Who Has Actually Played BI's SYRUM Game? The Silence is Deafening!

During today's #hcsmeu chat session (see archive here) I asked "Truthfully - has any of my EU colleagues actually played SYRUM?"

There's been a lot of hype about Syrum previous to its launch by Boehringer Ingelheim (BI) in the EU (see here), but I've heard nothing post launch from anyone who has actually spent time playing the "game" (I'm told that it's not a form of "gamification").

"Who's the EU 'pharmaguy' who will take on this task and report back?", I asked.

Turns out that one person (Maria Öst, Sweden, aka @mariaatomaca) admitted she signed on to a beta account, but she didn't actually play the game. By signing on, Maria gave Syrum (and BI) permission to "post on [her] behalf" and "read [her] checkins" even if she does not play the game (see here).

According to @fision (Kai Gait, UK) Syrum opens "lots of potential opportunity in the future by accessing the interest graph of players" -- even if they don't actually play the game ("If a user doesn’t ‘disconnect’ the game, they [BI] still have access to data in theory," said @fision).

Felix Jackson (@felixjackson, UK, founder of medDigital) actually has played the game and said "I ... enjoyed it! I liked the way it showed me drug development." I thank Felix for taking the time to give me a live tour of the Syrum via Skype during which I saw a few peculiar things such as a masked avatar that looked like an Al Qaeda terrorist! I guess it was supposed to be a surgical mask. I've worked in a lab and I never saw anyone wear a mask. Maybe drug development labs are different.

One of the features of the game is that you can see friends on Facebook who have also signed on to play the game. You can "recruit" these friends to be members of your drug development team or you can collaborate with them. Unfortunately, none of Felix's FB friends -- including BI's John Pugh -- were able to collaborate with Felix because they didn't have any molecules under development (ie, they currently are not playing the game).

Meanwhile, Helen Harrison (@harrassedmom) alerted me to this "walk through" on YouTube:



By the time you read this, one or two other people I know on Twitter may tell me that they also have played Syrum. These people, however, are mostly like me -- not representative of Syrum's target audience, which is the general public. We won't know very much about how many of those people have signed on to play, how long they have played, etc., unless BI shares that information with us. That make take another 3 years -- I'll wait :-)

"Gamification" (eg, Syrum) is Just Another Way for Pharma to Mine Our Personal Data and Wisdom

Everyone I know in Pharma Twitterdom is enamored by the launch of Boehringer Ingelheim's SYRUM FaceBook game, which is available ONLY to European FB users. BI says the game is "educational" for physicians and the public:

"The research driven pharmaceutical industry is immersed in education - whether aimed at medical or pharmaceutical professionals or providing information directly to the public," says John Pugh, Director of Digital at Boehringer Ingelheim. "Gaming is an experimental way for Boehringer Ingelheim to do this. The challenge is to do this in a truly engaging, educational and entertaining way that immerses the player."

Syrum allows players to create and run their own pharmaceutical company, using a virtual laboratory to discover and develop imaginary medicines to improve the health of the world.

But "educating" the public may be a minor goal of Syrum. It surely is not something that can be measured as a key performance indicator (KPI) to justify the years and money invested in developing this "game."

So how does BI justify investing all this time and money to develop a game if it cannot measure how better educated the public is about drug development?

I believe that Syrum is designed to educate BI and NOT to educate us. It's much easier for BI to measure how much better educated IT has become due to Syrum than to measure how much better I have become from playing the game.

What do I mean by BI being "educated" due to Syrum?

Firstly, BI requires everyone who plays the game to open up their FB information for access by the company.

I was able to access the game while in Spain recently. Before I could play the game, however, I had to agree to allow BI to gain access to practically everything I do on Facebook (see screen shot below).

This stopped me dead in my tracks. Perhaps this is a normal permission request for all FB apps, but I was loathe to "allow" this kind of access for a pharma company app. It seems that BI wants to do some market research about the people who opt in to play Syrum. This kind of data could be a valuable KPI for Syrum.

I must admit that I am mystified by FB. For example, what does "Post on my behalf" mean? Whatever it is, it doesn't sound good. "Reading my checkins" also does not sit well with me. 

