Pharma Pinterest Update: Bayer US Pins, Novo Nordisk Depins!

Two things occurred after I posted about Pinterest use by the pharmaceutical industry (here):

1. Bayer US started pinning (here)  and 
2. Novo Nordisk "depinned" (deleted) everything on its Pinterest boards (here).

"Bayer has joined up-and-coming social network Pinterest and is using it to share images and information about its activities in the US" (Hat Tip to PMLive: "Bayer starts using Pinterest").

Bayer snapped up the Pinterest username "bayerus" ("bayer" is being used by an individual named "Courtney Bayer"). It currently has three Pinterest boards: (1) Bayer's Business, (2) Sustainability, and (3) Innovation. Twenty-eight items (including at least one video!) are posted to these boards.

Bayer has pinned a couple of product images, including this one for Bayer Aspirin (shown on the left; click on it for an enlarged view).

As you can see, visitors are able to add comments to these pins. Always the "spoiler," I added a comment that was a truthful concern of mine, but one that points out a possible "adverse event."

Aspirin, of course, is an over-the-counter drug not regulated by the FDA like Rx drugs are regulated. Therefore, Bayer does not have to worry about reporting this adverse event to the FDA. But will it allow the comment to stand and/or make a reply? I'll let you know.

I have also "repinned" this image to my Pinterest "Pins from Pharmaceutical Companies" board (here). I notice that my comment does not carry over to the "repinned" image, so I added a comment about the comment I made over on the Bayer US Pinterest site.

I have found no way to edit or otherwise manage comments on Pinterest. It appears that the only option is to delete the pin and then repin it without the comments. This inability to moderate comments may be Pinterest's Archilles heel as far as pharma is concerned. But as of this date, pharma's presence on Pinterest is virtually unnoticed except for me and a few other pharma social media followers!

P.S. As I mentioned, Bayer included at least one video as a pin. I didn't know you could do this. Kudos to Bayer for taking advantage of that capability!

UPDATE: Bayer responded to my comment today (4/9/2012) - about 4 days after I submitted my comment. Their response was:

"It is important that you speak with your doctor before you begin a daily aspirin regimen, only your doctor can determine if you are an appropriate candidate for aspirin therapy. Please contact us at 800-331-4536 (M-F 9:00AM -5:00PM Eastern Standard Time) we would like to learn more about your use of Bayer Aspirin."

At least Bayer responded rather than deleting the pin as I suggested was an option (see above).

It's still early in the game for Pinterest as a viable social media site. However, Pinterest is now the 3rd most popular social networking site behind Facebook and Twitter (see here).

I think pharma needs to provide support to patients through every channel at its disposal, including social media. When Bayer, for example, suggested I call their phone number (M-F 9:00AM -5:00PM Eastern Standard Time) in response to the comment I made on their Pinterest site, I was surprised they didn't just continue the conversation on Pinterest since that was the channel I used to open the conversation and thus clearly my preferred channel.

Bayer's CEO Accuses Patients of Being Ungrateful B*stards! We Cured Cancer, Dammit!

That's my takeaway from this comment by Marijn Dekkers, "outspoken" head of Bayer Pharmaceuticals, in which he not only disses patients but claims to have cured cancer!

"If you have cancer, you get a pharmaceutical product, and your cancer goes away. You're quick to call the doctor and [say] the staff at the hospital was great. But the pill that did it gets forgotten. We struggle with getting society to put value on what we do, and it becomes particularly important as we get under more pressure to develop the next pill" (read the WSJ article here).

This guy must be living on another planet. That planet, of course, is Planet Pharma where the drug industry rules, all cancer has been cured by the industry and where patients bow when they see a pharma CEO ride by in his open-air limo!

I've brought up the subject of pharma taking most of the credit for improving cancer survival rates when in fact most of the credit in those gross numbers is due to the fact that many people have simply quit smoking. Dekkers' remark, however, is the first time I've seen the drug industry take credit for curing cancers. Perhaps he was making unsubstantiated claims about regorafenib, a colon cancer drug Bayer is developing. It's hardly a cure. "The median overall survival of patients on experimental regorafenib was 6.4 months. That compares to five months for patients who were given a placebo" (see "Bayer, Onyx cancer drug shows modest improvement in survival").

On Quora, I posted the question: "How close are the pharmaceutical companies to "curing" cancer?" (see here) and got some interesting feedback. Dan Munro (@danmunro), Founder / CEO - iPatient, had this to say:

"While curing a given cancer is clearly a worthwhile goal - it is often not the primary focus - and early detection is still the leading indicator of successfully treating all cancers. Some cancers are simply pushed so far into remission that you're more likely to die of a different cancer or old age in your sleep. It's not a technical cure - but it's a practical one.

