WikiPharmaLeaks: TALES OF A PHARMA CEO

S E C R E T NYC 000700

SIPDIS

EO 12958 DECL: 11/08/2016

TAGS PGOV, PINR, SCUL

SUBJECT: TALES OF A PHARMA CEO:  PHARMAGUY (PG) MEETS WITH CEO OF PFIZER’S FIXER

¶1. (S) On November 7 the PG met with a prominent Western businessman who is close to the CEO of Pfizer, Jeffrey bin Kindler. The businessman is known as a “fixer” for CEO bin Kindler. During their conversation, he recounted to the PG a number of his interactions with the CEO bin Kindler.

¶2. (S) The businessman’s third encounter with CEO bin Kindler coincided with the visit of Brian alem Markison, CEO of King Pharmaceuticals, Inc. He informed the PG that CEO bin Kindler and the King CEO share a love of painting. The businessman told the PG about a call that he received from a nervous CEO bin Kindler because of the party that he had offered to host for the King CEO. During that time CEO bin Kindler, who has since built a new residence, was living in his father’s old residence. His mother lived upstairs on the second floor of the residence, but the first floor needed attention. The residence was described as aged and in dire need of renovation. The businessman recounted how he was called and asked by the CEO bin Kindler, to take care of renovating the ground floor of the residence for a party that would take place in three weeks from the time of the phone call. The businessman asked whether he had a choice, and when told an emphatic “no,” then agreed to do it.

¶3. (S) According to the businessman, the first thing that he did was cut off all electricity so that no one would be able to turn on the lights and see what was taking place. Secondly, he inserted styrofoam into the holes in the walls. Thirdly, he set up projectors to project colors and designs onto the walls. On the evening of the party candles were the only source of lighting throughout the house. The plan was successful as the King CEO commented on how luxurious and beautiful the house was, despite the fact that it was not. CEO bin Kindler was very happy and the relationship between the businessman and the CEO bin Kindler was cemented. (Note: The CEO bin Kindler’s old house has since become a hospice. End note.)

¶4. (S) The next day CEO bin Kindler phoned this businessman and invited him to meet the King CEO. What the CEO bin Kindler did not know was that while the businessman had sacrificed three weeks to renovate the residence, his sister had been visiting from out of the country and he had other obligations, which he disregarded. The businessman ultimately declined the invitation to meet with the two CEOs. When he received a phone call and a summons, the next day, from CEO bin Kindler, he was frightened. He did not know what to expect and he feared the worst.

¶6. (S) When the businessman arrived to meet CEO bin Kindler he was pleasantly surprised to receive a painting by each of the CEOs, as gifts. He was also shocked to receive, what CEO bin Kindler called, a “tip,” in the amount of  $13,333. He confided to the PG that CEO bin Kindler is “known for being extremely cheap.” The businessman concluded by reiterating how close his relationship is to CEO bin Kindler and sharing more fond memories of the “phony dinner” at the CEO bin Kindler’s residence.

[Based upon cable 06JEDDAH700, TALES OF A PRINCE: CG MEETS WITH GOVERNOR OF ASIR’S FIXER; wikileaks.org]

Drug Discovery is as Much an Art as a Science, Says GSK CEO Witty

GSK's "More Than Medicine" blog posts today announced that GSK CEO Andrew Witty "recently wrote a forward-looking essay focusing on the future of the pharmaceutical industry for 2011 and beyond."

In that essay -- published in the Economist (here) -- one paragraph stands out: "Art, not just science" is the heading, under which Witty says: "First, we need to recapture the ability to empower creative talent in the discovery phase of r&d by creating an environment in the labs that reflects the fact that discovering a drug is as much an art as it is a process."

Maybe Witty envisions "Jackson Pollock" wannabe lab researchers throwing chemicals against a wall & seeing what sticks?

Is Your Digital Marketing Solution Mentioned in the CDD Brief? It Should Be!

After a day of cooking, I spent the remainder of the Thanksgiving Holiday weekend reading and highlighting sections of the 144-page brief that the Center for Digital Democracy (CDD) filed with the FTC on Thanksgiving eve (see "Center for Digital Democracy Challenges FTC to Reign In Online Pharma Marketing").

