It may seem like an uphill battle. How could a patient change the way a physician prescribes? Believe me, I’ve heard it many times before. “We don’t focus on patients,” and “Our only real target is physicians – patients don’t matter.” Really? That sounds like a great strategy – for 1997. Let’s keep up with the times, people. Consumers are hungry for information. It doesn’t matter what the category. My dad used to choose whatever the local mechanic recommended, but now he won’t even buy a new headlight without searching ratings, reviews, and shopping engines. People want to be fully informed before making a decision. Show me the CARFAX!

So why would we think healthcare is any different? People want to make the right decision when it comes to health and safety, and they will do the research. So why fight it? It isn’t hard to give people what they want. It doesn’t require a multi-million dollar ad campaign. You just have to be there when they are looking for you (even if they don’t know they are looking for you).

1-800-flowers can run commercials all day long and I may never feel the need to order flowers. However, a search ad is very likely to get my attention when it appears for the term “same day flower delivery” on October 7th (my Mom’s birthday). This is exactly how it works in pharma. Consumers develop symptoms/are diagnosed/need a refill and immediately start searching. These are the opportunities you must pounce on. They are looking for you. They want your help.

Encourage them to seek diagnosis. Prompt them to ask questions. Help them save money.

If you don’t, your competitor will. I have a great case study, but first something I stumbled upon while writing this post. I asked a coworker to pick a random disease and then I started searching. “how can I stay awake?” “narcolepsy treatment.” “ghb coupon.”All roads should have led to Xyrem. But they didn’t. They led to Nuvigil. Even a search for “xyrem coupon” led me to Nuvigil. The icing on the cake – Xyrem.com won an eHealthcare Leadership Award in 2008 for “best website.” People want to be empowered, and they will use the tools you make for them. But only if they can find them…having a great site does nothing for you if people can’t find it!

Let’s get back to my original question. Can patients influence prescribing habits? Well, I work with a smaller brand in a marketplace dominated by several blockbuster drugs. This smaller brand can’t afford a big consumer campaign, but they do make sure they reach the right people at the right time. Year after year they continue to prove that smart paid and organic search campaigns get results. Results that are driven by patient requests. Patient requests for a brand that those patients had never heard of before they started searching.

This brand dominates natural search, continually being the only brand on the first page for key disease-state terms. This natural search presence plus a strategic paid search campaign has resulted in highly qualified patient traffic that continues to increase every year. More than 20% of their traffic in 2009 printed a coupon and 30% of those prints were redeemed. Need more proof? The brand did a 3rd party study and found this interesting stat:

In 2009, 10% of their prescriptions were driven by patient requests.

Not bad for the annual cost of a handful of sales reps.

With viewers “tuning in” to watch video online, the consumption of broadcast content will continue to morph dramatically. Pepsi opted to skip advertising in the the most widely-viewed sports events to focus on social media efforts. Soon, Hulu could become more of a threat to traditional television than DVRs. Some companies continue to use long-form video, such as GlaxoSmithKline and the Alli-themed documentary, but brief, serial clips may yield an advantage for continued engagement.

In pharma, the opportunity is yet to be fully seized. Nearly half of online physicians in Western Europe reported watching Web videos for professional purposes. At the FDA social media hearing, we learned physicians watched instructional videos online the night before performing an orthopedic surgical procedure. And this doesn’t change translating from professionals to consumers. Video can be extremely effective in communicating with patients and caregivers beyond simple text. Video can communicate complex ideas, such as mechanism of action, more easily than the written word. Patients telling their own stories in their own words yields greater emotional engagement. And, very often it becomes viral.

This should encourage brand managers to recognize the unique benefits of video and leverage these assets online – whether on corporate, unbranded or products sites, or shared on social media channels.

The path goes something like this:

• Identify an emerging trend that presents a new marketing channel opportunity (ie, the Internet)
• Research and purchase a large, comprehensive system or platform that is a “best in class” solution for highly sophisticated marketing campaigns (think BMS and Broadvision)
• Pay an enormous sum for an outside consulting firm to determine the best way to implement the platform and train the organization…and then spend a year+ doing so
• Attempt to force brands to use the resource by mandating platform usage as well as providing partial funding and man power
• Do all this before the solution has been proven successful to brand marketers, or before they understand how to integrate it into their marketing plans

What then follows, of course, is that the platform is under leveraged and usually deemed obsolete three years later, after millions of dollars have been invested and much time wasted. Finally it took some “Cowboy” brand manager on an overlooked brand (See Famvir at Novartis, circa 2001, the first brand to utilize an online coupon) to be the first mover, which the company then used as a model for the rest of the organization.