I'm not the only one who doesn't use apps due to privacy concerns. More than half of mobile application users have uninstalled or avoided certain apps due to concerns about the way personal information is shared or collected by the app, according to a nationally representative telephone survey conducted by the Pew Research Center’s Internet & American Life Project (see "Privacy and Data Management on Mobile Devices"). What applies to mobile apps also applies to FB apps - maybe even more so given FB's bad rep viz-a-viz privacy (see for example: "How Facebook Plans On Using Your Prescription Drug Purchase History, And How To Stop Them").

Another way that Syrum can educate BI rather than educating us is by allowing BI to cash in on "crowdsourcing" WITHOUT financially compensating the crowd!

BI says it has steered clear of therapeutic areas it is involved with as potential areas of interest in the Syrum game, although it has left the door open to change that. Perhaps BI's objective is to test the social aspects of the game and access the "wisdom of the crowd" to help it develop new drugs.

The pharma industry seems ready -- even desperate -- for help from the crowd to develop new drugs. Ten top U.S. and European drugmakers -- including BI -- started a nonprofit organization, called TransCelerate BioPharma, to collaborate on the problem of developing new drugs (see here).

Meanahile, Lilly's Clinical Open Innovation believes that crowdsouring can help fix drug development, which it claims is "broken." Lilly believes that "Open Innovation models – focused on clinical drug development – can result in transformational gains in value-to-patients and efficiency. We also believe that open data, linked, crowdsourced, consumed and curated by experts outside (as well as inside) the walls of pharma will bring innovative insights and wisdom. And that open communities will set and meet objectives to reduce costs and improve outcomes" (see "OMG, LCOI! Open Source Pharma: Creative Commons Coming To Pharma").

Perhaps Syrum is a precursor to that kind of "collaboration" - what I call "semi-open access" drug research. This could be of tremendous educational as well as FINANCIAL benefit to BI. And all it costs is the price of developing a game with very little payback to the crowd other than "fun" and "engagement!" P.S. On KPI I forget to mention was ROI on PR. BI recently retweeted this tweet from the PM Society: "RT @PMSociety: How is PR ROI for Syrum being measured? 50 pieces of press just from launch party. Value in positioning of @Boehringer". 50 easy "pieces of press" -- some kind of "POP"!

Mirror Mirror on the Wall, Who's the Most Innovative of Them All? Pharma, Social Media Wise, That Is.

The pharmaceutical industry has consistently promoted itself as an "innovative industry" by which it means it discovers new, innovative drugs through research. No one ever claimed the drug industry was very innovative in marketing in general or in its use of social media. However, consultant and strategist Andrew Spong, just came close to doing that in a post titled "Innovation: the name of the game for Boehringer."

"By dint of the sheer weight of evidence that has accrued over the past three years alone," says Spong, "Boehringer Ingelheim may reasonably be identified as the pharma company that sets the pace for the industry in digital environments...Boehringer merits recognition as the digital leader in the pharma industry not because of what it has achieved, but because of what its activities say about the cultural evolution that has taken place within the company."

Spong and many others are lauding Boehringer's Facebook Syrum game based solely on hearsay evidence -- Syrum won't be officially released until September 13, 2012 (see "BI to Launch Beta Version of its Syrum FaceBook Game on September 13, 2012"). The "weight of evidence" comes almost exclusively from tweets, blog posts, and press releases written by BI PR people and John Pugh, BI's Director of Digital.

I doubt if Spong or any other laudatory commentator has actually played the game. If they did, I am sure they would have mentioned it and actually written something new about it.

I am not sure what kind of "cultural evolution" is going in within BI, but I know that the company has exhibited some PR and marketing behavior that regulatory agencies have frowned upon (see, for example, "BI Masters the Art of WOM through Its 'Parrots,' er, Spokespersons"). This is not indicative of a cultural evolution in pharmaland.

Spong also mentions BI's "experiments with outré humour" and links to this "Famously Unpronounceable" YouTube video as an example.



Spong neglected to mention that the above video is NOT found on the official BI YouTube site, which no longer hosts the video in question. BI yanked it because of negative comments from industry commentators such as myself who are “slow to acknowledge its transformation” (see “BI’s Famously Unpronounceable Video Lives On!”).