This document -- now in the public domain (find it here) -- is perhaps one of the BEST reviews of healthcare-related digital marketing techniques that I have ever seen! I recommend that ALL pharma marketers read it to learn which companies to contact to help them do a better job reaching online consumers and physicians.

There were several companies and products mentioned that I have not heard of. In that regard, this brief -- negative though it may be -- is a promotional boon for these companies, IMHO. You can't buy this kind of publicity and as a recent article in the New York Times proves, even negative publicity can help you get top listing in Google searches (see "A Bully Finds a Pulpit on the Web").

I compiled a list of more than two dozen innovative online marketing products/solutions mentioned in the CDD brief. My list includes the product name, company/site name, description, link to online information, and the paragraph number in the brief where you can find what the CDD has to say about it (download the list here).

If your company is NOT listed, I suggest that you (1) contact CDD and ask them to amend their brief to include your solution and/or (2) file your own brief with the FTC.

Of course, CDD does not view these solutions as "innovative." In fact the CDD thinks they are "unfair and deceptive":

"The companies named in this complaint, as well as others involved in real-time tracking and bidding -- including those that provide data optimization services for profiled targeting -- are engaged in unfair and deceptive practices."

I must admit that one or two of the services were a bit scary. QualityHealth's "Focus on Formulary" solution, for example, claims to be "sophisticated technology" that "links consumer marketing with brand formulary access." It designs "targeting messaging directly to millions of profiled consumers based on prescription coverage." CDD says: "Few consumers likely realize, however, that they have consented to become the subjects of a 'proprietary profiling technology' that “captures… valuable information across over 100 individual data points,” including 'consumers’ conditions and preferred treatments'; 'doctor relationships and plans to visit the doctor'; and 'insurance and formulary coverage.'"

ConditionMatch (offered by Good Health Media) claims to use “cutting edge behavioral targeting technology…[and] identifies groups with common sets of conditions/health-related characteristics by geographic region via insurance claims and individual ‘opt-in’ data.”

Both sound like they may have HIPAA privacy issues.

There is no lack of innovation regarding the names given to some of these solutions, such as:

• ActuatoRx Geo-Medical Targeting
• Acquire2Convert
• Healthographics
• Pluck
• Intent Targeting Advertising
• Target 2 Measure
• BuzzScape
• Social Operating System
• Bizo Targeting Platform
• Quantemo Engagement Index
• Subconscious Resonance Testing
• Evoked Response Potential

The CDD does not analyze whether or not the claims made by the companies it cites are credible or designed to hookwink gullible pharma marketers into purchasing their solutions. For example, are there any pharma marketers who are convinced that "Pluck," which is designed to engage consumers in conversations with brands, is a viable solution for Rx products?

Which leads me to wonder why the CDD focused exclusively on healthcare marketing as a target for its critique. Many of the marketing tactics cited by CDD probably were first developed for the consumer goods industry and then renamed/rebranded to appeal to healthcare marketers as well. The CDD has helped accelerate the process!

Center for Digital Democracy Challenges FTC to Reign In Online Pharma Marketing

Today, the Center for Digital Democracy filed a 144-page brief with the FTC challenging that agency to investigate its charges that Google, Microsoft, QualityHealth, WebMD, Yahoo, AOL, HealthCentral, Healthline, Everyday Health, and other health marketers -- including major pharmaceutical companies -- have "unleashed an arsenal of techniques to track and profile consumers" in an unfair and deceptive manner.

In the brief, which you can download here (huge pdf file), the CDD urges the FTC to "immediately conduct a thorough investigation and analysis of contemporary Digital Direct Marketing to Consumers of drug and health-related products and information. In addition to seeking the appropriate injunctions and other relief, we also urge the FTC to issue a report and recommendations designed to inform consumers and health professionals of the issues raised by interactive ads for medical products and services."

CDD has a long list of specific requests that can be found on the last few pages of the brief. I'll list a few of the more juicy ones here.

