Jonathan Richman is a respected e-marketer and the author of Dose of Digital blog, in which he writes there is a Myth of Adverse Event Reporting in pharma marketing.  Drawing upon a Nielsen Study which found that only 1 in 500 postings on the Yahoo Health discussion boards met the full criteria for adverse event reporting, pharma may in fact be over-sensitized to the issue.

Do AER staffing requirements prevent social media dialogue?

Assuming that the Nielsen study is statistically significant (is a sample size of 500 from Yahoo sufficient?) then what resources would be required to audit a message board with high volume traffic?

Example 1: ADHD Message Boards

ADHD Message Boards is a site devoted to the discussion of attention deficit and hyperactivity disorder. A particularly popular forum is Parents of ADHD Children with 105,938 posts as of July 2009.  Applying the Nielsen metric of 1/500 would yield 211 reportable adverse events.

Assuming an AER auditor could review 2 messages a minute, auditing this board would require 882 person hours – or 110 person days – over the life of the board. This would be an almost full time job were it not for the fact that ADHD Message Boards do not feature personally identifiable information (curiously, the site lacks both a privacy policy and a terms of use statement) so any reporting obligations on this site would be obviated by lack of an identifiable patient and identifiable reporter.

What about social media sites with identifiable information?

Facebook, however, is a completely different story, with members’ identifiable information including a first and last name, an email address, and often a phone number on the user’s “info” tab.

Example 2: ADHD Moms on Facebook

As of July 2009, McNeil Pediatric’s ADHD Moms page on Facebook counted 8,505 members.  Assuming 1 post per member multiplied by the “Nielsen coefficient” would yield a possible 17 adverse events, requiring 70 person hours – or 8.8 person days – of monitoring.  Of course not every member would post, and some members would post more than once, so these estimates are just back of the envelope calculations.  This scenario is staffable.

It’s a matter of appropriate dialogue

Richman’s blog post suggests that “adverse events are nothing more than negative reviews” and compares them to reviews for computer products.

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.

I would agree with him, but only up to a certain point. When making a purchasing decision for a discretionary product, I am willing to accept that “Dave from Des Moines” or “Sally from San Diego” might be qualified to review a new piece of software or a computer peripheral.

But are they qualified to provide accurate information about prescription drugs beyond their own experience? Unless they are willing to also share their age, weight, lifestyle, diet and exercise regime, medical history and enumerate any other medications they are also taking, I say “no.” There are too many confounding variables for me to believe there would be much, if any objectivity.

Social media is merely an extension of direct to consumer advertising

Television viewership is down.  Newspaper and magazine readership is down.  Follow the eyeballs and you end up on the Internet.  DTC spending was down 18% last year. Follow the money and you find a lot of people scrambling to recapture a portion of that DTC spend by reallocating budget to social media.  There’s some great work out there done by stellar agencies, but…

• Do you really want to hear tweets from a race car driver about Rx drugs?
• Do you really want to hear one mother’s opinion about an ADHD drug without the back story that her kid drinks 3 sugary colas and eats 2 candy bars a day?
• Or wouldn’t you prefer to learn about your insulin from video featuring method of action and patient testimonials?

Social media is merely a platform, not an ends onto itself.  So while Richman may be on to something with his “myth of adverse event reporting” the real question remains:

What evidence is there that patients want a dialogue with a pharmaceutical company given their lack of trust in the industry at large?

Listening without engaging may not be glamorous.  It may not recapture the entire DTC spend. But given the recession, $80 Billion in concessions to the federal government, and the need to maintain a low profile until health care reform legislation is hammered out, what’s wrong with using social media as a distribution platform and skipping the public dialogue altogether?

What this means for your digital marketing initiatives

The Pew Internet & American Life Project reports that 61% of American adults look online for health information and continue to deepen their engagement with the online world.

• 41% of e-patients have read someone else’s commentary or experience about health or medical issues on an online news group, website, or blog.
• 24% of e-patients have consulted rankings or reviews online of doctors or other providers.
• 24% of e-patients have consulted rankings or reviews online of hospitals or other medical facilities.

Social networking sites are used only sparingly for health queries and updates

• 39% of e-patients use a social networking site like MySpace and Facebook
• 12% of e-patients use Twitter or another service to share updates about themselves or to see updates about others

Group 8020 suggests: Given the lack of FDA guidance for pharmaceutical, biotech and medical device manufacturers looking to engage in social media, this sparse interest is not surprising.  It does provide health care communicators with guidance, however, on allocating budget for social media marketing until such regulatory guidance is provided.

Positive self-help

• Half of all online health inquiries (52%) are on behalf of someone other than the person typing in the search terms.
• Two-thirds of e-patients talk with someone else about what they find online, most often a friend or spouse.

Online health inquiries have an impact on decisions or actions and there are clearly more positive experiences than negative ones. Fully 42% of all adults, or 60% of e-patients, say they or someone they know has been helped by following medical advice or health information found on the internet. This represents a significant increase since 2006 when 25% of all adults, or 31% of e-patients, said that.

Group 8020 suggests: Health care communicators may want to focus greater effort on the tools associated with sharing – “forward to a friend” links for example – to give existing content greater reach.

Exercise and fitness are hot

The percentage of American adults getting exercise and fitness information online has jumped from 21% in 2002 to 38% now – an 88% growth, a more rapid increase than any other health topic covered in the survey.

Group 8020 suggests: While the focus on fitness may be attributable in part to the recession, brands with a lifestyle story to tell would be well-advised to trot that content out.  Consider creating a YouTube channel of repurposed materials.

Mobile drives digital consumption

Wireless connections are associated with deeper engagement in social media and an accelerated pace of information exchange. adults between the ages of 18 to 49 are more likely than older adults to participate in social technologies related to health.