Why didn’t this path work for “e”, and why won’t it work for HCP RM? Two reasons:

1. The company failed to follow a simple business rule – fulfill market demand. In this case, the “market” is their brand management, and no one in brand management was clamoring for a sophisticated, enterprise-wide solution. They wanted to dip their toe in, follow the guidance of their agency partners and test different solutions, different approaches. They didn’t want the 500 lb gorilla solution, and they weren’t prepared to leverage it so early in the adoption lifecycle (Neither was MLR or the rest of the organization).
2. The company tried to circumvent evolution – the most effective form of natural selection. Innovative brand marketers (aka, the “brand cowboys”) will see the new channel opportunity and find a way to test it out, to start small, to move in the right direction. If successful, this effort will grow and evolve and eventually become something comprehensive that can be replicated across other brands. Think of the early brand adopters of paid search, and how that spread like wildfire once the ROI was demonstrated! If unsuccessful, the solution will fail, without undue time or budget waste, and it will be up to the next brand or partner to do better. By starting with a massive and mandated solution, this process was overridden and platforms that did not serve the needs of the brands or the end customers were mistakenly chosen.

I certainly understand that HCP RM is complex, more complex than internet marketing, and involves many groups across the organization. Thus, no one brand cowboy can likely implement a true RM program without a lot of internal support and collaboration. However, let’s pick a cowboy on a brand that has much to benefit from RM; start small and simple, and scale up from there. Once success has been demonstrated and processes have been worked out, then consider what larger platform or system might be needed, and what other brands can be added. At the end of the day, it will have taken just as long to get the whole company on board, but the solution will be far more suited to the needs of the company/brands, it will have been proven successful in driving business and there will be meaningful support and adoption throughout marketing and the rest of the organization.

Innovation Lab Panelists

Alan G. Reicheg, SVP Commercial
Operations, Qforma

Devin Paullin, Ex. VP, Business
Development, Physicians Interactive

Mary Anne Greenberg, President
Alliance Healthcare

Michael J. Laferrera, Sr. Vice President,
Sales and Marketing, J. Knipper & Co.

Everywhere in the industry these days, you hear talk about Healthcare Professional Relationship Marketing (HCP RM), Non-personal Promotion (NPP), and Channel Preference Marketing (CRM). Nearly every company has these programs on their “to do” list, but few are actually implementing them. Why is this? On November 4, 2009, Compass Healthcare Communications hosted its Innovation Lab Series workshop in Princeton, assembling a team of participants and expert panelists to discuss this very topic.

HCP RM: Why Now?

The old model for how to target and communicate with healthcare professionals has been turned on its head. The time physicians have to interact with sales forces continues to diminish and access to physicians is becoming increasingly difficult. Up to 35% of all physicians are now considered “no see” docs and some states such as Massachusetts are imposing restrictions on sales rep activities. Add to this the fact that pharmaceutical companies are drastically cutting their sales forces and you have an environment that’s ripe for new and more effective ways to reach HCPs.

What HCP RM Is Not

Before exploring HCP RM programs in more detail, it helps to establish a few things that HCP RM programs are NOT. They are not newsletters or mailers or phone calls created in a remote conference room and then force-fed to a recipient. They are not comprised of generic content that makes no provision for how the recipient wants to be communicated with, what his or her level of knowledge is with the brand, or where the recipient resides along the brand adoption continuum. They are, instead, customer-focused programs, delivering the right message to the right audience segment at the right time using the right channel. The right message is one that is meaningful to the HCP. Figuring this out means understanding who the HCP is—what their needs and interests are, what motivates them—so that you can truly service their needs, not just sell them stuff.

Where To Start

When many pharma marketers hear the term relationship marketing, they are quick to think of patient relationship marketing efforts such as compliance programs. But given that some physicians either cannot or do not want to meet with reps and that many prefer other and more varied forms of contact, it’s clear that HCPs want to engage with the brand through several communication channels.