CDD says FTC should

• "Examine and analyze the data collection and usage practices of pharmaceutical advertisers to assess the extent of consumer information collected through websites, social networks, online video sites, and other interactive means. This should include personal information, IP addresses, cookies, flash cookies, Web bugs, tracking pixels, Web analytic tools, conversational and sentiment analysis [my emphasis], and any other 'data-mining' applications. We urge the FTC to resist suggestions that such data collection methods are appropriate because they can help identify risk-averse-related information."
• "Analyze how health-related social media marketing influences consumer behavior and attitudes on drug use and about medical conditions. The agency should examine social media marketing applications for the health market designed to foster 'viral' marketing approaches, including the targeting of specific consumers in order to influence their own network of relationships."
• "Investigate whether there is a violation of the FTC’s Endorsement guidelines (which the FTC has extended to the Internet) when advice is given to patients or consumers from seemingly independent health bloggers who do not disclose that they are paid or sponsored by pharmaceutical or other companies."
• "Obtain from pharmaceutical companies a list of the keywords used for paid search campaigns. The companies should also be required to inform the FTC of the techniques and applications they may use in so-called organic search to show up prominently in the results. U.S. consumers should be informed by the FTC of the implications of search marketing practices when they are looking for information and advice.
• "Work with the Food and Drug Administration and other appropriate agencies to develop a set of policies for regulating the use of behavioral targeting, data collection, and other digital techniques in the marketing of drugs and health-related products."

I have the "honor" of being quoted in paragraph 119.

Memory Lane: The Internet in 1995 - I was There BEFORE Google!

While cleaning out my basement I came across a box that contained the premiere issue of "The Net," a magazine published in June, 1995. I saved this magazine because my photos of Paris were featured in an article about "Le Louvre," a popular Website of the time (see image below, which shows the cover and the page with my photos; click on image for a larger view).

The author of the article claimed that WebCrawler -- the first Web search engine to provide full text search that went live on April 20, 1994 -- found 308 links to the "Le Louvre" site. This was enough in those days -- BEFORE Google -- to make a site "popular." Today, a Google search on "Le Louvre" yields 4,380,000 results!

But the article actually talks about "Treasures of The Louvre," which wasn't the official Web site of the famous museum! It was a series of pages put online by a UCSD student. Around the same time, the "unofficial" Glaxo pharmaceutical web site was created by a single employee without the knowledge of executive management! Can you believe it?

Anyway, my photos were not part of the "Le Louvre" site but were included in a site about Paris, which was linked to "Le Louvre" (wow, the WWW is nifty). My section of that site was titled "A Personal View of Paris." I am happy to say that "John Mack's Views of Paris" is still available on the Web here on the www.paris.org site.

Some of the other Internet pioneers and pioneering apps, however, are no longer available or relevant. These include "Gopher," "Archie," "WAIS," and "Veronica." Ah, my first loves!

BTW, I was providing pharmaceutical information on the Web even before 1995. In 1994, I teamed up with Oncolink to post articles about new oncology drugs. Oncolink was started by an employee of the University of Pennsylvania. His daughter had cancer and that's why he developed the site. Later the University took over this most popular health site on the Net, without so much as a thank you to the creator! It now claims the site "was founded in 1994 by Penn cancer specialists."

After that -- in 1995 -- I launched my own pharmaceutical site called "PharmInfoNet" and the rest is history.

Detailing by Telephone Accounts for Nearly Half of "New Media" Promotion to Physicians

*** PODCAST: Pharma TeleWeb e-Detailing - A CASE STUDY: Lilly's Experience in Europe Recorded LIVE Feb 23, 2011, 2 PM Eastern US. ***

It's always been difficult to get a handle on the amount of money pharmaceutical companies spend on promotion to physicians and especially how much of the total spend is focused on "e" channels such as Web advertising and Internet detailing. Several different companies offer estimates that vary depending upon exactly what they include when totaling up the numbers.

But no matter what the source and how the numbers differ, my analysis is always the same: spending in the "e" space is a tiny fraction (less than 5%) of total promotional spend and has remained in that range every since I can remember!