"The sad reality is this: The death rate for cancer (adjusted for the size and age of the population) has dropped only 5% from 1950 to 2005 (see here).  

"One weapon that will aid in their research for effective treatments was announced at CES earlier this month. Life Technologies Ion Proton Genetic Sequencer."

So, (1) the reality is that the death rate for cancer hasn't improved very much in the past 50 years, and (2) pharma's little "pills" haven't contributed much to that statistic. Shame on Bayer for taking credit where none is due!

FDA's Advisory Committee Voting Double Standard

I learned today that the FDA allowed physicians with ties to Bayer to participate and vote in an advisory committee weighing whether or not the benefits of four popular Bayer AG birth-control pills outweigh the blood-clot risk (read the WSJ story here: "FDA Advisory Committee Members Had Ties to Bayer").

At least one of the physicians (Paula Hillard, Stanford Univ; see her financial disclosure info here) was a Yasmin advocate. According to a Bayer document released during litigation, Hillard "enable[d] us [Bayer] to now have another huge ... Yasmin advocate here in Nor Cal -- she will be well utilized!"

Hillard, the advocate, was allowed to vote on the issue.

In the same story, it was noted that drug-safety crusader Sidney Wolfe -- who was appointed to a four-year term on the FDA's Drug Safety and Risk Management Committee (see "Wolf(e) at DTC Piggy's Door Huffing and Puffing") -- was NOT allowed to vote "because he had publicly criticized the drugs' safety in newsletters published by his Public Citizen Health Research Group."

So, an "advocate" of a drug is allowed to vote whereas a "critic" of a drug is not allowed to vote. This is an astonishing double standard, IMHO.

This little excerpt from the WSJ article is also interesting:

The FDA says members of the public speaking before advisory committees must declare any financial relationships to the relevant drug maker, to "ensure ... transparency." However, committee members must disclose potential conflicts only to the FDA, which doesn't generally make the information public.

Jill Hartzler Warner, an FDA official who oversees advisory committees, said the agency is "prohibited from giving the public any information contained in a financial disclosure" from committee members. When picking committees, the FDA weighs "whether a meeting would affect the financial interest" of a panelist. The agency also does "look at whether past relationships would give the appearance of being a conflict," she said.

I was not aware that the FDA is "prohibited" from supplying information contained in financial disclosures, but it may be a moot point in a year or so when the physician sunshine act is in full effect and all payments to physicians are made public. We'll just have to wait for that and do our own research. Still, with FDA's double standard regarding voting privileges, it won't much matter how much transparency there is in who serves on these committees!

P.S. For more on how the FDA determines whether or not a physician's financial conflicts disqualifies him or her from serving on FDA advisory committees, see "FDA Advisor Rule Loophole?" where you'll find a complex chart depicting FDA's "Algorithm for Considering Advisory Committee Member Participation."

P.P. S. For some more background on Wolfe vs FDA regarding Wolfe's participation in this committee, read "FDA Pulls Wolfe Off Panel Over ‘Intellectual’ Conflict" (Pharmalot).

Who Regulates Press Releases? The Case of Bayer's "Melt-in-Your-Mouth" Erectile Dysfunction Tweet

Digital Pharma caught Bayer posting a Tweet - via its @BayerUKIreland Twitter account - that seems to violate new social media guidelines published by the UK's Prescription Medicines Code of Practice Authority (PMCPA), which oversees the self-regulatory code of the Association of the British Pharmaceutical Industry (ABPI).

Here's the Tweet stream that Digital Pharma preserved:

The tweet in question states "First and only melt-in-the-mouth erectile dysfunction (ED) treatment launches in the UK today." It includes a link to a LEVITRA BRANDED press release. I have preserved the press release as a PDF version (here) of the original Web version. I did this because Bayer might remove the original after it reads this post.

The PMCPA code states: "If a company wanted to promote a medicine via twitter it would have to ensure that if the medicine was prescription only, the audience was restricted to health professionals and that the message, in addition to any link to further information, complied with the Code. In addition companies would also have to ensure that recipients had agreed to receive the information. Given these restrictions and the character limit on twitter, it is highly unlikely that the use of this medium to promote prescription only medicines would meet the requirements of the Code. Using twitter to alert health professionals about the publication of a study on a medicine is likely to be considered promotion of that medicine."

