game does what it says it does? Indeed, proving one's claim hasn't stopped, say, magnetic jewelry makers and vitamin salespeople from edging in on what should be solely pharma's domain.

The real issue is that pharma, by playing ostrich, is letting tech get a huge head start. Kodak used to believe that no one would want digital pictures to much the same effect. Acting outside the traditional pharma section puts tech in a position to be a true disruptive agent. Ten years ago, no one thought a guy with a list named Craig would be able to put thousands of journalists out of work. So let's not assume the protective force-field of the FDA will stop tech companies from trying to do to pharma what Craigslist did to classified ads.   

So, in an honest attempt to learn where Mr. Mack stands on the issue of gamification, I will ask that he define his stance free of argumentative distraction like the FDA, insurance providers, and things not necessarily germane to the issue at hand. I think that would be very enlightening.

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Who's Scared of Gamification? (Besides pharma, I mean)

It's hard to remember, but there was a time when the idea that disease came from unseen microscopic organism that moved from person to person (or from water well to person) was something akin to "magic." Disease was a function of luck, karma, the god's displeasure, or some secret failing of one's own soul.

You know what changed all that? Science.

So, if I told you that there was a tool whose regular use lowered (and even eliminated) a patient's symptoms, and I could back it up with a set of clinical studies, you'd have to assume that I had a viable product on my hands, right? That's the rule that pharma follows for the pills, topical treatments and injectables right? 

But last week, Pharma Guy decided to stomp all over the idea of gamification like it was irritating pest. A game that helps kids with ADHD train their brain to not need Ritalin? Laughable!

Now, I'm not picking a fight with John Mack (oh, wait. Yes I am), but he seemed to take actual joy in pointing at it and calling it names.

I'm not calling for pie-in-the-sky (mmm... pie) thinking that leads to rose-colored glasses (so hot this year), but in science. If I can prove that a divining rod is far more likely to predict water than a placebo, it may seem like mysticism, but science proves that there's something there (not that I have any proof that divining rods are any more than drought-based snake oil). And it's the same with all sorts of things that aren't pills and topical treatments and injectables and whatnot. I can't see how penicillin works, but science proves it does, so that's that.

Why can't we apply the same rational thinking to games?

It seems like Mr. Mack is focusing on the politics of funding, testing and reviewing a game like a drug, and I agree that it's a long road to follow, but pharma follows the path where science leads. What if playing a game every day really lower or eliminate the need for taking Ritalin?

Let's not forget that games probably won't have a lot of side-effects like nausea, heart palpitations and addictions (like Ritalin does). And what kind of adverse events would a game cause? Yeah, that doesn't seem like a path worth following, does it?

The best part is that pharma can and should be making money marketing these new kinds of treatments. If pharma doesn't get on ball and start playing with these ideas, the tech world is going to beat us to it and shut us out of the market completely. We'll be busy playing an outdated game while tech moves the playing field out from under our feet.

Now, I'm not saying that we shouldn't apply a critical eye to games like we do any other brand, but declaring them dead before they've had a chance to prove themselves like any other brand is short-sighted and closed-minded.

Or maybe Pharma Guy thinks washing one's hands before an operation is lunacy.

Just wondering.

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The Trouble with Facebook

Facebook is serious about getting pharma on board with social media.

You remember Facebook, right? The number one or two website in the US and the world? The place where people spend insane amounts of time playing games, posting photos, and chatting with their friends? I know you know of it, because I'm almost certain that you have a personal profile on it. 

You may have wiped it from your professional memory because for the last few years, Facebook spent a lot more telling us that it wanted our business than actually learning what it was like doing business within pharma. They were playing B2B footsie, occasionally bending their very retail-oriented rules about commenting and interaction when a brand reallyreallyreally needed them to turn off comments (read: spent a lot of money buying ads on Facebook). 

But you were probably right for writing the FB off as a place where pharma should fear to tread.

So it was surprising to see that Facebook has taken itself to the woodshed and returned a changed company. They really are serious about bring pharma into the fold, going so far as to put together a team of six full-time staffers dedicated to pharma. This team will teach any brand manager or agency willing to listen the lessons learned from the early adopters. They have regular newsletters describing new ways of targeting customers, building brand awareness and driving engagement. They will sit you down and walk you through a deck describing all the ways they can help you achieve your brand goals.

