The Socialisation of the Internet is Bogus

"The whole web is now socialised..." said Alex Butler in a pharmaphorum interview ("Psoriasis 360: How pharma can do social media").

Alex does NOT mean that socialists have taken over the Internet, although, if you think about it ... hmmm. I digress...

"We live in a post-advertising age where messages no longer resonate without dialogue, and where information is best exchanged through community," said Butler (see "Social media doesn't really exist" and listen to this Pharma Marketing Talk podcast interview of Alex Butler: "Is 'Social Media' a Distinction Without Meaning in Today's World?"). "But although it is tempting to think that contact is now king, in fact high value dynamic content, valued by the consumer, has never been more important...there is little of value on the internet that is not socialised in some form, even if it is just the capacity to comment and share. So how as an industry can we influence the exchange of ideas and information if we are not prepared to be where our audience and communities exist?"

When all is said and done, what Alex is really saying is that commenting, sharing, and all that community stuff really is second fiddle to content. Throughout his comments to pharmaphorum, Alex refers to Facebook, Twitter, etc. as "channels" through which he reaches his audience to deliver valuable content.

Some agencies and consultants are telling their pharma clients that social media is NOT a channel -- it's a different way of interacting with people online. Frankly, I think that is bogus.

First, VERY FEW PEOPLE on the Internet -- and that includes Facebook and Twitter -- are social. I mean VERY FEW are socializing with entities like brands and corporations or even real people from companies, publications, and other corporate entities.

For example, there are about 20,000 individuals that VISIT (and presumably READ) this blog every month. Maybe 12 or so submit comments and perhaps a few dozen tweet (share) the content with their friends online. I suspect the ratios are similar at publications that receive a lot more comments and shares. That is, at least 98% of visitors to blogs, Facebook, or Twitter followers are "lurkers" -- they don't socialize, they read.

Which is just fine with me! I don't have time to socialize with 20,000 visitors to this blog and I'm sure you don't have time for that either! (Which is the #2 reason why the Internet is NOT social. Or is that part of reason #1? Whatever!)

Questions I Intend to Ask DDMAC Director Thomas Abrams at the ePharma Summit

I've noticed that FDA's DDMAC Director Thomas Abrams has been making presentations at several recent drug industry conferences. At the 10th Annual ePharma Summit that begins today in New York City (see here), Abrams presentation is titled: "Regulation and Oversight of Prescription Drug Promotion: Update from DDMAC," which is similar to presentations he's made at other conferences.

Of course, as I mentioned in a previous post ("11.5 Things I'd Like to Learn at ePharma Summit"), most attendees of the ePharma Summit are looking for updates on FDA's guidelines for use of the Internet and social media by pharmaceutical companies; ie, Where are they? When are they? What are they?

From a preview of Abrams' Powerpoint presentation, it appears that he will have very little to say in answer to these questions. Only 3 out of 46 slides concern social media guidelines. Two slides merely summarize what we already know: how many people made presentations at the November 15, 2009 public hearing and how many comments FDA received to the public docket.

The third slide describes the FDA's guidance sausage-making process (shown below; click for enlarged view):

Again, nothing new: Abrams, for example, has said before that FDA will issue "multiple guidances." We are somewhere in the "Prepare a draft guidance document and vet through internal clearance process" stage; ie, the sausage is jammed in the machine.

Here's what I hope to ask Tom Abrams at the Summit (if he allows questions from the audience):

"Tom -- I hope I can call you 'Tom'; I've seen you at so many of these conferences that I feel we should be friends on Facebook or Twitter if not in real life, but I can't find you on these social networks, so maybe I should stick to Mr. Abrams: What's holding up the process of releasing SM guidance? For example:

• "Has President Obama's recent executive order for government agencies to review all regulations old and new to determine if they hinder economic growth thrown a monkey wrench into FDA's 'Social Media Guidance Process'? That is, is the FDA's guidance process slowed down because of this extra internal review that is required?