As Digital Pharma points out, tweets are viewable by the general public and therefore cannot be "restricted to health professionals" as required by the PMCPA code: "The @BayerUKIreland account has about 500 followers, some are clearly members of the public, but many show no information as to followers’ location or occupation. As an open account all its tweets are on public display and indexed by search engines like Google."

BTW, I could NOT find the tweet by searching Google OR by examining the @BayerUKIreland Twitter stream. That's because Bayer DELETED the tweet according to Digital Pharma. This immediately raised red flags.

But does the Bayer tweet violate the PCMPA code?

In a previous post (see "Brits Beat FDA & PhRMA: Issue Social Media Guidance for Pharma. This BI Tweet May Not Pass Muster") I pointed out that Tweets such as the following from Boehringer Ingelheim (BI) may violate the PMCPA code:

The BI tweet mentions a BRAND name and its indication, but does not include fair balance information. The Bayer tweet, however, does NOT mention a brand name, just the indication and a benefit of a treatment (ie, "dissolves in the mouth in seconds, there’s no need to take it with water and it’s discreet").

Although the Bayer tweet does not mention a brand name, it may still be considered promotion of a drug in the UK. If so, does it violate the PMCPA code? According to Bayer, "Despite the recent publication of a discussion paper from the PMCPA, the position on use of social media and digital communication in relation to prescription medicines remains far from clear."

Bayer's Unregulated Press Release Posted via Twitter is NOT Balanced
Another issue that is FAR FROM CLEAR to me is how the Bayer PRESS RELEASE can pass regulatory muster in the UK. According to Digital Pharma, Andrea Postles (@AndreaPJPostles, LinkedIn public profile), PR & Media Relations Manager at Bayer UK, said: “We have sometimes ‘tweeted’ approved news releases where we know that the content, while of interest, is nevertheless non-promotional, and contains only factual and balanced information."

To which I say BULLSH*T! You can read the "approved" press release here. It is clearly NOT "non-promotional" as Ms. Postles claims.

For example, the first paragraph of the press release states: "Today marks the launch of the first ED treatment available as an orodispersible tablet. In contrast to other drugs of the same class, the new formulation has been designed specifically to be discreet and convenient, has a minty flavour and dissolves on the tongue within seconds."

Here's another example of promotional language found in the second paragraph of the press release: "Levitra orodispersible was developed to help remove the known barriers associated with erectile dysfunction medication by providing men with a more convenient and discreet treatment option which may also help to lessen the embarrassment surrounding the condition."

I'm sold! Where do I get it?

OK, so the press release IS promotional. It mentions the brand name and benefits. But shouldn't it also mention possible side effects and safety information -- ie, the fair balance? Contrary to what Ms. Postles says, the press release does NOT contain "balanced information." There is NO mention of any possible side effects, other treatment options, risks, etc. It's all about LEVITRA and its benefits.

Most pharma product-specific press releases I have seen have a section entitled something like "IMPORTANT SAFETY INFORMATION." The Bayer press release has NO such section. How can it be called balanced?

The importance of PR as a marketing tool has increased DRAMATICALLY, IMHO, with the ascendancy of Twitter and other social media applications.  Pharma corporate communications people seem to be taking a leading role in using social media to promote products while claiming what they do is NOT marketing or promotional. This is a hot topic that I will explore with colleagues in tonight's #socpharm chat at 8 PM Eastern. Join us!

---------
P.S. @Alex__Butler tweeted this: "@pharmaguy on the broad point of press materials they are public and covered by the code/clause 22; http://t.co/U9FM6UC" which links to the 2011 version of the ABPI Code of Practice for the Pharmaceutical Industry (here). Clause 22.2 states:

"Information about prescription only medicines which is made available to the public either directly or indirectly [my emphasis] must be factual and presented in a balanced way. It must not raise unfounded hopes of successful treatment or be misleading with respect to the safety of the product.

"Statements must not be made for the purpose of encouraging members of the public to ask their health professional to prescribe a specific prescription only medicine."

A press release is information that is intended for journalists with the intent that they will write a story about the information in the press release. Thus, the Bayer press release was made available "indirectly" to the public -- and even directly because of the Tweet linking to the press release.

The press release is "misleading about the safety of the product" because it contains NO SAFETY INFORMATION whatsoever!

Although the press release does NOT directly "encourage members of the public to ask their health professional to prescribe a specific prescription only medicine," the benefit statements made in the press release are simple for the average Joe (or Nigel) to understand and certainly aim to encourage the public to get a prescription of this product.