You might be interested in hearing that FB can reach hundreds of thousands of pharmacists, nurses and doctors (and based on numbers I've seen, assume 60-80% penetration). They can segment pretty well by specialty type, demographic-type, and geography.

They can also help you build a page that abides by your particular MLR needs. No longer is Facebook pretending all companies are the same: they are serious about getting pharma into social.

And that's great news. Except one small detail.

While I'm all for getting pharma to embrace the twenty-first century and admit what we all already know (everyone, including your doctor, your mother, your pharmacist, your nurse, your support group, your physical therapist, your KOL, and your pharma executive are all on social media and using it quite a bit), Facebook may have a bit of problem: clicks on their ads aren't all by people.

Someone has uncovered evidence that as much as 80% of ad clicks that businesses pay for on Facebook are by "bots." Now, in this world of indexing spiders and other crawling bots, we expect a few clicks on any ad to be worthless because they aren't being made by a person (good luck persuading a piece of software to ask their doctor about Humira). And it's safe to say that this traffic is about 1% of traffic we end up paying for. But 80% is outrageous.

It would be easy to say that this is how Facebook is artificially inflating click numbers to charge you more (and if last month's earnings report is any indicator, everyone in FB is aware of the value of charging clients money: Zuckerberg lost more than $420 million yesterday!), but there's no real proof. It's just as likely that bot-writers focus on their software on Facebook because that's where people are. However, it's not obvious what their motivation would be to fake-click on links.

As this story grows (and it will, as the "GM says FB ads aren't effective" story is still fresh in our minds), Facebook will have it's hands full managing the PR. They will need to prove 1) that it is not doing the fake-clicking and 2) that it is working towards eliminating the problem. Otherwise, all their hard work in building a targeting system we want to leverage will be almost worthless.

Provided it can fix both parts of the fake-click issue, Facebook will be well-positioned to become an effective pharma marketing partner. 

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The Next Big Tech Disruption? Internet Speed

If you haven't spent 60 seconds reading this article on how Google Fiber is the biggest thing BigG has done since Gmail, you probably should. Why? Because it underlines how important the next big disprupting to tech is going to be, even to (and maybe even especially to) pharma.

Tech specs: First there was dial up. Then there was DSL, which was about 10 times faster than dial-up. Then came modern cable internet (what most of us think of when we think of broadband) and that's like ten times faster than DSL. But we've been stuck at eking out a few more bits per second from cable for the last ten years. Fiber (meaning fiber optics)? Well, if I said it's going to be ten times faster than cable, I'd be lying. Because fiber is far faster than that.

In a world where we're all very very used to downloading massive files and streaming Netflix, why do we need more speed? Well, remember when you couldn't understand why you'd need more than a 486mHz processor to run Windows (to be fair, it was Windows 3.1)? Then came photo editing, and music downloading, and movie editing, and movie streaming.

There are new technologies on the horizon waiting for the bottle-neck of internet speed to get fixed. How will fiber everywhere change things?

Well, we're start with wifi everywhere. No more dial-up like speeds at the Startbucks because 3 dozen people are leeching on a single connection (and one is on a video chat -- who does that?!) to a computer in your pocket (who's bottle-neck is also internet speeds via 4G). So that means any two people in America with two decent mobile devices can have a video chat pretty much anywhere with a high-res screen interface. Congrats, you just invented a way for a doctor to consult from anywhere: virtual office hours.

Or take EMR to the next level: the ability to collect patient data from anywhere. Not just from doctors, but a simple API would allow my health chart to collect data from my wifi scale, my Fitbit heartrate monitor, my ZEO sleep data, etc. Heck, just plug my Kinect and my doc can give me a pretty good physical... while i'm at home.

And pharma? As it starts to open up to being a health care partner instead of "just a pill-maker", it can interact with all its customers in real-time. Mobile phone apps can become pill-reminders and track that data, embedding it into the EMR. 

But the real breakthrough will be in understanding Adverse Events. With so much data now being tracked and dumped into a central location, pharma will be able to see in weeks that there might be an unanticipated reaction with some real-world factor.

