In just a year, social media marketing has come a long way within the industry — in relative terms, that is. And in the coming year, more strides will be made. Pharma still lags behind other industries in its social media spend and use, but it has taken some baby steps in communicating with patients and physicians through digital media. Industry leaders say they have observed forward movement by the industry, but it will need to pick up the pace if it wants to stay in the race. There are many hurdles on the course, but none are insurmountable, our experts say. Regulatory issues still have pharma dragging its feet, and has created fear of interacting directly with consumers, and the lack of messaging control. Social Hurdles Of all the challenges our thought leaders identified, regulations or rather the lack of regulations, was named as the No. 1 drawback for the industry when trying to use social media for marketing messages. With the continued delays in FDA guidance, Facebook disabling page comment controls, and the increase in enforcement letters, companies have significant benefit-risk determinations ahead, says Kyle Kennedy, managing director, The Medical Affairs Company. “Balancing marketing agencies’ affinity for using these digital channels against the cautious and purposeful traditions of the FDA’s regulation of healthcare communications will be no easy task," he says. “Social media are dynamic and rapidly changing marketing tools that are extraordinarily involved. Embracing this medium has proven to be more complex than anyone anticipated." Mr. Kennedy’s view is that since the industry can’t jump this hurdle, it has to wait for the guidance to come from FDA. “The medium is here to stay and maintaining equilibrium in a ‘patient-safety-must-come-first’ industry is no small hurdle, and only a defined FDA guidance will allow that hurdle to be cleared," he says. Companies are used to being regulated and accustomed to building campaigns around unclear guidelines, but no company wants to take a chance and receive a letter from the FDA, says Marc Weiner, managing partner of Ogilvy CommonHealth Worldwide. “We’re finding ways to participate responsibly, but it is a slow process," he says. “The push to participate comes from the many social channel participants who want health conversations and knowledge of the benefits of medications. If Facebook and Google+ can help us to have a conversation and still be responsible to our brands, then we’ll see more pharma brands participating in social networks." The industry should change its view of social media and look at it as a form of customer service, instead of as a marketing vehicle, suggests R.J. Lewis, president, e-Healthcare Solutions. “The industry shouldn’t shy away from social media, but embrace it," he says. “Companies shouldn’t let regulation — or in this case the lack thereof — be an excuse for inertia. Companies need to take a leadership position and talk to their customers." Socially Acceptable Behavior Kurt Mueller, chief digital and science officer at Roska Healthcare, doesn’t view the lack of regulations as the biggest challenge to social media, but rather the challenge is a lack of comfort around communicating with full transparency. He notes that there are DTC guidelines from the mid 1990s the industry should follow, and companies should function inside that box instead of waiting for new guidance. Mr. Mueller believes what is slowing the industry down the most is its comfort level around communicating openly and honestly and monitoring conversations on its properties, or for which it has significant influence, for adverse events and off-label comments. “Patients and caregivers want pharma companies to sit at the table during their social media discussions," Mr. Mueller says. “And now, more than ever, monitoring services are available to ensure companies stay within promotional guidelines without adding huge administrative burdens to the company itself. “Openness and transparency are critical success factors and pushing content at people, taking brand.com assets and slapping them on YouTube or Facebook just isn’t going to work," he continues. “Brands need to conduct conversations in the social spaces or be left behind as second- or even third-line therapies." It is a race for the brave, to be sure, and those who have taken the risk have found some positive results from their actions. For example, Ryo Kubota, M.D., Ph.D., chairman, CEO, and president, of Acucela Inc., uses a Twitter feed and blog to educate patients, raise awareness around important ophthalmology issues, and highlight people who are combating blinding eye diseases every day. “Social media is a valuable platform and communications channel, and one that I think more people in the industry should want to be a part of," Dr. Kubota says. “While many people in the biotech industry are hesitant to engage in social media because of the absence of regulations from the FDA, I think it’s important to be courageous and innovative." Tony Russo, Ph.D., chairman and CEO, Russo Partners, says there needs to be more companies like Dr. Kubota’s to lead the way and act as role models to demonstrate the use and benefits of social media. “We are finding that more companies are understanding more about the uses and boundaries of social media, and what policies they need to establish for its use," he says. In fact, about half of Russo Partner’s pharmaceutical clients have Twitter feeds or YouTube channels and about 60% of this growth occurred in 2011. The industry needs to remember the rules of engagement, which include two-way communications that involve both responding and listening, and offering content that doesn’t just sell, says Jeffrey Lee Simons, director of social media, Drug Market Info. “There are also legal and PR implications to social media engagement; companies need be sure whoever is in charge of their social media strategy understand all of the interconnecting threads," he adds. “If companies treat social