Is There an Upward Career Path Within Pharma for Social Media Pioneers?

I just tweeted this bit of news: ".@Alex__Butler - 1st recipient of Pharmaguy SM Pioneer Award - leaves J&J to start online comms agency: @The_Social_Moon #hcsmeu #hcsmuk" Alex received the FIRST Pharmaguy Social Media Pioneer Award last year when he was Digital Strategy and Social Media Manager at Janssen UK (see "First Pharmaguy Social Media Pioneer Award Given to Janssen's Alex Butler"). His pioneering work was the Psoriasis 360 Facebook page (see "Markets as Conversations: Can You Have a Discussion with 'Psoriasis 360' on Facebook?").

At that time, I presented the following chart showing how readers of Pharma Marketing Blog voted for a list of nominees:





Since then, several people on the list are no longer employees of pharmaceutical companies. Aside from Alex Butler, the "dropouts" include Marc Monseau, Shwen Gwee, Len Starnes, Gary Monk, and Michael Parks.

This year, I put together a list of seven contenders for the 2nd PharmaGuy SM Pioneer Award (see"2nd Annual Pharmaguy Social Media Pioneer Award Goes to..."; vote for your favorite). This year's list is considerably SHORTER than last year's! Included on the current list are:

• Craig DeLarge, Novo Nordisk 
• Tony Jewel, AstraZeneca 
• Ray Kerins, Pfizer 
• Kevin Nalty, Janssen 
• Brad Pendergraph, Novartis 
• John Pugh, Boehringer Ingelheim 
• Dennis Urbaniak, Sanofi

I sincerely hope that I am not jinxing people by including them on my list of award nominees!

Seriously, however, are we witnessing an exodus of SM pioneers from pharma similar to the exodus of interactive pioneers back at the turn of the century? That last exodus presaged the infamous "dotcom" bust. Perhaps the current exodus presages a similar setback for the interactive industry. In any case, there now appears to be a glut of independent social media communications "agencies" out there as these people set up their own shops. Not all of them will be successful, unfortunately.

Just coincidentally I came across this article in the Philadelphia Inquirer: "Rating Pharma on the Steve Jobs Checklist," which attempts to assess if the pharma sector follows Steve Jobs' principles. The relevant section is this (I highlighted in bold text the most relevant section):

• Don't waste your time living someone else's life

Jobs' reflections on his own mortality led him to an insight reached by Jean Paul Sartre and other philosophers. Man's knowledge of his inevitable demise, something no other animal possesses, provides the spark for understanding one's purpose. Since our time on earth remains limited, none of it should be wasted on inauthentic pursuits.

Among the modern industries, a high percentage of pharma's professional workforce began their careers as a result of an individual passion and a sense that their organizations encouraged personal contributions from them. During the recent years of downsizing, however, the sense of alienation among the industry's workers has grown considerably. Critical thinking, for example, has dissipated in an atmosphere where companies encourage narrow vision, smaller steps, and timid acquiescence to innovation-killing lawyers and soul-chilling finance managers.

Could it be that SM Pioneers inside pharma are feeling "alienated" within their companies, which no longer need their "critical thinking"?

I have often heard from my colleagues who work inside pharma sentiments that support the feeling of alienation in the wake of mergers. These people have often praised my "critical thinking" on issues -- ideas that they themselves would love to espouse if only they could and also keep their jobs.

Let me end with a personal note I just received from Alex Butler:

“The time has come for me to hand the shirt [symbol of Pharmaguy SM Pioneer Award] on to a new recipient, I doesn’t seem like a year ago I was awarded the Pharmaguy award with the famous Hawaiian shirt by John. So much has happened, the landscape has changed tremendously in that short 12 months. I always believed that social media and digital technology has the capacity to revolutionise healthcare, I think we can start to see what the possibilities could be. Whether it is the ability for people to bring their data together to change a civic culture and place translational medicine on fast forward, or simply giving people a greater voice and a chance of informed partnership in the management of their health.

The new economy in pharma companies will be the passionate dedicated people who are prepared to change not just tactical implementation of ‘social platforms’, this does not make a social business. I have been very proud to work in pharma for over a decade and very proud to work for J&J. I am sure the new Pharmaguy pioneer will have the same passion and hopefully will inspire more people within pharmaceutical companies to open up the research and development, clinical trial recruitment and management right through to communications and the broader relationship pharma has with the outside world. We can also develop a new more successful marketing model. I congratulate the winner and look forward to another 12 months of social business development in pharma.”

