Pharma Facebook Pages Being Phased Out: A Good Run While It Lasted! Did Facebook Kill the Beast?

August is the cruelest month, especially for pharmaceutical company Facebook pages.

No doubt you've heard that as of August 15, 2011, Facebook will be opening up comments on ALL pharma pages with some exceptions (listen to these podcasts: "Implications of Facebook's Page Commenting Changes: Turning Off Comments May Be a Problem" and "Pharma Facebook Commenting Changes: The 'Final' Story"). That means that the pharmaceutical industry will no longer be able to shut off comments on their Facebook pages. This has lead to speculation that many pharma FB pages will be shut down come August 15.

A couple of pharmaceutical companies have already taken down their Facebook pages or announced they will do so. These include Janssen's ADHD Moms page, which was the first pharma Facebook page, launched in June, 2008, by McNeil Pediatrics (see The Pharmaguy Social Media Timeline™).

"A new Facebook policy, scheduled for Aug. 15, will specifically impact communities that are formed to help people learn more about disease conditions, such as ADHD Moms™, which we sponsor," says a note on the ADHD Moms page. 

"This new policy will alter our ability to consider the appropriateness of comments before they are posted which is important to us as a company in a highly regulated industry." 

"As a result, our ADHD Moms%reg; community will not be available after Aug. 14. Additionally, as of Aug. 9, our Moments™ tab will no longer be available. We want you to know that we value the community formed on this page and this was a difficult decision, but necessary given the Facebook policy change. We apologize to anyone in our community who may be disappointed by this decision."

Sanofi-Aventis said it would discontinue its VOICES page, which became infamous when it was attacked by a "disgruntled" patient (see "Disgruntled Patient Shuts Down sanofi-aventis Facebook Page").

"Please note that we will be discontinuing the sanofi-aventis VOICES page, effective August 9. We would like to continue this conversation with you, so we ask that you go to the Sanofi US Facebook page to do so."

This marks a turning point in pharma social media. Janssen effectively abandoned 23,725 (more or less) people (including 28 0f my Facebook friends) who "liked" ADHD Moms. It offered no alternative to these people other than third-party resources. Sanofi-Aventis, on the other hand, directed its 859 friends (including 22 of my friends) to its Sanofi US Facebook page, which currently is liked by 360 people (including 11 of my friends).

On the Sanofi US Facebook page, the company states that "To comply with applicable Laws and regulations, we do not use the standard Facebook wall for discussion." It does, however, allow comments on a special "Discussions" page where it previewsthem before being posted. "Just a friendly reminder that all posts are being moderated to ensure they comply with our Terms of Use," said Sanofi.

I had problems finding the Terms of USe, so I posted a question asking where I could find them. I received a reply within 2.5 hours (see screen shot below). The time stamp is odd - I actually posted my question around 3 or 4 PM Eastern US, but the time stamp says 2:20 AM; perhaps my Twitter pal @jonmrich can explain this discrepancy. Another thing Jon might be able to explain is how come Sanofi can still have comments shut off on its wall?

Did the new Facebook policy actually cause these companies to shut down their pages? Janssen seems to put all the blame on Facebook whereas Sanofi seems to blame "Laws and regulations," implying government interference. Of course, there are NO federal Laws or regulations specifically prohibiting Sanofi or any other pharma company from using the "standard" Facebook wall for discussions.

Blaming Facebook or "Laws and regulations" for this reminds me of the final scene of King Kong where the beast is lying dead at the foot of the Empire State Building:

Police Lieutenant: Well, Denham, the airplanes got him.
Carl Denham: Oh no, it wasn't the airplanes. It was beauty killed the beast.

I think there are other reasons why these pages are being shut down -- (1) one (ie, ADHD Moms) may have outlived its usefulness, and (2) one (VOICES) may have been ill-conceived in the first place, giving no benefit to the company and having a tainted history. In these cases, it's just best to shut them down and move on.

Unfortunately, Janssen doesn't seem to have an alternative FB page. It just "abandoned" its 23,725 FB friends. In the scheme of things, this is not a big number considering that Janssen claims ADHD "impacts five million children in the United States, while nearly eight million adults have been diagnosed with the condition" (see here). 23,725 represents only 0.47% of the children's ADHD market. In other words, ADHD Moms was a dismal failure in terms of reaching this market - maybe.