For example, clinical trials reveal that 0.05% of people who take your brand get nauseous. Your clinical trial won't give you enough data to see what other factor creates that condition. But four weeks after brand launch, you see that people in the real world reporting nausea have also been diagnosed with sleep apnea. A quick study can confirm the finding and that information is now added to the label.

Fiber brings everyone closer together, and that includes HCPs, patients and pharma.

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Media Buying: Don't Throw Money Down A Hole

Three years ago, someone was able to estimate that most people in America saw about five thousand ads in a given day. Before most people were on Twitter and Facebook, you could anticipate that your audience was subjected to more ads in a day than your parents saw in a month. Objectively speaking, that a whole lot of ads.

Let's do some very simple math. How many HCPs are on your target list? Even if you filter out your low-performing deciles, what are we talking about? Ten thousand people? Is that a safe number? That means that in a day, your targets are seeing... Carry the two... Fifty million ads. In a day. Times 365 days, that's 18.2 billion ads.

And somewhere, your friendly neighborhood brand manager is hoping that they can catch their target’s eye. In fact, some might be hoping that they can buy up lots of ad space to try and blunt a competitor’s message upon launch.

What the numbers tell me is that there is a nearly infinite space in which to advertise (remember, the 5,000 number predates Facebook’s growth, which now accounts for one in every five page views in America. Let that idea sink in a little bit) which means that the job of ”simply” increasing brand awareness in so much space is a full-time job. You are, in essence, trying to get someone to see your particular star in a milky way of stars. And in a world of Pepsi and Coke, Disney and McDonald’s – the stars that can spend big cash to look as obvious as Orion’s belt – how can a non-blockbuster brand even register?

Well, the answer comes down to message and placement (though I'll save a discussion of messaging strategies for another day). At its most basic, it’s about delivering what you want to say to someone who’s inclined to listen to it.

You can target “old-school-style” by buying placements on HCP-centered websites and networks (like WebMD and eHealthcare Solutions) or electronic medical records sites (like PracticeFusion or Precision Health). These kinds of sites allow you to filter even farther, focusing on specialty, condition, and sometimes even to specific people on your target list. Some companies, like PracticeFusion, can even tell you how well your ad buy is doing to increase prescription-writing (by holding back a sample of the target group and comparing the two groups at the end of the test period, they can see if seeing the ad changed the HCP’s behavior).*

Or you can “kick it new-school” and focus on behavior-based placements (like when a target hits your branded site, gets cookie-ized and suddenly sees your ads on USAToday or their Google Reader). This placement process lets you filter to a very specific group of people in places that fall far from the usual HCP-centered sites. The question remains whether unusual placements like this are useful, as your target probably isn't thinking about their patients when they are searching for a tee time or researching vacation destinations.

These same placement strategies can also be applied in a competitor-blunting process without going broke in an attempt to completely ad-block them.

For example, if you have a competitor launching in May, you can use old-school placement strategies to target placements during the month before and after May (they won't be able to counter before their launch and they may leave buying placements until the last minute to avoid the possibility of having to push the date back and wasting money). This is your opportunity to seize as much brand space as possible.  

You can combine that with an email push which embeds a tracking cookie on their system. A re-marketing (sometimes called a re-targeting) campaign, done just before the competitor’s launch, can push a lot of placements on a variety of non-HCP locations. Best of all, re-marketing costs are a small fraction of those on HCP-centered sites.

In the last year, we’ve seen a huge upswing in the places and ways in which you can target your users. Are you up-to-date on all of them, or are you trying to negotiate banner ads on AOL.com?

*full disclosure: I have placed Insertion Orders (the industry term for buying ad space) with PracticeFusion and EHS, and have had conversations with many reps from the companies mentioned in this post. I am not attempting to recommend any of them, just trying to show you that there are a lot of options out there.

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How Social Can Pharma Truly Be?

It wasn't that long ago that my mother got all of her email on paper. Once a week, she would check her email, by which she meant she would have my dad log in, delete the junk mail and print out anything that was relevant, interesting, or useful. Then, she would call people back. She was proud to tell people that she was up on new technology like email and would give out her address to anyone who seemed interested.

Since most people didn't get a response for almost a week via a completely different medium, eventually everyone learned to just call.

This begs the question: was my mother really on email? (is “on” the right preposition? Whatever.) She had an email address, and she got information through it, but wouldn't you say that she was just bending the medium against its inherent... “emailness?” You might cover yourself in feathers, but that doesn’t make you a bird, does it?