Group 8020 suggests: Asking your agency to validate your digital content for mobile browsers like iPhone’s Safari and Blackberry’s Web Browser.  The incremental cost to remedy any mobile access issues are minute compared to the gains you’ll achieve in engagement.

Links:

• Download the full report “Health, Mobile, Web 2.0 : The Social Life of Health Information” from Pew Internet [opens PDF in new window]
• Survey questions and methodology

A lunch with Gene Faba, President Volvox Motion

This week’s Pho Friday with Gene Faba – a lunch event where experts in the business swap wisdom for noodles – highlighted the problems of any executive trying to manage a video production line item in their budget. 

• What should you expect to pay per finished minute?
• When should you always try to save money?
• When should you never try to save money?
• When should you consider print?

Gene has more than 20 years in the business, much of it in the pharmaceutical promotion side.  He helped launch Xanax and pioneered a production process that made footage serve triple duty.  From that experience and the war stories that go with it came some take-away messages that may help you:

What should you expect to pay?

For customer-facing media a minimum of  $1,000 per finished minute for anything you’d put your name on. Good lighting and great audio will make a huge difference and are the foundation for any quality piece. Expect to pay more as  you add effects, shooting locations, actors, graphics, etc.
 

When should you always try to save money?

When you are communicating information that employees want to know or at least understand why they should know it.  The goal is clarity and that can be done inexpensively.

When should you never try to save money?

When messages must convey an emotional payload.  When you must inspire, awe or change a behavior or impress, you need great production value.  

Audiences will compare your message to contemporary film and television.  You need to use techniques like analogies, examples, testimonials, a judicious use of graphics, and an inspiring soundtrack.  Only attempt what you know you can fulfill.  Consider a shorter running time by focusing your message, to make available dollars sparkle brighter on the screen.

When should you consider print?

Not every project is well-suited to a video execution.  When you have a great deal of factual information where visuals support but do not carry the lead you may be better off looking at print, including PDF. 

Dessert

Our lunch wrapped with a war story about choosing between a company based upon low price alone, or moderate price plus experience.  In this case it had to do with a New York shoot on a night which all the weathermen had agreed would be pleasant.  Except for the 4 inches of rain that Gene and his crew experienced. 

"It’s why you always put a weather contigency in the budget.  Your client knows that if all goes well you’re coming back with a 10% refund in hand. But if Murphy pays you a visit and the unexpected happens your client is still covered.  You’ve planned for the unexpected.  You’re covered.  And  you’re still on budget."

I agree that there is value in knowing all that can go wrong and planning for it.  I also agree that it’s difficult to know when and where to save budget dollars. The take away message here is that only by listening to vendors closely can you hope to tap their experience.  The good ones may even tell you when they’re not needed.

Links: Volvox Motion (Flash Plugin Required)

There are two ways to explain almost anything: simply or with great complexity. Ironically the former takes more intellectual horsepower than the latter. An example: Suppose you were asked to brief your boss on “Content Management Systems” for the web. You know, the powerful back ends of electronic publishing that contemplate work-flow, versioning, archiving, syndication and all the necessities of corporate communications.

Demystified:

“A content management system is really just a way for us to separate content – the words we write and the images we create – from their presentation. This is an advantage for us because it means whether a customer looks at us on the web or on their mobile phone, they are presented with information perfectly formatted for the way they’re looking at it. Because content and presentation are separated, we can use a lot of our existing management processes already in place to determine who can create, who can edit and who can publish to the web.”

Detailed and Complex:

“A CMS system usually consists of a web server like Apache (though I.T. will want us to stay with Microsoft II), a database like SQL or Oracle, and an authoring environment. We can use Vignette, but I think we should leverage our Documentum investment. Although there’s a lot to be said for Interwoven. We create a series of templates, one for news releases, another for product information, and yet another for our e-commerce initiatives. A template is chosen for the given task and then one of our people populates it with text and images from the media library. We send the draft through a review process and ultimately push it live to the web. It’s great.”

The detailed explanation has it’s advantages. It is more faithful to the technology and begins the process of specifying product. But unless you’re ready for that level of detail, it’s overkill. Simple is better. It frames issues from the listener’s perspective, not yours. It also allows for new information, such as your boss to say something along the lines of “well wait… we’re about to make some significant changes to our management process so I’m thinking…” The process of making the complex understandable and accessible is one part art and one part science. The art is in putting yourself outside of the situation… of having the self-confidence of possibly leaving out a detail. The science is in knowing what can be safely left out. Give it a try the next time someone asks you a tech question.

When I remodeled a 3-story townhouse in Washington DC it was quite the learning experience. Beyond the mystery and amazement that transpires when you open floors, ceilings and walls in a 100-year old structure, nothing prepared me for my general contractor. He was a good guy and he ran a good crew. He had won awards all over town and knew how to pull a permit in a difficult town (think Mayor Marion Barry). But he was a product of his industry and if someone had just told me what to expect I would have been so much happier. I wish I had know about the likelihood of cost-overruns. Or how to deal with no-show plumbers. Or a dozen other "little things." The truth is only someone who has been through it can tell you what to expect. So when someone in a high-ranking corporate communications job called Group 8020 "the Bob Vila of New Media" it resonated. We do in fact tell you what to expect and how you can make the budget work even if your copper pipes do need replacing. How to move line items around in a budget and still make it balance. If Bob Vila had paid a visit to my old house my pulse would have lowered, blood pressure dropped, and I probably would have finished the job sooner. Not that I’m complaining. For every $1 that I invested I got $3 back at closing. But why suffer? Whether a house or a video or a new media project, why suffer?