Over the next few days I will maintain a vigil over the pharma Facebook death march. Help me by letting me know of other pharma Facebook pages that announce their demise.

Pharma Planet of the Apes!

Grady Forrer over at the Pharmaceutical Research and Manufacturers Association (PhRMA) blog laments that the new version of Planet of the Apes -- a movie I don't think he has actually seen -- does not jibe with reality (see Movie Dark Fantasy vs. Biopharmaceutical Reality).

"I do want to rail for a moment against the trite movie convention of the evil pharmaceutical company purposefully or negligently perusing research which results in harm to patients or, as in this case, humanity as a whole," said Forrer, who urges viewers to resume their disbelief after seeing the movie. I assume he means disbelief that science and the pharmaceutical industry can do harm. I'm all for that, up to a point.

Anyway, I thought Forrer's comments deserved a graphic that perhaps illustrates PhRMA's fear of how surviving humans might view the pharmaceutical industry's role in creating the NEW Pharma Planet of the Apes:

Two Doctor-Created Provenge YouTube Videos: Which One Would Dendreon Reps Prefer to Show Their Docs?

I read with interest today a Pharmalot post about Provenge after seeing this tweet from @jackbilson3: "Outstanding article & comments about Provenge from @pharmalot http://ow.ly/5XGzH".

Provenge is a "controversial and innovative Provenge prostate cancer vaccine" that Pharmalot says is experiencing problems because "many doctors, particularly those in smaller settings, were slow to adopt the $93,000 vaccine since they had to wait for reimbursement." Pharmalot interviewed one such doctor -- Leonard Liang, a Los Angeles urologist -- who gave his personal experience regarding reimbursement issues.

Of interest to me were the comments to the post in which "zuppy" accused Dr. Liang of bias because he owns stock in Dendreon, the company that manufactures and markets provenge. "zuppy" stated:

"I think it should be noted that Dr. Liang has a record of contributions to the Investor Village DNDN Message Board, that clearly demonstrates his shareholding interests in Dendreon. As for the YouTube video released 1 August, 2011, I found it inappropriate that a practicising Urologist with a public display of shareholder interest in Dendreon, would create and put on YouTube a video featuring one of his patients being treated with Dendreon’s Provenge."

Dr. Liang admits he owns stock and said "I have never not disclosed this." However, Dr. Liang does NOT disclose this in his video, which you can see below (while it's still available):



It's a rather long video, but informative. In it, Dr. Liang makes a very good case for Provenge. I especially like how he describes what is meant by mean survival rates of Provenge (25.8 months) vs. placebo (21.7 months). "Another way to look at the data," says Dr. Liang, " is that your 3-year survival rate is going to be a lot better."

 Basically, Dr. Liang paints a rosy picture in his video, emphasizing the positive and adequately explaining the risks, which are mainly "flu-like symptoms that go away." Is Dr. Liang biased because he owns stock in Dendreon? Who knows. But he certainly is promoting his infusion business -- his YouTube channel (here) links to his web site, which promotes his practice.

Dr. Liang, however, is not the only doctor who has produced a Provenge YouTube video. Another doctor -- Gerald Chodak -- has a prostate cancer YouTube channel (here) that includes the following video about Provenge:



I don't know if Dr. Chodak owns stock in Dendreon, but he points out one very important problem with Provenge that sheds further light on the reimbursement problem:

"One of the things that is unusual about this treatment," says Dr. Chodak, "is that it has no effect on the PSA results and it has no effect on whether the cancer may progress to other parts of the body...And that can make it a little difficult to determine if a man is getting a good response or not."

The point is that if it can be figured out who is NOT responding during treatment, the expensive Provenge infusions ($31,000 per pop) can be halted and other treatments tried. Obviously, payers are reluctant to pay for something that may not be working.

Anyway, I find it interesting that doctors like Dr. Liang and Dr. Chodak are producing videos that promote specific brand name products. My questions are:

• Can/should Provenge sales reps of Dendreon marketers provide urologists with links to these videos? Would FDA have a problem with that? 


• And which video do you think Dendreon sales reps would choose to share with their potential clients? Dr. Liang's of Dr. Chodak's?