I have a similar (mostly internal) conversation about pharma and social media. We all know that social media is mainstream. Does anyone reading this not have their own personal Facebook/Twitter/LinkedIn accounts? I didn't think so. We’re social, and the numbers tell us that pretty much everyone else is, too. When you post to Facebook, have you ever thought about turning off comments? No, of course not. You might think about blocking your brother-in-law because he’s obnoxious and won't stop posting political rants, but you would love it if everyone you knew commented on that photo of yourself, especially if they comment how good you look.

In return for comments, you’re more likely to comment on other people’s posts, maybe even share videos of babies giggling or helicopters made of stuffed animals. The funny thing is that you might have done stuff like that even before Facebook. You might have had a blog of great links, a LiveJournal, or maybe you just passed emails around with your friends and family. You were “social” online long before you were on Facebook.

We can't mistake the platform from the intention. Facebook the “social” platform merely facilitates your intention, which means that simply being on Facebook doesn't mean you are being social – you're just leveraging a social platform. Being on a social platform doesn't mean you’re social. To return t the bird analogy, it just means you're covered in feathers.

So many pharma brands are patting themselves on the back by claiming to be social, when they are really just on Facebook, furiously fighting to turn off all the functions and features that make Facebook social. To pharma, Facebook is just a blogging platform with a lot of unnecessary (and risky) opportunities for people to talk back. However, it is the conversational features that make Facebook social, and what made it popular in the first place.

No one wants to get messages from Pepsi and Doritos and the new Batman movie. What they really want is to be social, either with other fans, or to the brand itself. For example, if you “friend” the TV show Archer (it's a cartoon for adults) on Facebook, you will get posts from the character Archer himself. You can reply. You can be social.

Now, I appreciate that there are rules and guidelines and all sorts of medical, legal and regulatory concerns that keep you from making your brand more social. Maybe that means you shouldn't be spending all this time and money trying to pretend to be social. The same resources, if dedicated to smart emailing and texting (tech that’s more than 30 years old, now) would reap far more benefits without having to pretend that your Facebook page’s seventy friends (almost all of whom work for the brand in some form or another) are worth the money it takes to post.

It's very possible that pharma brands’ trying to be social is as valuable as attempting to email people without a computer. Sure, you could create email accounts for all of them, allowing you to claim some great innovation, but since your targets can't actually access them, what’ the point?

I'm not anti-social. I love social media (my twitter accounts attest to that). But we need to use it right, or else use it not at all. Pretending to be social in the pharma sector is just a great way to spend money.

And get covered in feathers.

[digital-pharma-blog]

How Useful Is Your Hoarded Data?

I am a hoarder. Not the "I'll be appearing on an A&E series next month, buried in my belongings" type of hoarder. I’m more the "Oooo, that book looks interesting! I'll buy it and probably never actually read it" type of hoarder. I used to have shelves and shelves of books, but then I started paring them down to the point where I bet there aren't 50 books in my house. However, I have hundreds of electronic books that I hoard like an old lady with cats.

I hoard them because they make me feel as if I have access to new things. Every new book is the opportunity to learn something new and amazing (though, in reality, it's really like there's a 4.7% chance the book will be worth getting past the first few pages). I collect them in some vain hope that having them on my iPad will make me more likely to be smarter by some sort of mental osmosis.

Alas, it doesn’t work for college kids who buy their textbooks but never crack them open, and it doesn't work for me, either.

I'm guessing you have collected a lot of data lately. A lot of sales numbers. Geographic distribution data. Attitudinal data. Behavior data. Data about how many and who opened that last email, and the one before that, and the one before that. You know who is registered on your site, who watched the last eLearning, requested a rep, requested samples and requested patient sales cards. You know their specialty, probably where they practice, probably how old they are, where they went to school and if they ate lunch you paid for.

That’s a lot of data. What good is it doing you?

Ostensibly, you're going to use that data one day. You're going to hire a bunch of geeks who did their own math homework and probably majored in mathematical modeling. They are going to unlock that data and turn it into something called "usable insights." You are going to apply those insights, increase brand awareness by 17% per annum without spending any more money, and get that promotion and corner office you always wanted.