"Any comments at all about this issue that might be affecting the FDA's guidance process will be appreciated."

BTW, look for me wearing a special shirt, which may or may not be this one:

Should FDA Have Approved Contrave for Obesity Because Docs Are Too Stupid to Use the Generic Components Off-label?

As reported in the WSJ Health Blog, FDA said it wouldn’t consider approving the experimental weight-loss drug Contrave without another clinical trial. FDA's decision comes after an FDA advisory panel voted in December to recommend approval of the drug.

Many pundits consider this another example of how risk-averse the FDA has become and how its decisions are hampering innovation. Even critics of the drug industry like Dr. Carlat claim that FDA's Contrave decision was a "Big Mistake" (see here).

Why does Carlat think it was a mistake when Contrave "is simply a combination" of two generics -- burpropion (Wellbutrin) and naltrexone -- that have been available for a long time? He says "Combining Wellbutrin and naltrexone was not something the average doctor would have ever thought of for an obesity treatment, so this counts as an uncommon example in which a company had a bright and non-trivial idea for a combination of two existing products."

Carlat didn't exactly say that doctors are too stupid to combine generics but a commenter said "the fact that the average doc might not have thought of it implies we need more effective dissemination of such info, not a new commercial product. Or are you thinking the inevitable TV ads might be a good way to get us all up to speed?"

Ha Ha! Good one! As if branded TV ads would alert doctors that the drug is actually a combination of two generics. They'd have to read the small print of the package insert to realize that. But advertising ANY treatment for obesity might make doctors who prescribe the treatment appear smarter.

BiDil is an example of a failed combo-drug the FDA DID approve (for heart failure). It didn't sell well despite advertising (see "BiDil Sales Disappoint: Blame Genes or Marketing?") perhaps because doctors were already smart enough to prescribe the cheaper generic components of the drug.

Carlat also said "The good news is that patients can ask doctors to prescribe them the constituents of Contrave, both of which are available in generic form -- burpropion and naltrexone. Presumably, this generic combination will be much cheaper than Contrave's pricing anyway!"

Obesity is a big problem here in the U.S. and elsewhere. The drug industry is looking to capitalize on that by introducing new drugs to treat obesity. Unfortunately, instead of investing in research, many companies are going after low-hanging fruit like combo drugs or actually cutting their research budgets to shore up stock prices (see, for example, "Pfizer Inc: Working Together for a Healthier Investor™").

11.5 Things I'd Like to Learn at ePharma Summit

Next week I'm investing a lot of money to travel to NYC and stay at a fancy hotel to augment my HiltonHonors points in order to attend the 10th Annual ePharma Summit. Sorry, but it looks like it's all sold out, which may be thanks to me being paid to promote the conference (Pharma Marketing News is a Media Partner for the event).

I'll be seeing a lot of friends like DJ Edgerton (@wiltonbound) of Pixels & Pills, who promises to have a birthday surprise for me at the Monday night Pixels & Pills ePharma Summit Tweetup & Phone Drive.

But I have learned that to get the most from conferences like these, you must set goals. So, without further ado, here are my goals, or things I'd like to learn:

(1) Will Thomas Abrams, Head of FDA's DDMAC, actually have something new to say? Hello! We all just want to know about those social media guidelines. Where are they? When are they? What are they? On the ePharma Summit blog, Marc Dresner likens the FDA to a plumber who doesn't know how to unclog pharma's social media pipes! (see "Where’s A Good Plumber When You Need One?")

(2) Are patient advocates really consumer opinion leaders and what do they really want from partnering with pharma marketers? Will they help or hurt pharma's image? Is it like partnering with the devil? What part of their "souls" will they have to give up? For more on the issue of online patient opinion leaders, see "Pharma Collaboration with Online Patient Opinion Leaders" (pdf).