With regard to the Syrum game, BI has been milking that for almost a year making it one of the more spectacular examples of “vaporware” I have ever seen (again not culturally evolved). BI, IMHO, would have been much better off sticking with real world exhibits (see “'A Drug is Developed:' Easier than Launching an Educational Facebook Game about Drug Development?").

Before you label me solely as a negative commentator, I offer you this: “Boehringer Ingelheim Shows How to Support Patients via Twitter and Beyond”.

Just like every pharma company, BI has its social media triumphs and failures – or “Trials & Tribulations” as I like to call them. See my latest Slideshare presentation on that here.

BI to Launch Beta Version of its Syrum FaceBook Game on September 13, 2012

John Pugh, Director of Digital for Boehringer Ingelheim GmbH (BI), announced that BI will release a BETA version of the FaceBook game SYRUM at a PSFK conference in London on September 13, 2012.

I have been anxiously awaiting the launch of this game after I first heard about it 10 months ago at a pharma industry conference (see "Pharma & Fun, Not Oxymoronic? Here Comes Gamification!" and "BI's Facebook Game Syrum to be Launched 'When It's Ready'"). At least BI is speedier than the FDA in delivering on long-awaited promises!

I have not heard of the PSFK conferences until now. According to its website, PSFK "conferences offer a diverse program of speakers with backgrounds in art, technology, design, marketing, and media, creating an environment where disparate ideas can come together in new ways to fuel work that changes the world for the better. We set an agenda that allows participants to meet and discuss with one another, together sharing and building upon the ideas brought forth from the stage."

I am a bit surprised, however, that Pugh/BI did not choose to launch SYRUM at a pharma industry conference such as DigiPharm Europe, which will take place less than a fortnight later, also in London. Over the past year, Pugh has been making the rounds at such industry conferences promoting SYRUM. I'm not one to speculate (ha ha), but is Pugh getting ready to move on to greener pastures in another, more "innovative" industry? To be fair, it's important for pharma company employees to make connections with like-minded people in other industries to get new ideas that may be applied to pharma.

In any case, here's some of what Pugh revealed to PSFK (read the full interview here):

“We are taking a Silicon Valley approach,” said Pugh, “where we know we have got a really good game that’s stable but we’ll launch a beta version. We really want to make it so that we get lots of feedback from the people who are playing.”

“We’re offering rewards and prizes for people to give feedback so that we can really create the duration of the game, and develop it, and have more of a crowdsourced collaborative effort to develop the future stages of it, so the game will grow and evolve, as more people play it. This is a very unique offering from a highly regulated industry.”

"Crowdsourcing" seems to be all the rage now in the pharmaceutical industry. See, for example, "Crowd Sourced Creative Commons Drug Information" (free subscription required).

Meanwhile, here's a first glimpse of actual SYRUM game screens - previously, we've only been able to see the opening screen with the message "coming soon."

Pfizer and Janssen Halt Alzheimer Drug Development: Why Not Try Gamification?

"In the wake of another negative trial with the anti-amyloid biologic drug bapineuzumab, Pfizer and Janssen said they were halting development of the product for mild to moderate Alzheimer's disease," reports medpage today (here).

Pfizer may have had high hopes for this drug because it already launched a multichannel marketing/PR campaign centered around "getting old" (see "Pfizer's Social Media Initiatives are Getting Old") and this drug in particular (see "Can Pharma Cure Alzheimer's Disease? A Pfizer Pre-Launch Multichannel Marketing Case Study").

I'm not sure what other Alzheimer products Pfizer is currently working on, but maybe it's time for it think out of the box. Perhaps it should look into gamification as an alternative strategy.

You might ask, "Are you serious John? Just yesterday you pooh-poohed gamification as an alternative to ADHD drugs" (see "Cure by Gamification: Science or Wishful Thinking?").

True that. I still believe that games will never be approved by the FDA for treatment of a medical condition and doctors won't prescribe them even if they were approved. But that doesn't mean games cannot be effective in the treatment of Alzheimers Disease by slowing its progression, which has been the goal of clinical trials of drugs like bapineuzumab.