That's a great story, but are you really ever going to use that data?

How much did you spend on your data in the last month? The last year? The last five years? How much do you spend to maintain all that data every month? What could you spend that same amount of money on to make the needle move right now?

Let’s explore a simple “what if” scenario. If I told you right now that female PCPs over the age of 45 are prescribing your brand 20% more than the average (a fairly interesting and important finding), what could you do with that information? How long would it take you to design a campaign that focused on that segment and got it approved and launched? Three months? Six? Would the insight I just gave you still be useful in six months?

To that point, how hard would it be for you to turn off existing messaging to that audience? Could you do it in a week? A month?

The ability to respond to data insights is as important as the data itself. Just as the ability to leverage the knowledge in your books is predicated on reading and digesting them, getting value out of your data is a function of being able to change course. The CRM that holds all of that data is worthless without the system in place to leverage it.

Now, I'm a known fan of CRM strategies. But if you can't commit to one – if you can't commit to building a system that can respond to new information –  stop what you're doing right now. Those nice reports they give you are pretty and interesting, but if you haven’t used one to make a business decision in the last couple of months, or if you simply can’t change anything based on the data, you should stop looking at them. They will only stress you out.

Stop being a data hoarder. Data is only as good as its ability to influence your decisions. Keeping it around in the hopes that magic springs out of it is as silly as sleeping on your textbook.

[digital-pharma-blog]

More Expensive Responsive Design Is Far Cheaper Than The Alternative

You know all the numbers already; it appears that nearly every HCP target has or is about to get an iPad. They all had smart phones last year. The numbers are growing so fast, that some people have just stopped collecting them and have begun to simply say, “We are rapidly approaching maximum market saturation” and moving on to other, more interesting questions.

A quick check of your web stats and email applications confirms that almost 40% of your traffic is mobile. This leads you to one simple and inexorable conclusion: you need to get mobile.

If you talk to your agencies and partners, they will be more than willing to spend your money and re-build your website and your online tactics (eLearning, request forms, formulary tools, etc) into a mobile version that will look good on a phone. Some may even suggest that you put all that into a set of apps (one for iPhone, one for iPad and one for Android) to allow for device specificity.

Sure, you could do all that. And you could also just send me a check for six figures.

But you shouldn’t.

When talking to your agency partners, listen to the one who uses the phrase “responsive design.”  You may have already heard it, and not known what it was. Well, let me help you sound like an experience, and savvy web solution shopper.

If you go the old route of building a site for the desktop, the tablet and the phone, you have three sites. You know what kind of hassle it is to update one site already: between label changes and marketing position changes, it is a lot of work (read: expensive). Having three separate sites doesn’t get you any benefits of scale. You have three sites that must be coded completely differently, even if they have the exact same content. The management costs alone would make you blanch. Maybe you’ve already done the math, and that’s why losing 40% of your traffic to mobile isn’t the catastrophe I made it sound like before [link]. Maybe the return on investment to three sites doesn’t work for you.

Responsive design is the solution to the same problem that you and every other web business is having (this isn’t a pharma issue, it’s a web issue). The solution is a change in mindset for the coding of your site. Using HTML5 and CSS3 trickery, they can build a site once (with only a single maintenance budget) and have it look and work completely differently on a laptop, tablet or phone. The code can tell what kind of device the user is using to request the page and delivers the version that’s appropriate. It isn’t just a matter of making the text smaller or anything, with careful planning, it can do everything from make the link buttons on the phone big and easy to use, or even resizing the graphics for new retina-display screens.

Even the images can be adjusted, re-shaped and re-sized on the fly to maximize their value on a given screen.

This kind of responsiveness may already be in place in some of your sites, like when it delivers slightly different versions of code to different versions of browsers. The current understanding of responsive design just takes the idea and moves to its logical conclusion: one site that looks and acts like many.

The framework can even be used to more easily port content into device-specific apps. Users can download apps – which are really just slightly modified browsers – that pull your responsive site through their window.

Now, it’s not magic. But it’s not free, either. You can expect to pay more for a site that uses responsive design practices. But one responsive site is far cheaper to build and maintain than three sites.