Pharma Tweets: Followers Trump Content. Pfizer vs. Sanofi Case Study

Everyone is tracking how the pharmaceutical industry uses Twitter and other social media. Jonathan Richman maintains the Pharma and Healthcare Social Media Wiki, which lists dozens of Twitter accounts (no rankings, although Jonathan does give out awards). EyeOnFDA Blog maintains its TWANK! Pharma Twitter Rankings, which is ALL about numbers, especially followers. And I maintain the Pharmaguy Twitter Pioneer list (see here).

None of these compilations says much about the quality of the content (ie, Tweets) pushed out by these sites. Some include 3rd-party measures such as Klout scores. But Klout is a poor barometer of how well pharma tweeters ENGAGE in conversation via social media. To demonstrate this, I compare recent tweets from @Pfizer_news ("The official site for Pfizer Inc., where we apply science and our global resources to improve health and well-being at every stage of life. I'm Jen Kokell, GMR") and @SanofiUS ("The official Twitter feed for Sanofi US. Tweets on news, updates, and other info come from Jack Cox and Stacy Burch. Intended for U.S. audiences only").

I picked these two because my friend @AndrewSpong posted this in today's #hcsmeu Twitter chat:

"despite only having been active since Jan '11, @SanofiUS has published nearly twice as many tweets as @pfizer_news"

To which @rohal responded:

"number of tweets is not a measure for effectivity of comm, quality of perception and understanding is!"

Sometimes marketers say "communication" when they really mean "messaging" or "marketing," which is one-way communication. By now social media should have changed what we all mean by communication; ie, two-way conversations. It would be interesting to measure this aspect of Pfizer's and Sanofi's Twitter accounts.

Before I do that, let's look at the numbers:

@Pfizer_news

• Followers: 17,705


• Follows: 2,078


• Tweets: 487


• Klout score: 51

@SanofiUS

• Followers: 1,728


• Follows: 1,676


• Tweets: 891


• Klout score: 46

Except for tweets sent, Pfizer beats Sanofi hands down in this numbers game -- although I am amazed that the Klout scores are relatively close considering that Pfizer has TEN TIMES the number of followers than does Sanofi. I am on record questioning how Pfizer obtained all these followers. It boosted its number of followers by about 3-4,000 in just a few days around Christmas 2009 How Did Pfizer Get So Many Twitter Followers?.

Since then, I've heard that Newt Gingrich has been paying to get fake Twitter followers (Gawker received a tip from a former staffer, saying that Gingrich had paid firms to create fake Twitter followers; search company PeekYou analysed his follower list, and found that 92% of them were dummy accounts. Adding insult to injury, PeekYou added that Gingrich's percentage of real followers was "the lowest we had ever seen"; see story here).

I'm not saying that Pfizer did this, but it would interesting if someone analyzed its Twitter follower list and other pharmaco Twitter follower lists.

For my case study, I merely compared 20 of the latest tweets from @Pfizer_news and @SanofiUS to see what was different about them (find my list here).

Here's what I learned:

Self-serving Tweets: 60% of Pfizer's Tweets (12 out 20) were self-serving in that they referred back to Pfizer press releases, blog posts, etc. The tone is overtly NON-CONVERSATIONAL; eg, "Pfizer did this...", "Pfizer did that.." as in "Positive top-line results for Pfizer’s Lyrica in Phase 3 study of patients with fibromyalgia in Japan on.pfizer.com/ntYymj" (there's a tweet FDA should take a look at!). In contrast, I found only 1 self-serving Tweet among Sanofi's last 20 Tweets (5%). If I met Pfizer_news at a cocktail party, I would find any excuse to run away! (Note: Whenever I meet Jen Kokell at conference receptions, however, I look for excuses to stay put!)

Retweets: Retweeting is usually a good measure of "conversation" vs. "communication" in Twitterdom. @Pfizer_news's Tweet stream did not include a SINGLE RT, whereas Sanofi's included 13 (65%). I did not include one RT that retweeted from another Sanofi account. An example of a Sanofi RT: "RT @andrewspong How do we achieve equality for patients with rare diseases? http://bit.ly/pA4bdb | pharmaphorum #rarecare #hcsmeu #hcsm" Not only does Sanofi RT, but it adds hash tags, another indication that it engages in conversation rather than one-way communications.