Building a successful HCP RM program is no easy feat. It all starts with understanding the different segments of your audience and delivering tailored, meaningful communications to them in the form, method or vehicle they prefer. Every disease state and therapeutic class is different. Organizations will have to adopt a different mindset beyond just a rep knocking on a quickly closing door. And there are no simple formulas that will guarantee success in any given specialty. But there are some best-practices tips we discussed over the course of the Innovation Lab session that can help overcome common challenges in the HCP RM space.

1. Identify leadership, budget, and resources: One of the biggest challenges to implementation, especially in larger pharmaceutical companies is: Who is going to lead the initiative? Who owns this “new” program? The brand? The sales force? Another party? Who will pay for it? And what changes will need to be made to the technical infrastructure to support the program? This may prove to be the biggest obstacle. A truly effective RM program should be thought of as an infrastructure investment; not a mere campaign. By its very nature and considering the many departments that an effective RM program impacts, this initial step has the highest likelihood of derailing or significantly delaying the entire project. Our advice is to pilot a program with one or more brands that share the same specialist. Do not go “enterprise wide” right out of the gate. Learn from the mistakes that were made with the adoption of online programs in Pharma. (See sidebar)
2. Devise the right segmentation strategy: Who are the right and wrong physicians for your program? What are the best messages to deliver to your different audience segments? To succeed in this area, you’ll want to work with outside resources to “really” understand your audience segments. Successful programs are based on segmentation that’s psychographic rather than segmentation that’s demographic, script-driven, or decile-driven. It’s important, too, not to forget the nurse segment, as nurses perform most of the legwork and patient interfacing. By first effectively segmenting HCPs and determining your goals, you can then move onto choosing the appropriate tactics and channels for those various segments.
3. Build the right databases. Having a database that meets your RM goals is key to delivering customized communications to each specific audience segment. Successful and strong relationships can only be attained when the database can continually “learn” and react over time. Pharmaceutical companies are notorious for having physician databases that are anything but robust. And many lack the capability to appropriately design, build, and maintain the right kinds of databases. Unfortunately, many vendors who excel in this area have proprietary databases that pharma companies can only rent, preventing the pharma companies from truly owning, mining, and leveraging its own data. Still, there are tips for creating an effective database. It’s essential, first of all, to set up your database correctly from the beginning, ensuring that the data fields you collect are indeed the right ones and that the right people are using the database. It‘s critical, too, that the database be designed to acquire and decipher incoming information—eMails opened, poll questions answered, site pages visited, rep observations—so that the database continually learns where each target is on the behavioral continuum and what is required to move them further along. This ensures that your communications meet the specific information needs of each segment, reflects their knowledge of the brand and where they are on the continuum. Your budget and technical requirements must also be able to support the data to be collected and stored.
4. Abandon political silos. Beware the turf battles that may ensue, although this may be easier said than done. Chances are, a lot of hands will be touching your RM program, and there will be many interested, affected and vested parties—from individuals in multiple internal departments to a network of outside vendors. This is not the time to retreat to political silos. These different teams need to work together and complement each other’s contributions. Pick the core competencies of each group and have them focus on the task at hand. Everyone needs to know how to play well together in order to deliver the best program results.
5. Address sales force fears. Nearly everyone would agree that the in-person relationships developed by the field force are the number one relationship marketing vehicle available. However, it’s not uncommon for sales reps and their management to view HCP RM programs with resentment. In reality, these programs aren’t intended to replace the sales force—ideally, these programs should serve to assist and augment sales force efforts. A successful RM program must be integrated with all the efforts put forth by the sales group, and be developed with their involvement at all levels. To do so, it is imperative that all parties see the value of the program from the beginning and be allowed to not only participate in the upfront design but also have direct access to all ongoing reporting and results.
6. Measure results. It’s amazing how many companies budgeting for HCP RM programs fail to invest in proper metrics. ROI strategies are key to analyzing which strategies and tactics worked, which didn’t, and which audience segments are worth investing in. It is hard to predict which tactic will work, and which path is most successful for each segment. There are no easy formulas for determining all this. At a minimum, everyone needs to identify and agree to specific measurement criteria before ever launching a single program. Given the pioneering stage of HCP RM programs and the number of variables involved, pre-program ROI analysis is difficult. Many times, a combination of models, formulas, and basic trust among your partners and internal measurement team is all that will suffice. You take your best collective guess ahead of time, implement a pilot of your program, and then closely measure the results.
7. Develop a program of tactics. This is not about eMarketing or Interactive Marketing, but about giving your targets another opportunity to engage with your brand. It’s less about selling and more about customer service. There is seldom one singular tactic that you can pursue at the expense of all others. Tactics should be regarded as an entire program. Thinking multimodal is key. We have to give physicians a chance to respond to determine their preference for not only the tactic but also how it is delivered. The good news is that physicians are already accessing some of the technology you’ll be using. An estimated 80% of all physicians under the age of 45 carry smart phones and nearly 1 in 4 participates in eDetail programs . There are many vehicles at your disposal—take the time needed to invest in the right ones.
8. Don’t lose sight of the message. If you’ve been delivering the same message to your audience for a while, changing the medium in which you communicate that message is not likely to have much of an impact. Concentrate instead on delivering information that’s new and meaningful to physicians. Translate those hours and pages of physician insight research into meaningful content that can result in behavior change. Find a balance between branded and unbranded communications. Focus on providing needed services to your audience versus simply selling yourself and you just might find yourself becoming the de facto expert in an area.