Today, I received a summary of a report from SK&A, a market research company, titled "U.S. Pharma Company Promotional Spending Trends in New Media" (see here). Of interest to me were the sections on "New-Media Average Monthly Expenditures, 2006 to 2010" and "Promotional Expenditures by New-Media Channel, Oct. 2009 to Sept. 2010." Again, the numbers show that pharma spends very little on ePromotions or "New Media" promotions or whatever you want to call it.

According to this report, "Pharmaceutical companies are finding novel ways to promote their products to physicians and other prescribers, namely through new media channels such as internet detailing, tele-detailing, e-meetings and web advertising." It's interesting that the telephone (as in "tele-detailing"/"Telephone Detailing") has been included as a "new media" channel. And here I thought the telephone was invented over 100 years ago!

SK&A says that "tele-detailing" accounts for 49% of the new media channel physician promotional spend, whereas "Internet Detailing" is only 35% and Web advertising is a meager 1% (see chart below).

According to the report, which is based on an "ongoing survey panel of 2,455 physicians and other healthcare practitioners," the total U.S. "New Media" channel promotion spend by pharma focused on physicians was $327 million during the 1-year period between October 2009 and September 2010. That includes $160 million for "Telephone Detailing."

The report claims that "In the U.S., promotional spending [aimed at the HCP audience] totaled $24 billion between October 2009 and September 2010." Thus, "New Media" spending represents ONLY 1.4% of the total spent on promotion to physicians by pharma companies. If we eliminate the $160 million spent on telephone detailing, that percentage drops to 0.7%!

But I bet the $24 billion includes the retail cost of samples, which could account for as much as $18 billion a year (see here). If so, then only $6 billion was spent on non-sample promotion to physicians and 2.8% of that went to "true" new media (ie, not telephone detailing).

But "New Media" promotional spending is increasing by leaps and bounds according to the report, which states "[monthly] promotional spending in new media has increased significantly from about $5 million in January 2006 to about $26 million by September 2010" (see chart below).

Again, telephone detailing is included in the "new media" category. It could be that ALL of this "significant" increase is due to docs receiving more telephone calls from sales reps!

FOLLOW UP: November 23, 2010. Rich Meyer over at World of DTC Marketing Blog clarified how "Telephone Detailing" works and why it may have been included under "new media" in the SK&A report.

"There are many types of electronic detailing including detailing by phone," said Meyer. "Phone allows physicians to hear a detail on demand along with an interactive presentation via the Web."

See Meyer's complete post: "Detailing by phone: What do physicians think?"

EU to Release Data in December That Could Put Alli Diet Pill Sales in the Toilet!

The European Medicines Agency (EMA) -- Europe's equivalent to the FDA in the U.S. -- "will make thousands of pages of clinical trial reports public next week after pressure from drug-safety activists because of suicide risks linked to Sanofi-Aventis SA’s failed diet pill Acomplia," according to this report.

The data will include results from clinical trial reports on three obesity drugs: Roche Holding AG’s Xenical, Abbott Laboratories' Meridia and Sanofis Acomplia. Acomplia was never approved in the U.S., and EMA pulled the drug from the market in October 2008. Abbott agreed to take Meridia off the U.S. market in October. The EMA halted sales of the 13-year-old diet pill in January. But Xenical is still available in Europe and both the EMA and FDA have allowed GSK to sell Xenical’s active ingredient, orlistat, as the non-prescription diet pill Alli.

Who knows what will come to light when this data is released. Anders Joergesen, a researcher at the Copenhagen-based Nordic Cochrane Centre, which called for the release of the data, said "It's a very detailed report describing the benefits and harms, more detail than is available for example in medical journals. The medical journal's report is about 10-15 pages, maybe less, and these consist of 100, 200, 300 pages per trial. Let's see what we get," said Joergesen, "because it may be fully redacted and a blank sheet."

After analysis of the diet drug clinical trail data, Joergesen and colleagues may do for Xenical and Alli what Cleveland Clinic's Dr. Steven Nissen did for Avandia -- ie, put sales in the toilet, exactly where Alli's "treatment effects" end up (sometimes; see "Alli Oops! I Just Pooped Myself!" and "Alli Newspeak: Oily Spotting is 'Treatment Effect'").