There is actually some SCIENCE published in a peer-reviewed medical journal (JAMA's Archives of Neurology) that purports to have found a link between “brain-stimulating activities” and levels of protein -- ie, β-amyloid -- thought to cause Alzheimer’s disease (see "Brain Games May Help Thwart Alzheimer’s: Study"). The authors of the study state:

"We report a direct association between cognitive activity and [11C]PiB uptake, suggesting that lifestyle factors found in individuals with high cognitive engagement may prevent or slow deposition of β-amyloid, perhaps influencing the onset and progression of AD."

At least one patient support group supports the idea that games might be helpful in thwarting Alzheimer's Disease (see this LivingStrong web site page: "BRAIN GAMES FOR ALZHEIMER'S").

For anecdotal evidence, I have been solving 2-3 crossword puzzles per day (as recommended by LivingStrong) for a couple of years and am happy to say that I have not been diagnosed with Alzheimer's -- yet. Unfortunately, I did not have a brain scan before starting nor do I have a control group so as to scientifically prove or disprove that I am not slowly developing the disease.

Nevertheless, I still think it's unlikely that any drug company would get into the business of "drug gamification" -- ie, developing games approved by the FDA for treatment of medical conditions. For one thing, it's much more expensive getting games approved by the FDA than it is to develop the games themselves -- an economic reversal of the typical pharma drug development model.

As a consequence, it would be very easy for competitors to develop therapeutic games of their own and get them approved by the FDA, which is likely to consider such games as medical devices (they are not consumed by patients). I believe that the way FDA approves medical devices makes it easier for competitors to get similar games approved without having to finance new clinical trials. "Me too" game developers can use existing clinical data paid for by the "innovator" company as evidence of safety and efficacy.

Then there would be "over the counter" competition from games that do not have to be approved by the FDA as long as they are not marketed as being effective in treating a disease like Alzheimer's (the marketers, however, can say things like "helps improve cognitive ability").

Hey, I'm sorry to break your bubble -- ie, hype -- about the potential of gamification for the pharmaceutical industry in so far as treatment modality goes. It's not that games may not be effective in the treatment of certain medical conditions -- they could be. My point is that it is unlikely that traditional pharma companies will develop games for that purpose for the reasons cited above and in previous posts. That's my opinion and I'm sticking to it!

Cure by Gamification: Science or Wishful Thinking?

Last week, I wrote about a video game -- Akili, meaning "wisdom" in Swahili -- that the developers plan to submit to the FDA for approval in the hope that "clinicians will turn to before prescribing medicines for ADHD" (see "The Next New Drug: An FDA-Approved Video Game").

"We would aim to have efficacy and tolerability that outstrips any of the drugs," said Dr. Martucci, an associate at PureTech Ventures, which formed the start-up company that is developing the game.

I expressed strong doubts that the FDA would ever approve a game to treat a medical condition. Even if the FDA did approve such a game, I doubt insurers and other payers would pay for it. I also doubted that physicians would prescribe it.

This morning, James Ellis (@digital_pharma), a "digital strategist" at closerlook tweeted:

"Gamification is laughable, says @pharmaguy? I'd rather listen to what science says. bit.ly/NjIo9G"

In his blog post ("Who’s Scared of Gamification? (Besides pharma, I mean)"), Ellis says:
"But last week, Pharma Guy decided to stomp all over the idea of gamification like it was irritating pest. A game that helps kids with ADHD train their brain to not need Ritalin? Laughable! Now, I’m not picking a fight with John Mack (oh, wait. Yes I am), but he seemed to take actual joy in pointing at it and calling it names."

Let's start with the "laughable" crack. I certainly did not call this game or even the idea of developing FDA-approved games "laughable." And I did not call it a "name" other than what it's called by its developers! I also did not "stomp all over the idea of gamification" -- my post was simply about one particular game and not a critique of gamification. If you want that, Ellis, I suggest you read "A Drug is Developed:" Easier than Launching an Educational Facebook Game about Drug Development?

As for the science, I have no idea what Ellis is referring to in this case. There certainly is NO SCIENCE -- ie, clinical trials -- that I know of that proves a video game can treat ADHD. And certainly no scientific data that has been submitted to the FDA. Nor does Ellis offer ANY science in support of his thesis, which is nothing more than wishful thinking.

In the end, Ellis makes this wise crack: "maybe Pharma Guy thinks washing one’s hands before an operation is lunacy."