Hash Tags: Use of hash tags is another good indicator of how well a company engages in conversations via Twitter. Eight out of 20 (40%) of Sanofi's tweets included one or more hash tags, whereas only 2 (10%) of Pfizer's tweets included a hash tag.

Klout may or may not look at these things when computing a score for Twitter accounts. If it does, then IMHO Sanofi's score should be MUCH higher than Pfizer's. But I think the numbers still outweigh the relevance for Klout and even for industry pundits; ie, Followers trump Content!

In the old days of Web 1.0 the the adage was "content, content, content". Today, in the social media Web era, it appears the NEW adage is "numbers, numbers, numbers." It's a shame.

Is Over-the-Counter Lipitor in the Cards? One year's sales could cover original R&D costs!

The Wall Street Journal (see here) reports that Pfizer is considering seeking approval from the FDA to sell Lipitor over-the-counter (OTC). Although OTC sales of Lipitor are likely to be only a fraction of the the annual $10 billion in global Lipitor sales currently enjoyed by Pfizer, OTC Lipitor may generate up to $1 billion in annual sales. That's almost enough to cover the original costs of bringing Lipitor to market in the first place; that is, if you accept the industry's estimate of $800 million to $1.2 billion as the cost of development for an Rx drug.

How did I estimate the annual sales of OTC Lipitor? I used the Claritin Rx-to-OTC switch as a model. According the the WSJ article:

"Merck's Claritin OTC generated $401 million in sales for 2010. In comparison, annual sales of the prescription version of Claritin once exceeded $3 billion before the drug lost U.S. patent protection nearly a decade ago"

$3 billion in 2000 dollars is worth about $3.9 in 2010 dollars. Therefore, $401 million represents about 10% of pre-OTC income. If the same OTC/Rx sales ratio holds true for Lipitor, Pfizer can potentially sell $1 billion worth of OTC Lipitor in the first year (keep in mind that Claritin treats seasonal allergies and sales probably spike in the spring, whereas Lipitor sales would be sustained all year long).

But it is unlikely that Pfizer will depend entirely on OTC Lipitor sales to maintain this all important anti-cholesterol brand. It may do what Merck did after Claritin went OTC, which was to develop a new Rx formulation of the drug; ie, Clarinex.

Is Pfizer currently working on a new formulation for Rx Lipitor? I have no idea. It did, however, fail spectacularly to bring a new anti-cholesterol drug (torcetrapib) to market in 2006 (see "torcetrapib: '$800 Million' Failure but Kindler Safe"). Perhaps, after recent cutbacks, Pfizer no longer has the R&D resources to be as innovative as it once was.

One other thing to consider is this: the WSJ articles points out that Merck has been unsuccessful in its attempt to switch its anti-cholesterol statin drug Mevacor from Rx to OTC. FDA shot them down 3 times. The argument against OTC statins such as Mevacor (and presumably Lipitor as well) is that these drugs can be highly toxic to the liver if not used properly and require periodic blood tests to monitor such problems.

Adding to the debate is a benefit/risk analysis of statins based on a little-known but useful statistic, the number needed to treat. You can read more about that here: "The Statin Lottery: Number Needed to Treat Statistic". According to Dr. Jerome R. Hoffman, professor of clinical medicine at the University of California at Los Angeles, people could do as well dieting and exercising to lower cholesterol while avoiding the cost and potential side effects of taking a statin every day. BTW, people pay out of pocket for OTC drugs that were covered by insurance when the drugs were Rx. Those costs could exceed copays.

I note with interest that Pfizer is currently in the middle of a direct-to-consumer (DTC) advertising campaign that disses diet and exercise as a way to lower cholesterol; see "New Lipitor Ads Dis Exercise & Healthy Diet. Are You Kidding Me?". I wonder if the target of this ad campaign is the FDA rather than the general public? Hmmmm....

[This post originally appeared in Pharma Marketing Blog. 

Make sure you are reading the source to get the latest comments.]

FDA Intern & the Quest for Social Media Guidelines

There have been many theories attempting to explain why the FDA is dragging its feet in developing social media guidelines for the drug industry (see, for example, "FDA, DOJ, & Google: Conspiracy Theory, Part 2"). Whatever the reason, financially strapped and under staffed, FDA clearly needs help. To get this help, does the FDA plan to pull in any outside consultants, hire additional experts internally, or approach the drug industry itself to help craft the guidelines?