media as just another funnel through which to push one-sided communication, they will fail." Brian Loew, co-founder and CEO of Inspire, says the one-way push of information that the industry is accustomed to using is not what social media was designed for. “Social media is intended to foster conversations between two or more people," he says. “But instead of embracing this reality, much of the industry has treated social media as a broadcast medium." To test this statement, visit the public Facebook page of a pharmaceutical company and begin conversations about a drug’s alarming side effects, Mr. Loew says. “Those conversations will likely disappear in 24 hours," he says. Although Mr. Loew understands and is sympathetic with why the industry handles social media this way, he wonders why bother engaging in sanitized social media conversations rather than simply buying banner ads. Jay Carter, senior VP, director of strategy services, AbelsonTaylor, says for pharma companies to be successful using social media there has to be a venue to listen to and interact with the consumer. “There are some categories, such as infant nutrition, where both consumer and healthcare professional decision makers are heavy users of electronic media, and the way to interact best with them is through social media and the Web," he says. As America ages and technology becomes even more ingrained, that trend will continue and peak when the sweet spot for pharma — patients and caregivers 55 to 85 years old — is completely reliant on e-technology. “We’re 10 to 15 years from that happening, but each year the reliance will continue to grow," Mr. Carter says. This reliance is already evident in other industries and by the fact that social media is firmly integrated in the generation and flow of today’s news, with many top-tier outlets posting and discussing their articles online before they even make it to print. “As such, it is not pharma’s hesitancy or fear of social media’s interactivity that is the biggest hurdle, but the assumption that social media is wholly separate from traditional media and can be segmented as an afterthought to traditional strategies," says Eliot Harrison, VP, MCS Healthcare Public Relations. “Lead generation, networking, and market research have all reached past the traditional confines of emails, meetings, and phone calls to include social media channels. Pharma’s task is to navigate those channels and view them as an integral aspect of any media strategy." Control Issues Almost all of our experts say the industry needs to move beyond its control issues around messaging. Social media is meant for conversations in real time, and consumers using social media will not accept less. While this is easier said than done, experts say the verdict is still out on how much progress the industry will make on this issue in the future. Before social media can be fully integrated into the marketing mix, the biopharmaceutical industry must come to terms with its inability to manage the message, says Pam Garfield, VP, at Patient Health Perspectives. “The biggest challenge in multi-way communication lies in how to handle the other voices, sometimes dissenting, that are invited to join the conversation," she says. “And the fast-paced nature of the conversation means that companies do not have the luxury of shepherding their messages through the traditional levels of analysis, review, editing, and approval. “The good news is that social media enables an authenticity that has never been possible with traditional marketing," Ms. Garfield adds. “The industry will need to give up some level of control. That said, there are solutions available that will enable it to move forward with social media, while still protecting itself in this new era." While it is true that pharma brands spend millions on market research to understand the customer but have limited experience dealing with customers in a truly interactive, engaging, and mutually respectful two-way dialogue, it still is not a viable strategy to sit back and hope that things will work out or regulators will issue a detailed document outlining what brands should be doing in social media. “The industry must lead the charge to map out the landscape and envision a world where they can define the future and create innovative marketing, customer service, and loyalty programs based on the needs of the customer today and in the near future," says Mark Bard, board member, Digital Health Coalition. “Brands must learn to play in social media — based on the ground rules of the customer —not the brand. Forcing a customer to dial into a toll-free phone number to engage with a brand, when the majority of patients are now interacting with the brands they use every day via digital, is not sustainable." Industry Misperceptions One common misperception about social media channels is that they are dominated by young users. Studies show that social networking is common across all age groups, says Chris DeAngelis, VP, strategic initiatives, SSI. “In every age group, we’ve identified a segment we call ‘avids,’ those who spend five or more hours a week social networking," Mr. DeAngelis says. “About half of social network users 24 years old or younger fall into the avids category; but there are avid users in every age group, even those 65 years old and older." As expected, according to recent SSI reports, about 90% of respondents 18 to 24 have visited social networking sites within the last week. And about 70% of those 35 to 44 and 60% of those 45 to 54 and about half of those 55 and older have been social networking within the last week, he says. Donna Wray, executive director, management advisor, TGaS Advisors, says another misconception is that the problem lies not in pharma’s inertia toward social media, but in the volatility of the medium itself. “Pharma companies do not have to use social media for conversation, but rather they can use the communities on social media as another place to reach their audience," she