(3) Kevin Nalty, you magnificent basterd, I read your book on the iPad ("Beyond Viral: How to Attract Customers, Promote Your Brand, and Make Money with Online Video (New Rules Social Media Series)" Whew!). Actually, I downloaded it on my Kindle, but haven't read it yet. I hope Nalty is giving away free, signed hardcopy editions. I probably won't read that either. I have run into Nalty at many of these conferences, but never heard him speak. I wonder if he's any good? I think I will bring my Flip video camera and make money online showing a video of me interviewing him. Maybe we'll pull some famous Nalty pranks in the audience while he speaks? BTW, I made Nalty famous when I exposed him as ADHD Boy! (see "Nalts Talks About His Days at J&J, His ADHD, and His Merck Performance Review").

(4) Does Pfizer really have anything to add to my knowledge? David Ryan, Senior Director, Multi Channel Planning, Pfizer, Inc. will give a keynote titled "Achieve Personalized Professional Marketing at Scale." I have no idea what the hell that means, but I think it means "you know, there's more out there than just social media, which we stink at. But we are great doing the other 'multi' stuff and that's what I will talk about." Anyway, I am willing to learn about multi-channel planning.

(5) Why is Wired Magazine giving a keynote titled "The Future of Health is in the Hands of the Consumer"? Is that magazine still published? I guess I'll find out.

(6) I want to learn more about "Pharma's Headline Catchers" and what that has to do with "ROI Drivers Online" from Comscore. Will it feature the kinds of headlines I caught in the 2010 Pharma Marketing Yearbook?

(7) I am all excited about "The 2010 MM&M Awards," which James Chase will present at the conference. Who are the winners? It's a closely guarded secret! I hope they allow live tweets while James does his thing. I don't much care for these kinds of awards but I do love the parties (see "MM&M Award Winners Announced at Gala NY Event!").

(8) I'm looking forward to hearing Lucy Rose lead a discussion about "Addressing Internal Regulatory and Legal Concerns and Challenges." She is dynamic and knows her stuff and will keep the audience awake during what would otherwise be a dull session.

(9) Social Media: "Wish I'd Done That!" This is one session I won't miss, although I think it should have been called "Wish I didn't do that" -- I notice, for example, that sanofi-aventis isn't on the panel (see "Disgruntled Patient Shuts Down sanofi-aventis Facebook Page"). Novo Nordisk's Craig DeLarge, however, will be there. I hope to ask him if other pharma companies wish THEY were first to post a branded tweet (see "Novo Nordisk's Branded (Levemir) Tweet is Sleazy Twitter Spam!").

(10) What's Tried, Trusted True, and New in search engine marketing? Google's Maryann Belliveau will tell us. No, she's not That Girl from Google who advised everyone to use the "one-click rule."

(11) Is this REALLY "The Year of Mobile"? No matter how many presentations I hear about mobile technology in healthcare -- and I've been to many starting about 6 years ago -- it's always "the year of mobile" for someone, somewhere. I'm just not sure it's pharma's year.

(11.5) I also hope to learn if there's an underground, secret passageway between the Hilton, where I'm staying, and the Sheraton, where the conference is, because I hear it's going to snow again next Tuesday!

Pfizer Inc: Working Together for a Healthier Investor™

Pfizer's corporate slogan -- Working Together for a Healthier World™ -- may be "commercially unpromising" and in need of restructuring.

"[Pfizer's research] employees worldwide - along with patients awaiting breakthroughs in therapeutic areas that have been deemed commercially unpromising such as urology, allergies and respiratory ailments - are the losers in a reshuffling of priorities by the world’s largest drugmaker," reported the Financial Times (here).

Pfizer's incoming chief Ian Read plans to continue along the shareholder-pleasing path established by Jeff Kindler, the company's outgoing CEO.