More Pharma Twitter Chats: Medicare is Topic

The Campaign for Modern Medicines (@Modernmeds) and Eli Lilly & Company (@LillyPad) will host two separate Tweetchats on Medicare Part D to "help raise awareness on the value of the current system, and to learn how to prevent potential changes to it." As reported by PhRMA in a blog post (see "Join the Chatter on Medicare"), "the first chat will be held on Thursday, Oct. 13th from 4-4:30PM EST, with Bart Peterson, Sr. Vice President of Lilly Corporate Affairs & Communication" and the second will be held on Wednesday, Oct. 19th at 9-9:30AM EST "to share your thoughts on the economic implications of proposed changes to Part D, with President of Lilly USA, Dave Ricks as host." Join the conversation using the hash tag #mmeds.

The latter chat is a milestone because it is the first time ever that the president of a pharmaceutical company will host an open Twitter chat.

Recall that the first ever PHARMA Twitter chat was hosted by Astrazeneca in February, 2011 (see "OMG! AstraZeneca Hosts Twitter Chat & World Does NOT End!"). The subject of that #rxsave chat was how to "raise awareness about helping patients save money through prescription savings programs." The discussion was led by Jennifer McGovern, the director of the AZ&Me prescription savings programs.

Eli Lilly is on a campaign to block any changes in Medicare that implement price controls in the prescription drug payment section (Part D) of Medicare. "A new congressional super committee has been charged with raising the debt ceiling and eliminating more than $1 trillion in spending by the end of the year," noted Lilly's Amy O'Connor -- Associate Consultant, Channel Payer Marketing, Managed Healthcare Services; @ambro93 -- in a blog post (see "If It’s Not Broke… Preserving Medicare Part D"). "One of the current proposals includes instituting a Medicaid-like government price control in Medicare Part D."

What Lilly and other pharmaceutical companies are concerned about is a proposal to add Medicaid-style rebates to the Medicare Part D program that has been introduced in Congress by Representative Henry Waxman (D-CA) and Senator Jay Rockefeller (D-WV). The proposal (S.1206 - Medicare Drug Savings Act of 2011) would require drug manufacturers to provide drug rebates for drugs dispensed to low-income individuals under the Medicare prescription drug benefit program.

Meanwhile, a congressional deficit-reduction panel has a Nov. 23 deadline on what cuts, if any, to make to Medicare, Social Security, Medicaid and other entitlement programs.

Thus, there is an ad hoc coalition of industry and senior citizen groups (ie, PhRMA and AARP) opposed to changes in Medicare: the industry doesn't want to see rebates and seniors don't want to see cuts to benefits or raising premiums.

@lilypad tweeted: "Hope you can join @Modernmeds for a Twitter chat on #Medicare tomorrow [ie, TODAY] at 4:00. Ask questions now via #mmeds"

As of now there are no pre-chat questions on the #mmeds list, so I will ask a few that address ideas for keeping Medicare solvent aside fro instituting rebates. such as:

"What's Lilly's position viz-a-viz republican proposals to privatize Medicare or raise premiums for higher-income seniors?" Another question I have is "To reduce the deficit, should the gov't raise the age of Medicare eligibility to 67 from 65?"

I encourage readers to ask their own questions and join the chat later today.

Without Free Gifts from Pharma to Docs, Would Research be Useless?

In a recent blog post (here), PhRMA said "Without Promotion Research will be Useless." To support its case, PhRMA cited "an interesting opinion editorial" in the latest edition of the Annals of Emergency Medicine – the medical journal of the American College of Emergency Physicians (ACEP). In the op-ed, entitled "Limiting Gifts, Harming Patients," Emory University economist Paul Rubin, Ph.D. expressed concern that ACEP policy regarding Gifts to Emergency Physicians from Industry "could have the unfortunate effect of limiting the exchange of critical information between medicine makers and physicians about the benefits and risks of new medicines, how to use them properly and how best to diagnose the right candidates for particular treatments."

Basically, Rubin and PhRMA are saying that gifts to physicians are an integral part of promoting new discoveries to physicians and without these gifts and promotion, medical research would be "useless."

I haven't read the op-ed piece because it cost about $32 to download the pdf file for 24 hours! Highway robbery is all I have to say about that! I did, however, request a complimentary copy, but haven't received any response yet. No matter. The op-ed piece obviously is attacking ACEP policy on the subject of free gifts to emergency physicians. You can find that policy here.