[digital-pharma-blog]

CRM Is a Strategy, Not Technology

No, wait. Just because this is going to be about CRM doesn’t mean you need to bring your call to action into the room. This will not be about computers. The problem is that we just see the acronym and not the words themselves. You think you know what CRM is, that it's a big database filled with info about all your customers and it spits out all sorts of insights like what channels each target prefers and what messages they seem to respond to.

Except none of that is in the name itself: Customer relationship management. No tech. No servers. No database. No channel preference. It's just a way to manage the relationships you have with your customers.

If you owned a bar, knowing what the regulars liked to drink and remembering that Ol’ Joe gets a little maudlin after his fourth – that would be customer relationship management. You wouldn't need a server, because you would know many of your customers by name, by drink, and by story. That's what a good bartender does, right?

So why do we need to inject databases into the concept? When you think CRM, don't think servers and analysts, think strategy.

Because that’s what CRM is -- a strategy. It is a way of thinking about your customers to help them have a positive experience, so that they come back for more. It is a system and structure that forces you to put the customer in the center of all your marketing thinking.

Allow me to be specific. You’ve got a target list. Maybe you’ve broken it down by deciles. And you are recruiting everyone on that target list to opt in to your email campaigns. Now, your email campaigns, are they a bunch of emails you send out every few weeks in a specific order? Maybe you occasionally interrupt that order with breaking news about a conference or a label change? Yeah, I figured as much. So what’s that getting you? Are you learning about your targets? No, you’re shouting at them. And worse yet, you’re shouting at them all the same way. The twenty email messages you’ve spent the last nine months crafting and pushing through MLR are to be sent in order, to everyone who opts in, are they increasing your prescription rates? Are they increasing your rep and sample requests? Are they increasing your target’s understanding of your brand?

I’ll buy you a drink at ePharmaSummit West this year if you can answer ”yes” to all those questions.

Let’s assume you’ve embraced an adoption path for all your targets, that everyone was either unaware of your brand; aware but ignorant of what the drug does; educated but unconvinced of its value, convinced of its value and prepared to prescribe; or ready to tell other people about their positive experiences with the brand. Which of your twenty emails speaks to which of those audiences? Are you sending your messages in a way that moves each target from one step to the next? Can you confirm that each target has moved to the next step before you send the next message? (Did you notice that every question asked where the customer is? This is what I mean by customer-centered.)

This is what CRM can tell you. With proper implementation, it can see that Dr. Smith is aware of the brand (because she went to a conference and dropped a business card in the bowl to try and win an iPad). So it sends Dr. Smith three emails in a row about what the purpose of the drug is. The system knows that after the second email, the doctor clicked the link to learn more and watched most of the eLearning video. This means that our target has moved to the next step, so skip the third ”brand awareness” email and move on to the campaign to get them to request a sample.

At the same time, Dr. Jones already is aware of the brand and it's mechanism of action, so a series of messages are sent about requesting samples and formulary information.

This is how you manage your customers. The strategy comes first. We can figure out how to build the database and tracking system later.

Here’s the scary part: you can't say that you don't think CRM is valuable because every business tries to manage their relationships with their customers. It's a cornerstone of building a good business. What you may object to is the way that strategy is implemented, but you can't ignore the strategy itself.

So tell me: how are you managing the relationships you have with your customers?

[digital-pharma-blog]

How To Cut 25% of Your Marketing Budget Today

You have a lot of possible and actual targets, and almost as many ways to describe those targets: deciles (based on past prescribing data), deciles (based on predictive modeling tools), engagement scores, adoption path position, geographic area, specialty, practice type, and more.

The problem with many of these descriptions is that they tend to paint a partial picture of your targets. For example, deciling by past prescription data says ”this group used to prescribe a lot, this group used to not prescribe much.” That’s great information if this were a history class.

Conversely, deciling by predictive modeling (so sexy, so hot this year) is so complicated, most of us can only say ”based on an equation so complicated I'd need PhD and a white board the size of a building to explains it, this group should prescribe a lot and this group shouldn't.” It’s less like history class and more like science fiction.

The issue is that while this kind of segmentation tells you who should write and who shouldn't, it doesn't try to tell you why. And that’s important because if you know why, you’ll know what you want them to do, which means you’ll know what kinds of messages to send them to change their behavior.