I learned that FDA Intern, strange visitor from an Ivy League school who came to FDA with powers and ability far beyond those of FDA Commissioner Margaret A. Hamburg or even former FDA commish Andy von Eschenbach, has actually been on the case, attempting to get FDA moving on developing social media guidelines!

FDA Intern! Who can change the course of mighty clinical trials, approve drug ads faster than a speeding bullet, jump through Congressional Subcommittee hoops of fire and ire, and who disguised as Emily Jameson (no relation to Jenna Jameson), mild-mannered intern for a great regulatory agency, fights a never ending battle for fast-track drug approvals, pharmaceutical company user fees, and the FDA way!

Let's join FDA Intern in her latest adventure:  

FDA Intern & the Quest for Social Media Guidelines

Alas, boys and girls, the FDA is not going to get any help from Pfizer's "Playbook." For more background & fun summertime reading, enjoy these previous Pharma Marketing Blog posts:

• F**k the FDA! Drug Industry Should Issue Self-Regulatory Social Media Guidelines!
• Citizen Petition Filed by Pharma Likely to Delay Indefinitely the Issuance of FDA Social Media Guidance
• Is This Pfizer's Social Media "Playbook?"
• Pfizer Asks for New FDA Regulations, Not Guidance, for Social Media

[This post originally appeared in Pharma Marketing Blog. 
Make sure you are reading the source to get the latest comments.]

Point-of-Care Pharma Marketing: When Is It Appropriate?

In the world of smartphone apps for physicians, Epocrates plays a leading role. The Epocrates iPhone app is free (with a $99 PREMIUM upgrade option) to physicians -- and anyone else -- who can use the app to find information on drug dosing, interactions and insurance coverage while seeing a patient. According to a New York Times article (see here), 70% of Epocrates' revenue comes from pharma point-of-care advertising; ie, messages from pharma advertisers that pop up as "DocAlerts" when the app is used to look up drugs, etc.

Some docs complain about the messaging, claiming they don't have time for that "nonsense." A few reviews on the iPhone app store suggest this is a common complaint:

"why must I be badgered with your alerts?"

"Paid for 'premium' subscription, getting nagging pharma clinical alerts that are rarely useful. Alerts don't go away unless you tap through them. If this is the case, should be free app."

According to the NYT article, "Epocrates is betting that the 320,000 physicians who use its apps, much like those who use Google and other advertising-supported data services, will tolerate some marketing to get the information they want at no charge." However, unlike Google, ads delivered directly to doctors while delivering care can have a much greater influence over their prescribing. If you are of the opinion that advertised drugs are usually more expensive and sometimes less safe than generics, then pharma paid DocAlerts (ads) are not in the best interests of patients and payors.

For pharmaceutical manufacturers, Drug information apps such as offered by ePocrates and ePrescribing may offer a new channel to influence physician prescribing at the point of care. “The beauty of the work we do with Epocrates is that we literally put ourselves in the palm of their hand,” said Dr. Freda Lewis Hall, chief medical officer at Pfizer.

Being in the doc's palm is one thing, but interrupting his/her workflow is another. When is it appropriate to "interrupt" physicians with commercial messages at the point of care? There are several more or less disruptive ways to provide messages in apps at the point of care, including:

• Ads appear via a splash screen when doc turns on PDA, smartphone, or iPad. The message not related to any prescribing transaction.
• Specific targeted messages are "triggered" by doc's drug lookup choice, demographic, and/or prescribing history and designed to influence doc's prescribing decision.
• Non-targeted messages delivered before, during, or after the prescribing process.

Which do you think is most appropriate and why? Please take a few minutes to respond to my "Point-of-Care Pharma Marketing" survey (click here). After finishing the survey, you will be able to see a summary review of the results to date. No open-ended results that may contain personal information of respondents will be shown. Also, at the end of the survey, you will find links to these FREE Pharma Marketing News articles:

1. ePrescribing: What Role Should Pharma Play?
2. Ready or Not: Gearing Up for the Expansion of ePrescribing

Thanks!

[This post originally appeared in Pharma Marketing Blog. 

Make sure you are reading the source to get the latest comments.]