What's so onerous about the ACEP policy that an op-ed piece would attack it as "harmful to patients" and PhRMA would claim it renders research useless?  I looked at the policy to learn first hand why it's research Agamemnon.

First, the ACEP policy does NOT make ALL gifts to physicians from pharma unacceptable by their members. Here are gifts ACEP says are perfectly acceptable:

Emergency physicians may accept educational gifts that are not of substantial value ($100 or less). Examples include:

• Occasional modest meals in an office, clinic, or hospital setting that accompany an educational presentation 
• Evidence-based clinical care guidelines or pocket handbooks 
• Anatomical models designed for patient education 
• Informational materials to facilitate patient understanding of a disease or treatment

This sounds familiar. The PhRMA Code on Interactions with Healthcare Professionals says essentially the same thing. Code #11 states "It is appropriate for companies, where permitted by law, to offer items designed primarily for the education of patients or healthcare professionals if the items are not of substantial value ($100 or less) and do not have value to healthcare professionals outside of his or her professional responsibilities. For example, an anatomical model for use in an examination room is intended for the education of the patients and is therefore appropriate..."

The ACEP policy, however, cites examples of gifts that should NOT be accepted. These include:

• Meals provided for physicians or their family members, staff, or guests (other than modest meals accompanying educational presentations, as noted above)
• Personal or recreational items, such as tickets to theatrical or sporting events
• Direct subsidy of any expenses (such as registration, travel, lodging, meals) incurred in attending CME events or other educational or professional meetings (All industry support for such activities should be provided directly to the activity provider to offset program costs or to a general fund for continuing education programs.)
• Cash or cash equivalents such as gift certificates or vouchers
• Gifts offered in exchange for prescribing or using a product
• Medical equipment, such as stethoscopes or otoscopes
• Payment for token consultant or advisory arrangements
• Medical products for the personal use of the physician, the physician's staff, or family members

Again, PhRMA takes a similar stance. Code #3 states: "To ensure the appropriate focus on education and informational exchange and to avoid the appearance of impropriety, companies should not provide any entertainment or recreational items, such as tickets to the theater or sporting events, sporting equipment, or leisure or vacation trips, to any healthcare professional who is not a salaried employee of the company."

It seems tio me that Dr. Rubin could just as well criticized the PhRMA Code, which limits gifts to physicians, as being "harmful to patients." So, I am confused why PhRMA would cite Rubin's op-ed piece in defense of promotion being necessary for research success.

Of course, the drug industry is free to promote drugs to emergency and other physicians. There's nothing in the ACEP policy that limits access to physicians for promotional purposes. In fact, the policy states:

"The College also recognizes that emergency physicians should be free to interact with industry representatives if they choose, and that physicians may receive useful information about particular products from industry representatives. Emergency physicians may receive compensation at fair market value from pharmaceutical and biomedical device companies for legitimate professional services rendered, including participation in research and service as faculty in continuing education programs."

What PhRMA and Dr. Rubin should have focused on is the role of "promotion" in general and not the free gifts to physicians straw man. Rubin, for example, says that "Research and promotion are merely 2 sides of the same coin," which is a more rational point of view that deserves a bit more analysis.

What PhRMA and Rubin are claiming is that pharmaceutical companies need to have the freedom to promote new medicines to physicians (and "maybe" consumers too, says Rubin) in order for research to have a successful commercial outcome. I can agree with that. But are gifts to physicians really necessary to achieve that outcome? I don't think so.

There are many other ways for pharmaceutical companies to reach physicians with promotional messages, including social media (eg, Twitter posts). If a gift is required to get the message out about research, then pharma is in deep doo doo.

What's needed is NOT promotion. What's needed is true two-way communication. Without that kind of communication, research truly is useless.

The Pharma Marketing News article "Physician Participation in Peer-to-Peer Social Media Sites," which will be published on October 12, 2011 (free to subscribers; available here to everyone else for $4.95) speaks about what physicians want from pharma: users of online physician peer-to-peer communities want open and transparent participation by pharma and non-promotional information: “Give us the data, let us make up our minds, don’t try to spin me, I’ve got a rep who does that,” is a typical physician comment. “Make dialogue two-way, respect us, and focus on scientific exchange,” is another. Physicians are looking for negative findings also!

Some other information physicians want from pharma companies include:

• Drug pipeline information. 
• New information about product—not interested in being detailed, however. 
• Focus on topics like re-imbursement, patient education materials, etc.