I have no idea where that came from! Maybe Ellis thinks wishful thinking -- ie, that science WILL one day prove Akili helps kids with ADHD so they will "not need" ritalin -- is enough for the pharma industry to go out and hire "digital strategists" to develop games. Now that's "lunacy!"

The Next New Drug: An FDA-Approved Video Game

Imagine my surprise when I read this in today's Wall Street Journal: "Akili Interactive Labs Inc. of Boston, formed by start-up-creating firm PureTech Ventures, and San Francisco company Brain Plasticity Inc. are seeking Food and Drug Administration approval for a video game treatment they hope clinicians will turn to before prescribing medicines for ADHD" (read the story here).

I've been writing a lot about "gamification" and the pharma industry (see "Pharma & Fun, Not Oxymoronic? Here Comes Gamification!" and "Gamification, Then and Now", for example), but never from the perspective of games designed to compete with drugs such as Novartis' Ritalin, a stimulate indicated for the treatment of ADHD.

Akili -- meaning "wisdom" in Swahili -- is the name of the video game that Akili Interactive Labs hopes will be the first ever video game "treatment" approved by the FDA. The game is designed to run on smartphones and iPads. The company also hopes clinicians will recommend the game to patients before prescribing medicines for ADHD.

Fat chance!

First, fat chance that the FDA will actually approve a video game as an effective treatment for a medical condition. Second, fat chance that even if approved, health insurers/patients will pay for a game treatment after being conditioned all these years to think only of drugs as treatments. Third, fat chance that physicians will prescribe the game to their patients. That would require overturning the entire drug-physician industrial complex!

Nevertheless, Akili co-founder Eddie Martucci said "his company's research shows that people want choices other than today's powerful medicines. 'We would aim to have efficacy and tolerability that outstrips any of the drugs.'"

Wow! Are these guys anti-drug industry? NOPE! Senior Partner, Chairman of PureTech Ventures is Dr. Ben Shapiro who was previously Executive Vice President, Worldwide Licensing and External Research for Merck. Another Senior Partner at PureTech is Dr. John LaMattina, who was previously President, Pfizer Global Research and Development and Senior Vice President, at Pfizer Inc.

LaMattina, who also writes the Drug Truths Blog at Forbes, was once enthusiastic about torcetrapib, a drug that Pfizer hoped would replace LIPITOR. "We believe this is the most important new development in cardiovascular medicine in years," said LaMittina. That was before Pfizer halted development of torcetrapib and after it spent more than $800 million on its development (read "torcetrapib: $800 Million Failure but Kindler Safe"). Hopefully, Akili isn't costing nearly as much to develop as a new drug.

With such experienced drug industry veterans as partners, Akili might have a chance of making it to the FDA. Unless, of course, clinical trials reveal dangerous side effects.

It's not likely such side effects will be similar to those that torcetrapib caused; i.e., death. Some video game critics, however, fear that "electronic media might improve visual attention but impair the ability to sustain attention on a hard or boring task," notes the WSJ article. "The latter type is what teachers need from students, according to ... Douglas A. Gentile, a developmental psychologist at Iowa State University." What teachers DON'T need, however, is for students to claim that playing video games during school is part of their medical treatment!

It's interesting to speculate how FDA-approved video games would be marketed, assuming any will actually be approved by the FDA. Akili, for example, might splurge on exhibits at medical meetings and lure physicians into its booth to play the game. And maybe it would hire physicians to be "consultants" and "speakers" to promote the game to their peers. I'm betting that direct-to-consumer (DTC) TV ads would be out of the question -- much too expensive for a product unlikely to reach "blockbuster" levels of sales.

I do, however, envision that DTC social media could be very cost-effective for marketing FDA-approved video game treatments.

Gamification's Brave New World Circa 1984: Operation Frog

There's a lot of brouhaha these days in pharma circles about "gamification" as if it were the newest thing since sliced bread. What is "gamification," you ask? According to the Gamification.org wiki (here):

"Gamification typically involves applying game design thinking to non-game applications to make them more fun and engaging. Gamification has been called one of the most important trends in technology by several industry experts. Gamification can potentially be applied to any industry and almost anything to create fun and engaging experiences, converting users into players."

You might find this "Gaming Goes Mainstream" infographic interesting.