Are Pharma Marketers Using Viral Social Media Techniques to Promote Products?

Subtitle: This Bayer Sexy Youtube Video is Popular, but Will It Help Levitra Sales?

Is viral, peer-to-peer pharma marketing an effective tactic? Jeff Chester, who heads up the Center for Digital Democracy (CDD), thinks so. Speaking on NPR's All Things Considered show (summarized on NPR's blog), Chester commented on Bayer's funny "InBedStory" series of YouTube videos and claimed that "the drug company marketers are counting on you to forward the funny video. And," he says, "that's the idea behind all these techniques."

By "all these techniques," Chester includes techniques like the infamous Novartis Share button that recently was dinged by FDA (see "Implications of FDA’s Warning Letter to Novartis Regarding Facebook Share Widget" and "Who's in Charge of Your 'Invisible' Metadata? WARNING: Don't Invoke the 'Invisibility Rule'").

First of all, there was nothing "funny" about the Novartis button, which included this message: "Home - Tasigna (nilotinib) 200 mg capsules." I can't imagine a more uninspiring, absolutely non-viral message! Why would I bother to share that unless I was working for Novartis?

Ah! I think I really hit upon pharma's viral social media strategy -- get your agents, acting like real patients, to spread the word. By agents I mean ad and pr agencies who hire ordinary people to do the dirty work. I believe that this is happening (see "Professional 'Hired Gun' Pharma Tweeters. Is It a Good Idea?").

But Chester's point was that funny, sexy stuff like Bayer's InBedStory videos are popular and easily spread far and wide by ordinary Joes like me. Well, not like me. I am not among the "one in four men" who have ED, which is a claim made in one of Bayer's videos; in another video, the male character claims that "maybe there's a whole army of men out there needing to put more balls into the cannon, so to speak" (BTW, I have issue with these exaggerated ED prevalence claims; see "40over40: Lilly's DTC ED Awareness Campaign in the UK").

The funny thing is, Bayer has shut down practically ALL of the social media, viral functions on its InBedStory Youtube channel. You can't submit comments and you can't embed any of the videos in blogs like this one. So I can't embed Episode #9 ("Sex Tape"), which is by the far the MOST popular video in the series, in this post. But here's a scene from it, which you can click on to get to the Youtube site.


 View the Video

I should mention that you can "Share" InBedStory videos by distributing links to them in Twitter, Blogger, email messages, etc. I guess that counts as viral. It seems, however, that not many people are doing this EXCEPT for the "Sex Tape" video, which has been viewed more than 126,000 times! This video really has no message other than hinting at various ways of having kinky sex (go ahead, have a look!) All the other videos, which are at least educational and have the message to go talk to your doctor, have been viewed only about 1,000 times -- less than 1% of the views racked up by "Sex Tape." In contrast, "Macks' Osso bucco recipe" Youtube video has over 1,100 views (see embedded version at the end of this post).

BTW, there's also an InBed web site. "See one man's journey from droop to Don Juan" is how the site describes the series of videos. You can "Share This Site," but not by using any nifty social media tool -- you just enter some one's name and email address and Bayer sends them a message like this: "Hi, John Mack sends you the following recommendation http://www.in-bed.info/en/index.php" which is pretty enticing. NOT! I spent all morning entering email  addresses of everyone I know and I hope they will do the same. Yeah for the latest in viral marketing!

Curiously, the InBed website does NOT include Episode #9 ("Sex Tape"), which is the most viral of all videos in the series!

Even if Bayer allowed viewers to comment on and embed its videos, I doubt that it would help the sales of Levitra. The whole effort is UNBRANDED, except for the Levitra flame logo off to the right of the screen. You'd have to be pretty savvy to know that Bayer markets Levitra. The fact is, these videos may get more men to ask their doctors about ED treatments, but it's likely that the doctor will prescribe Viagra, the number one ED drug, and NOT Levitra (#3 in most markets).

But getting men to see their doctors about their erectile dysfunction problems is a good thing whether it sells more Levitra or not. Maybe some of these men have real underlying, untreated medical problems such as diabetes or hypertension that is causing ED. Unfortunately, only one of the 9 InBed videos I viewed mentioned possible underlying medical conditions (ie, high blood pressure).

So, the most viral aspect of InBedStory (video #9) is the least effective in promulgating Bayer's cause (get men to see their doctors about ED) and is the least promoted video on the official website. This hardly seems like a case in support of Chester's contention that pharmaceutical marketers are "counting" on the viral nature of social media to spread their drug messages.