Clearly, HCP RM programs are growing in prominence. Finding success in this area requires understanding your customers like never before in order to offer them meaningful information and tools that they actually want to use. By integrating these tactics and resources so they all work well together you can successfully shift from the mindset of physician “selling” to one of physician “service.” Making that shift will strengthen your relationships with all your key targets—a critical requirement in moving HCPs closer toward ultimate brand loyalty.

Are you a road warrior? Chances are if you are in Account Services within the agency world, you are going to have to be on the road at some point in time. One creamer and sugar at a time on your plane, strange hotel rooms that always have something quirky about them, high priced EVERYTHING, and never enough sleep. Trust me, I know how it is.

For some reason or another, I used to enjoy the “thrill” of being a road warrior: exploring new cities, indulging in delectable restaurants, meeting new people, and of course, all of the perks that come with travel – airline miles, free hotel rooms and upgrades, no lines for anything, etc. Think George Clooney in Up in the Air (which may be the story of my life).

After flying close to 150,000 miles last year though, the glamour of traveling has faded away; the reality of overbooked flights, sleeping in foreign beds, intrusive security pat downs, and travel size toiletries became my norm. If I can’t carry it in my luggage, I don’t want it. If it is more than 3.4 oz., I can’t carry it on. If it won’t fit into an overhead compartment, I am not buying it.

A road warrior doesn’t live the same life as normal folk. I constantly have people asking me where I am and when I am coming back. If I travel to a client for the week, that means I need to spend my weekends running normal errands like doing dry cleaning, getting haircuts, washing my car, shopping, etc. This leaves hardly any time for family and friends, let alone having a social life.

A real road warrior learns how to adjust though. The road warrior I am talking about knows how to get through security lines in 30 seconds by dropping their shoes on the ground with one hand and putting them on while shoving their laptop in their bag with their other hand; and then is putting their belt on while running to the gate and grabbing their boarding passes out of their pocket. We never check our bags either. I would rather lose my 5oz. shampoo that cost me $12 than going through the hassle of checking a bag. This road warrior also embraces the sporadic long lines at the airport because it means they can send a couple more emails on his Blackberry. We don’t care about fancy sheets and pillows in our hotels because we know to throw them off the bed the second we walk in the room. We don’t even take connecting flights unless we HAVE to.

I’ve learned a couple of other things along the way. Now set your ADHD aside for a second, and focus in:

• Always travel with comfortable clothes. You can’t predict that last minute request for some seemingly never ending power point presentation that strands you at your hotel room desk. Comfy clothes always make it better.
• Being that your body will begin to freakishly learn how to sleep more sitting up that lying down, make sure you get all the shut eye you can while traveling. You can’t be at your best with the client when you are walking around looking like a zombie.
• Patience is power. Road warriors don’t complain about traffic jams, flight delays, or having to put their bag in an overhead above seat 22F – even though they are sitting in seat 5A. Build extra time into your travel plans to counter these delays.
• Take advantage of the perks. Make sure you sign up for any and all rewards programs you possibly can. You can’t beat being upgraded to first class and moving up to a suite while traveling, and these perks definitely are usable when traveling for personal reasons as well. Build up those miles to plan that fun summer vacation down to Disney with the fam, or that romantic getaway with your significant other.

Feel free to chime in with your best travel tips! I will make sure to blog a second chapter to this with your suggestions.