During the past 5 years, "Pfizer returned about $45bn in cash to shareholders while continuing headcount-shredding mergers, most recently with Wyeth," said FT. "Now it will cut an additional $2bn from planned research and development spending to return the savings, and then some, to owners. Already having one of the highest dividend yields in the S&P 500, Pfizer will add $5bn to an existing $4bn share buy-back plan. The move pleased Mr Read’s most important constituency - shares rallied after the announcement."

In light of this, I suggest that Pfizer's new corporate slogan should be: "Working Together for a Healthier Investor™". But that wouldn't sound so good coming from @Pfizer_news, Pfizer's TwitterMeisters, who claim that Pfizer applies "science and our global resources to improve health and well-being at every stage of life." These days it's less about science and more about [financial] resources that power Pfizer.

Why Doctors Shouldn't Use Twitter for Patient Care

There's a lot of buzz about using Twitter and other forms of social media to improve health care (see, for example, "More Patients Meeting With Doctors Via Web Programs Such as Skype", and "Is The Future Of Healthcare Communications In Social Media?"). In particular, physicians are being encouraged to use social media -- Twitter in particular -- to help them deliver better health care.

But it seems that physicians are reluctant to do it for a variety of reasons (see, for example, "Are Doctors Avoiding Twitter Because of 'Doctor Bashing'?"). If doctors DID become big fans of Twitter, we might see the scenario depicted in the following New Yorker cartoon*, which appeared in the recent issue:

*Note: I changed the caption, which originally read “We’d like to start out being very involved with you but eventually be drawn away to much more interesting cases down the hall.”

GSK's U.S. Sales Reps "Europeanized": No Longer Rewarded for Ability to Push Prescriptions

According to the Financial Times, "GlaxoSmithKline will this month scrap payments to its US-based commercial staff based on individual sales targets, as it attempts to draw a line under past aggressive marketing practices that have incurred substantial fines" (see here).

GSK’s sales "reps" will no longer receive commissions "based on their ability to push prescriptions. They will instead be paid based on their scientific knowledge, feedback from customers and the performance of their business unit."

An anonymous poster to CafePharma described what the "new" sales model will look like:

You will be judged on 3 categories. Product Knowledge, Customer Value, and Business Acumen. Each one of these will be split into 2 parts. Preparation and implementation. Basically, 6 categories to be subjectively assigned expertise levels by your manager. Hope you have a good relationship... This is how you will get your "cut" of your region's take of bonus dollars.

Oh yeah... you are also no longer referred to as pharmaceutical sales reps... from now on you are called "Customer Facing Staff". No joke...

GSK recently revealed a $3.5bn charge to settle product liability lawsuits and regulatory fines linked to past sales practices (see story here), which may have prompted this change as well as changes in funding physician continuing medical education (CME): GSK will now restrict funding CME courses to a small number of non-profit institutions.

This seems to be a radical shift in the evolution of the pharma sales model that has been followed by companies like Kantar Health. I've written on this subject in several Pharma Marketing News articles over the past year or so. See this recent article: "The Changing Pharma Commercial Model in 2010 and Beyond" (use discount code '95MDK' to download it free).

I also note that in order for a pharma company to reward its sales reps based on prescription volume of physicians they have detailed (the "old" model), the company has to have access to the prescription writing data of individual physicians. It's not a coincidence perhaps that the Supreme Court will soon determine if states have the right to prevent access to that data by pharma companies (see "Supreme Court to Decide Fate of State Laws that Prohibit Use of Rx Records by Pharma"). GSK may be sensing that the decision will go against them and they can take the "high" voluntary road now instead of taking the "low" legally-forced road tomorrow.

Although this model may be new in the U.S., it's not so new in Europe where pharma companies never had access to individual physician prescribing behavior. In Europe -- as I understand it -- pharma companies can only see how prescriptions change among a block of physicians in a certain geographical area more or less equivalent to a zip code in the U.S. Thus, basing sales rep commissions upon "district" performance in the U.S. is similar to how it's done in the EU. From the anonymous post made to CafePharma cited above, it looks like U.S. reps are not going to be happy to be "Europeanized."