An example of an attempt to apply gamification to the pharmaceutical industry is the "Syrum" Facebook game being developed by Boehringer Ingelheim. The release of that game, however, has been delayed for nearly a year (see "Pharma & Fun, Not Oxymoronic? Here Comes Gamification!" and "'A Drug is Developed:' Easier than Launching an Educational Facebook Game about Drug Development?").

I know from first-hand experience how difficult it is to develop educational games. I started my career -- such as it is -- back in 1984 designing an educational life science personal computer-based game. It was a simulation of a frog dissection. The objective was to use the keyboard or joystick to move a simulated hand, pick up simulated instruments, and "dissect" a simulated frog and identify its organs. At the end, the user (usually a high school biology student) was challenged to reverse the process by putting the frog back together (the game aspect). If successful, the user was rewarded with a fun animation of the (simulated) frog dancing off in a top hat and cane -- no harm done (except to the frog I dissected doing research for the simulation). The codename was "Defrogger" but it was published by Scholastic as "Operation: Frog".

Operation: Frog ran on the Apple II computer, which at the time had the most advanced graphics of any personal computer on the market. It was an 8-bit computer with a screen resolution of 280x196. You could get 16 colors using a technique called "dithering." Here's a screen shot showing the frog's digestive system:

You can count the pixels without a magnifying glass! To get this level of detail from an 8-bit 16-color computer display was quite a challenge requiring planning and storyboards (I also created the graphics and wrote the screen text and user's manual). Here's the storyboard for the dissection screen, which is evidence that I actually did this more than 28 years ago (OMG!):

In my proposal to Scholastic I said that "dissection of a living animal or one stewed in formaldehyde is an unpleasant experience for many biology students and teachers alike. Not only does it require the sacrifice of many animals, it is also expensive and potentially dangerous. Consequently, many children never carry out a dissection."

Okay, I was playing it up a bit too much. However, the program was a hit. It was  featured in the October 15, 1984 issue of Newsweek Magazine and played a role in a 1987 California court case in which Jenifer Graham, a brave 15-year-old high school girl, defended her right to refuse to dissect a frog. Ms. Graham suggested "she could learn just as much from models or computer graphics as her fellow students learn from the dissection of a frog. It seems incredible," said a Los Angeles reporter at the time (here), "that a school would resort to a dead frog, formaldehyde, forceps and scalpels in this age of computer graphics."

At the time, Ms. Graham was vilified. Unfortunately, although we've come a long way in terms of computer graphics and gaming, students who refuse to dissect real frogs are still vilified (see, for example, "Middle school student claims teacher bullied her over refusing to dissect frog").

For more Operation: Frog screen shots, see my Pinterest Gamification Board.

"A Drug is Developed:" Easier than Launching an Educational Facebook Game about Drug Development?

About six months ago in December, 2011, Boehringer Ingelheim (BI) teamed up with the Mainz Natural History Museum in Rhineland-Palatinate, Germany, to create "Ein Medicament Entsteht" ("The development of a medicine"), which was an educational exhibit seen by more than 30,000 visitors who "marvelled at the story of a drug's development cycle from the first project outline through to market authorisation." Here's the YouTube video:



Meanwhile, back in October, 2011, BI's @johnpugh was tweeting about a "kick-ass [Facebook} game" called Syrum, in which "a player must first investigate molecular compounds at a research desk before putting them to the test in the laboratory, then conduct clinical trials and, if successful, advance a treatment to market." For more about this game read "BI's Facebook Game Syrum to be Launched 'When It's Ready'."

It turns out that Syrum has been much more difficult to "bring to market" than the Mainz Museum exhibit. Syrum is still not ready to be played and is "Coming Soon" (see screen shot below taken today when I clicked on the "How to Play" button).

I'm supposed to be a "beta tester" -- someone who reviews the game before it is launched to the public -- but, so far, I haven't been given anything to test. I'm afraid this game might take longer to develop and bring to market than an actual drug!

Meanwhile, John Pugh continues to talk about Syrum at industry conferences. Most recently, Pugh presented at "Doctors 2.0 & You™" and he is scheduled to provide "A Detailed Update on the Development and Continued Use of Syrum" at ExL's 6th Annual Digital Pharma East Unconference on October 17, 2012. Of course, that depends on the gamiification development process, which we know can take years!