So, let's call this this the Context Quadrant Metric (all you MBAs should feel very much at home, they rest of you, don't worry -- this is easy). It's a two-by-two chart. Across the chart, plot out engagement. You can decide how you want to measure this. It can be as simple as decile, but you could also count all the different touches you've made back and forth (number of emails sent, videos viewed, speaker programs completed, honoraria received, etc). Low engagement to the left, high engagement to the right.

Vertically, plot the number of prescriptions written in the last year. No prescriptions at the bottom, lots of prescriptions at the top.

Now, you’ve got four quadrants. The bottom-left is filled with targets who are low-engaged, writing few prescriptions. Call these your “Unlikelies.” In the bottom-right you have highly-engaged, low prescribers. Call these your “Underachievers.” Upper-right corner is your highly-engaged, high prescribers. These are your “High-Responders.” Finally, in the upper-left, you have low-engaged, high prescribers. These are your “Overacheivers.”

What does this tell us? Well, we now see where there are correlations between the marketing actions you are taking and prescribing. We’ll also see how in many instances the actions you make have nothing to do with the outcomes. For example, you spend a whole lot of money trying to talk to the Underacheivers, but they don’t seem to be doing what you want. How much money is too much? Or maybe it's proof that your marketing message isn't working for them. Maybe these are the moochers who are happy to watch any videos you put in front of them for the free MREI at the end. Maybe no amount of MREI in the world will get them to prescribe.

How valuable is that information?

And what about your OveracheiversYou are spending a lot of money trying to talk to them, but they are ignoring you entirely without negative consequence to your bottom line. They have massive ROI. Maybe instead of trying to get them to opt in, you should just start sending them thank you emails and leaving them alone. How much money would you save that way?

By understanding the contents of each target group, you can make smarter marketing choices, saving huge amounts of money on dead-end or already-satisfied targets that can be used on new messages to those who will actually respond to them. You can frame marketing strategies (and budgets) around better understanding your audiences.

[digital-pharma-blog]

Pinterest: Is This The Next Big Social Media Channel for Pharma?

If you haven’t heard of Pinterest yet, you are probably purposely avoiding it. It has become the fastest-growing social media site in the US (#3 behind Facebook and Twitter, ahead of #4 LinkedIn) and it has a fairly rabid fanbase. But what is Pinterest? How is it different from the other social networking sites we’ve grown comfortable with lately?

To understand Pinterest, you need to think about the internet not as a bunch of ones and zeros (bytes), but as a collection of things (photos, articles, posts, videos, graphics, infographics, PDFs, etc).

Typically, you might spend a lot of time crafting an article that includes a bunch of text, a few images, an infographic, and maybe some links. You think of the article as the unit of transfer – the product produced and distributed. This is a holdover from the previous generation of media (magazines and journals).

But what if the pieces were as valuable as the entire article? For example, let's say you have a set of instructions on how to make something interesting. A headboard, for example. You will write the instructions out and annotate it with a series of instructive photos describing each step. To you, the information, as defined by this collection of text and images, is the thing. Except, the final image is really pretty. It allows people to see the outcome and mentally project it on to their lives (or, in this case, in their bedroom). To them, the final picture is the thing, with a bunch of semi-interesting text and explanatory images along for the ride. The picture of the dessert is far more important that the recipe. The picture of the dress is more important that who makes it (but not who sells it, as many retail brands are finding that Pinterest is a more effective channel for sales that Twitter or Facebook). 

Think about it. The information needed to create something isn't as important as the marketing tool wrapped around it. That is the thing that Pinterest trades on. So people see the image and pin it to their board (it's like “Liking” something on Facebook, but allowing the user and their fans to see all the related likes in one place). Beyond that, other users (via searching or via networking) see the image and may choose to like the image as well.

This is Pinterest: A very visual array of ideas grouped by a user to collect inspirations on given topics. 

If you're confused by my examples (headboards, desserts, dresses), then you don't know the audience for Pinterest (whether it was the intended audience or not). Depending on the source of information, Pinterest's users are 68-97% female. What is successful on Pinterest is very pretty, very cute, very clever, or very funny. The marketing piece (the final product, the lavishly-designed graphic, the snarky line) trumps the supporting content. If you want your material pinned, you had better have a gorgeous photo or killer infographic.