Two tips to consider as your develop your HCP RM programs:

1. Develop a program of tactics. This is not about eMarketing or Interactive Marketing, but about giving your targets another opportunity to engage with your brand. It’s less about selling and more about customer service. There is seldom one singular tactic that you can pursue at the expense of all others. Tactics should be regarded as an entire program. Thinking multimodal is key. We have to give physicians a chance to respond to determine their preference for not only the tactic but also how it is delivered. The good news is that physicians are already accessing some of the technology you’ll be using. An estimated 80% of all physicians under the age of 45 carry smart phones and nearly 1 in 4 participates in eDetail programs¹. There are many vehicles at your disposal—take the time needed to invest in the right ones.
2. Don’t lose sight of the message. If you’ve been delivering the same message to your audience for a while, changing the medium in which you communicate that message is not likely to have much of an impact. Concentrate instead on delivering information that’s new and meaningful to physicians. Translate those hours and pages of physician insight research into meaningful content that can result in behavior change. Find a balance between branded and unbranded communications. Focus on providing needed services to your audience versus simply selling yourself and you just might find yourself becoming the de facto expert in an area.

¹ – Manhattan Research, 2009

HCP RM: Why Now?

The old model for how to target and communicate with healthcare professionals has been turned on its head. The time physicians have to interact with sales forces continues to diminish and access to physicians is becoming increasingly difficult. Up to 35% of all physicians are now considered “no see” docs¹ and some states such as Massachusetts are imposing restrictions on sales rep activities. Add to this the fact that pharmaceutical companies are drastically cutting their sales forces and you have an environment that’s ripe for new and more effective ways to reach HCPs.

What HCP RM Is Not

They are not newsletters or mailers or phone calls created in a remote conference room and then force-fed to a recipient. They are not comprised of generic content that makes no provision for how the recipient wants to be communicated with, what his or her level of knowledge is with the brand, or where the recipient resides along the brand adoption continuum.

They are, instead, customer-focused programs, delivering the right message to the right audience segment at the right time using the right channel. The right message is one that is meaningful to the HCP.  Figuring this out means understanding who the HCP is—what their needs and interests are, what motivates them—so that you can truly service their needs, not just sell them stuff.

Where To Start

When many pharma marketers hear the term relationship marketing, they are quick to think of patient relationship marketing efforts such as compliance programs. But given that physicians either cannot or do not want to meet with reps and that many prefer other and more varied forms of contact, it’s clear that HCPs want to engage with the brand through several communication channels.

Building a successful HCP RM program is no easy feat. It all starts with understanding the different segments of your audience and delivering tailored, meaningful communications to them in the form, method or vehicle they prefer. Every disease state and therapeutic class is different.  Organizations will have to adopt a different mindset beyond just a rep knocking on a quickly closing door. Finding success in this area requires understanding your customers like never before in order to offer them meaningful information and tools that they actually want to use. By integrating these tactics and resources so they all work well together you can successfully shift from the mindset of physician “selling” to one of physician “service.”  Making that shift will strengthen your relationships with all your key targets—a critical requirement in moving HCPs closer toward ultimate brand loyalty.

¹ – SK, A, 2009

The growth and usage of “new media tools” will always surpass and ultimately replace “traditional methods”. Smoke signals were replaced by guys with sandwich boards, who were replaced by newspapers, then radio then print and TV. There will always be a constant evolution. Marketing doesn’t change, the mediums that we use will always change, but at the end of the day, it is still marketing.

Having said that, how we approach marketing is changing, and quickly. In this past year we have heard a lot about Relationship Marketing or (RM). It was first discussed in the form of patient compliance programs, and most recently, given the changes in the sales force structure, size, and regulations, HCP RM. Both are the same, it’s about marketing to specific segments.

Segmented marketing the ability to identify and successfully reach and market to multiple different and distinct target audiences which has been pioneered and perfected by Interactive will continue to evolve as the marketing approach. In the past promotional campaigns consisted of leveraging one benefit into one message and then communicating that message through the reps, journal ads, and TV. The Intent has allowed us to think in segments. Going forward the agencies that will serve their brands best are the ones that internalize this approach across everything they do, from label design to brand messaging to all the promotional activities.  It is no longer what is the one message, it’s which segments do I want to reach, influence, empower; how do they want to consume my message (with or on the phone, online, in person, etc) and when do they need the information?