So there's a lot more to "promotion" than detailing physicians after gaining access made possible by free gifts!

P.S. I finally did get a copy of Dr. Rubin's Op-Ed piece from ACEP. Thanks very much. The Annals of Emergency Medicine will publish a "rebuttal" to Dr. Rubin in the next few weeks. Meanwhile, here's my rebuttal:

After reading just the first three paragraphs of Dr. Rubin's op-ed, I am bowled over by his cherry picking of "the best evidence" (eg, 3 citations of the same author). Dr. Rubin also said that "the best evidence" indicates that ACEP's policies are "likely to lead to worse outcomes for patients." He did not cite any references to "the best evidence." 

Dr. Rubin's naivete regarding the FDA approval process is breathtaking. According to Dr. Rubin,  the FDA drug approval is "restrictive"; ergo "this means that we would expect that newer drugs would be better than older drugs. Because this is so [my emphasis], actions that lead to increased sales of newer drugs [eg, free gifts for physicians] would be expected to improve patient health." Whaaa? Dr. Rubin offered no proof -- eg, clinical outcomes -- that this is so. That did not stop him, however, from criticizing studies that find fault with pharma advertising because they too offered no real proof; ie, "clinical outcomes."

It doesn't take a PhD in economics to rebut Dr, Rubin's shoddy analysis. Even so, I can't wait to see the rebuttal to be published in the Annals of Emergency Medicine!

Update from Corporate Marketing Team

October 7, 2011.

Dear SpeakAsian’s

It has been quoted in certain sections of the online media that Mr. Sanjeev Dandona, has made a statement that is contrary to our business model.

We would like to state that this particular article is completely false and written with an aim of spreading misinformation about the company.

SpeakAsia has access to the written and signed statement of Mr. Dandona and there is absolutely no mention whatsoever of the statement that is mentioned in this article. Furthermore, the company has only been associated with Mr. Dandona only for the past 18 months and therefore it is outside our purview to comment on any issues that do not pertain our company or has been reported in the past.

We once again urge you to ignore such scandalous and misinformed information that are aimed at not allowing the company to re-start the operations at the earliest.

Warm regards

SpeakAsia Online Corporate Marketing Team.

In Memory of Steve Jobs Will Novartis Sales Reps Really Embrace iPads?

Pharmalot reported today that "In a memo this morning, David Epstein, who heads Novartis Pharmaceuticals, wrote that before the end of next year, more than 80 percent of the sales reps will give up their PCs and switch all detailing and related work to iPads.'' The memo, which can be found here, is reproduced below:

Posted on 9:52 AM, 06 October 2011
In memory of Steve Jobs - a role model 

"Today a great man has died - one who has forever changed the world. A great innovator, a corporate leader and a visionary who would not take no for an answer. A man who could perceive customer desire in a very clear way, marry it with technology and compel an organization to execute at the highest level to deliver customers a truly unique and compelling experience. A man I adopted as a role model as we began to galvanize our organization to launch Afinitor at a meeting of our Oncology leadership held in Mexico in 2008. 

"Ultimately, after a long fight, he succumbed to the ravages of PNet (pancreatic neuroendocrine tumor), a cancer for which Novartis now has two approved medicines: Sandostatin LAR and Afinitor. With Steve Job's death it is clear that we cannot rest as we work to discover, develop and commercialize still better medicines. It is medical intervention - great doctors, surgery, medicines and more - that allowed us to enjoy having Steve on this planet just a little bit longer so he could inspire a new generation and give us great inventions like portable digital music, the iPhone, the iPad and iCloud. 

"In his memory we commit today that more than 80 percent of Novartis Pharmaceutical field forces around the world will give up their PCs and be executing their call planning, detailing, emailing, and communicating with each other and physicians via iPads before the end of 2012. Please help me to make this a reality. As a result we will be able to make more impactful calls thus better able to ensure that every patient who should be on one of our medicines has access. Our marketers will be empowered to more quickly update digital detail aids and interactive apps with the latest information. Our marketers will better understand almost instantly what our field forces find helpful in their daily work and what is useless. Our field forces will be able to get more of their work done during the day while waiting for their next appointment rather than doing administrative work later in the day. And there are many other possibilities. Let’s use our positive memory of Steve to do some more good in the world. I know we can."

Not so long ago, I was hearing that pharma companies bought iPADs without having a clear strategy for how they were going to be used. It was believed that thousands of these iPads were housed in warehouses and not deployed.