So what does all this mean to pharma? Based on the meager existing pharma usage of Pinterest, it's very hard to say. Like all social media, the tool is designed to facilitate conversations between people, a conversation that might sound like "I like this thing, and you might, too." Despite the value that pharma brings to people's lives, there isn't much activity on the boards. For example, a search for the enormously popular Viagra leads to seeing three pins: one bottle image, one ad, and one picture of red pills forming a heart. A search for Paxil shows roughly 20 pins, where Paxil is as likely to be used as code for "chill out" as in a professional frame. And searching for Nexium shows far more pins for "natural alternatives" and online pharmacies than anything the industry might consider useful or productive.

From the other side of the fence, Bayer US's Pinterest page (53 pins currently) is filled with advertisements for its business, sustainability, innovation and education initiatives. The only brand shown is for pet med Advantix.

We can see that Pinterest may not be an obvious channel for pharma. It is open (people can comment freely and re-purpose a pharma pin onto a board of any name they choose), it is conversational, and it is very visual. These are traits that do not lend themselves to pharma.

That said, there is a massive community here (mostly younger and female). If we look at the example of NuvaRing (female contraceptive), there aren’t many pins, but almost all of them are serious or informational in tone. Clearly, the audience here understands the value of this product to both themselves and their peers. The question is: will Pinterest become the way women talk to each other about this brand? That remains to be seen.

[digital-pharma-blog]

Your eLearning Video Is Missing 40% of Its Audience

You have a great eLearning program. No, really. I can see every dollar you spent on getting that KOL on film with a killer script that nails your message. The camera work and editing is spot-on. The coding work you did to build a custom interface is delightful. The website is fast, clearly laid out behind a login, and it even remembers which videos I've watched and where I left off last time. Excellent stuff. Kudos to your agency partners for putting it together. I bet you get great traffic, and that everyone involved got a nice pat on the back when it came time for their annual reviews.

There’s just one problem. It might as well not exist on my phone.

This is unfortunate, because I get all my email on my phone, and you guys send me emails all the time. They practically beg me to click on the link and watch the video, but when I do, I get a big grey rectangle. Or an error message (which is funny, because I didn’t do anything wrong). I wonder how much time and money you spent on that pretty video that is completely useless to me.

Suddenly I don't like your website anymore, mostly because it's built around encouraging me to watch a video I can't actually watch.

You've looked at your email metrics lately, right? You know that mobile devices account for anywhere from 40-60% of all email views, right*?

*[how do I know that? Because we have access to 29,000 Texas HCPs and we send them bi-monthly newsletters and that’s what our email metrics say.]

Have you looked at your web metrics? In particular, the percentage of mobile traffic to your site, and how it has grown at a near-exponential rate for the past year? That means that all those technical decisions you made only 12 months ago are kinda worthless now. Can you see how desktop traffic stays around and watches your movie, just like you want them to, but that your mobile traffic is almost all gone a minute after they show up? I bet you can (and if you can’t, I’m betting your web team can show you).

If you embrace the idea that mobile is here to stay (and if you’re reading this on a tablet or phone, I think you do), you need to understand how people use these devices.

Allow me to direct your attention to a study [http://go.ooyala.com/wf-video-index-q3-2011.html] that shows that tablet and phone users are more than happy to watch a ten minute video on these portable devices. The small screen is no deterrent. In fact, sitting on a train or waiting in line might be the only time your target has a chance to watch your epic video.

The problem isn't just the file format. It's not too much trouble to re-render the movie into some format other than Flash, but any interactions you’ve built in need to account for the fact that on a tiny screen, buttons need to be big and easy to use. And a mobile user is more likely to need that pause button. The rule of thumb, as described here [http://www.lukew.com/ff/entry.asp?1549] is that the smaller the screen, the smaller the slice of time the device works best at filling. When they start watching your movie in line at Costco, they may need to come back and finish it later. Not accommodating that behavior means that HCPs just won’t come back.

We've also seen that emails opened by phones tend to get opened sooner. We think it's because most people carry their phones around with them everywhere and are happy to check their email dozens of times a day, rather than checking their email a few times a day at home on the laptop.

So are you ready to embrace mobile and walk the walk? Just don’t walk while texting.  Will you go full-mobile to get your eLearning video seen by more of your target list? Yes? That’s what I figured.