It seems that Epstein is using the "in memory of Steve Jobs" memo as a tool to empty his warehouses of iPads and encourage reps to use them "to get more of their work done during the day" and "do some more good in the world."

But what are Novartis reps saying about the iPad? Here are some tidbits I found on the Novartis board over at Cafe Pharma:

• We are the laughingstock. 'Oh look, there goes the reps that are so incompetent in getting their message across, they are replaced by an iPad!' Hey doc, wanna play Angry Birds with me? 
• Next step in e-detailing is downloading "e-rep" app (doc gets to pick male/female e-rep to interact with,,need samples? click!, need a quick product review? click, heard the latest about managed care in your area? click! 
• Actually...with iPads why do we need high priced reps? The managers will be fine...you...I wouldn't be too sure. 
• I'm going to record all calls with the ipads camera & upload to youtube & publish live as soon as the next severence (sic) is paid out

At least pharma reps are not "selling sugar water to kids" as Steve Jobs once said of John Scully when he hired him to run Apple. Scully promptly ran it into the ground.

Does this memo violate FDA Regulations?

P.S. Epstein's memo was posted to a site called FreePDFhosting.com, which allows anyone to upload PDF files for free (duh!). I am not sure who posted Epstein's memo to this site, but I doubt it was Epstein, who probably intended it to remain an internal document. 

However, now that it is a PUBLIC document, easily accessible by any one, is it subject to FDA regulation regarding branded communications?

I notice that the memo refers to Novartis anti-cancer drugs by brand name and includes the FDA-approved indication: pancreatic neuroendocrine tumor. However, the memo does NOT include any fair balance (major side effect information). Technically, therefore, this memo -- as it appears on FreePDFhosting.com -- violates FDA law. Since FreePDFhosting.com has a rule against uploading PDFs that are "illegal or violates any laws," the memo should be removed from the site (hopefully before the FDA sees it).

2nd Annual Pharmaguy Social Media Pioneer Award Goes to...

Readers of Pharma Marketing Blog may recall that last year I presented the first ever "Pharmaguy Social Media Pioneer Award" to Alex Butler, Digital Strategy and Social Media Manager at Janssen UK (see here).

I've decided to make this an annual event and will present this year's award -- which is the coveted Pharmaguy Hawaiian shirt depicted in the illustration on the left -- to another pharmaceutical company employee who I believe deserves recognition for doing pioneer work in social media.

I will make the presentation at ExL's 5th Annual Digital Pharma East conference in Philadelphia (day and time TBD). I hope you will be there to witness this major event.

During the presentation, I will "pass on" the shirt that Alex Butler has been keeping safe in a secret location in the UK.

Who will be the lucky recipient of this year's award? Will the shirt return to America and reside in the closet of an American? Time will tell.

Here's a list of contenders. Pick the one you like. While this little poll will not determine the winner -- that's Pharmaguy's prerogative -- it will be interesting to see who readers of this blog think should be the winner.

Who Should Get the 2011 Pharmaguy Social Media Pioneer Award?
	Craig DeLarge, Novo Nordisk
	Tony Jewel, AstraZeneca
	Ray Kerins, Pfizer
	Kevin Nalty, Janssen
	Brad Pendergraph, Novartis
	John Pugh, Boehringer Ingelheim
	Dennis Urbaniak, Sanofi
	None of the above

Update from Corporate Marketing Team

Dear SpeakAsians,

Certain sections of the media have once again carried reports that are  false, unsubstantiated and  baseless allegations against the company.

 The arrest of Mr. Nayan Khandoor of Brand saloon Inc. is very unfortunate and disturbing.  Mr. Khandoor's company had been hired by SpeakAsia Online PTE. Ltd. to carry out the tasks of search engine optimization and adapting the content and language of the surveys that were uploaded to suit the Indian environment.

 Mr. Khandoor"s company did not create any content on his own and has only merely carried out a commissioned work given to him by the company. 

While the unfortunate trail by the media continues on our company, the authorities are yet to file a single charge sheet in the court despite taking  all measures that they deemed necessary for the investigation.

 This only leads us to believe that in absence of any substantial evidence against the company, the authorities are now aiming at spreading mis-communication with-in our SpeakAsia family. 

We are on our final lap and urge all of you to keep faith in the company and emerge victorious along with it.

Warm regards

SpeakAsia Corporate Marketing Team.