says. “Social media is a great place for communities to gather. Where communities gather, pharma can support and advertise, as they always have." Ms. Wray suggests using a Facebook page or profile much like a booth at a conference, or pharma companies can support the communities by sponsoring a forum. Current social media spaces are unsure of how to let pharmaceutical companies, or other companies for that matter, participate. “The hurdle is not for pharma; it’s for social media," Ms. Wray says. “Pharma companies will always have to be very formal in their communications, whereas social media is made for informal gatherings." “To succeed, social media needs to be a venue to listen and interact with consumers. " Jay Carter / AbelsonTaylor “Social media is not just for the young; our studies show there are avid users in every age group, even those 65 and older. " Chris DeAngelis / SSI “Pharma’s task is to navigate ­social media channels and view them as integral aspects of any strategy. " Eliot Harrison MCS Healthcare Public Relations “Pharma does not have to use social media to engage in a ­conversation, but rather it can use the ­communities on social media as ­another place to reach its audience. " Donna Wray / TGaS Regulated industries struggle with social media marketing According to the study Best Practices for Using ­Social Media To Drive Business Outcomes, ­conducted by Best Practices, marketing ­organizations in highly regulated industries, such as ­pharmaceuticals and utilities, struggle to ­incorporate social media into their marketing plans effectively and safely. This comes as no ­surprise to the pharmaceutical industry. However, 50% of companies are proactively managing ­social media through content generation and monitoring sites, such as Google, Twitter, and LinkedIn. Companies that proactively manage and ­generate content for social media as part of a marketing strategy employ about twice as many FTEs to manage social media as do companies with activities limited to content monitoring. Other key findings include: » A majority of social media employees undergo formal training on marketing, communications, and customer service, but only a third are ­required to have training specifically focused on social media. » Independent of their maturity in social media, about half of companies have written policies in place to govern the use of social media at the workplace. Source: Best Practices. For more information, visit best-in-class.com. “Social media use is on the rise; at least half of our clients have Twitter feeds or YouTube channels. " Dr. Tony Russo / Russo Partners “Much of the industry treats ­social media as a broadcast medium, but that’s not how it is designed. " Brian Loew / Inspire “Patients want pharma ­companies to participate in their social media discussions. " Kurt Mueller / Roska “Embracing the social media channel has proven to be more complex than anyone ­anticipated. " Kyle Kennedy The Medical Affairs Company “The industry must come to terms with its inability to manage the ­message on social media. " Pam Garfield / Patient Health Perspectives “There are ways for the industry to ­participate responsibly in social media, but it is a slow process. " Marc Weiner / Ogilvy Commonwealth Worldwide Experts Mark Bard. Board Member, a nonprofit organization, which was created to serve as the ­collective voice and national forum for the discussion of the issues ­relevant to digital and electronic marketing of healthcare products and services. For more information, visit ­digitalhealthcoalition.org. Jay Carter. R.Ph. Senior VP, ­Director of Strategy Services, AbelsonTaylor, an independently owned full-service healthca e advertising agency. For more information, visit abelsontaylor.com. Chris DeAngelis. VP of Sales, North America, Survey Sampling International (SSI), which is a global provider of sampling ­solutions. For more information, visit ­surveysampling.com, or email [email protected]. Pam Garfield. VP, Patient Health Perspectives, which ­specializes in creating and ­managing technology solutions to help healthcare organizations capture and maximize the patient ­experience. For more ­information, visit ­phperspectives.com. Eliot Harrison. VP, MCS Healthcare Public Relations, a global ­communications agency. For more ­information, visit mcspr.com. Kyle Kennedy. Managing ­Director, The Medical Affairs ­Company LLC, a full-service contract medical organization that provides a wide array of outsourcing capabilities for medical affairs activities. For more information, visit themedicalaffairscompany.com. Ryo Kubota, M.D., Ph.D. ­Chairman, President, and CEO, Acucela Inc., a clinical-stage biotech company focused on developing new treatments for blinding eye diseases. For more information, visit acucela.com. R.J. Lewis. President and CEO, e-Healthcare Solutions, a solutions-focused advertising network ­specializing in the digital ­healthcare marketplace and providing access to the healthcare professional and consumer health audiences. For more information, visit e-healthcaresolutions.com. Brian Loew. Co-founder and CEO, Inspire, which builds online support ­communities for patients and ­caregivers, and helps life-sciences organizations connect with them. For more ­information, visit corp.inspire.com. Kurt Mueller. Chief Digital and ­Science ­Officer, Roska Healthcare ­Advertising, a full-service ad agency that integrates data and insight-driven marketing and advertising solutions. For more ­information, visit roskahealthcare.com. Tony Russo, Ph.D. Chairman and CEO, Russo Partners, a public relations firm specializing in communications for the pharmaceutical, biotech, and healthcare services industries. For more ­information, visit russopartnersllc.com. Jeffrey Lee Simons. Director, Social Media, Drug Market Info, an ­Internet source for market reports on specific diseases with the patients’ ­perspective. For more information, visit ­drugmarketinfo.com. Donna Wray. Executive Director, ­Management Advisor, TGaS Advisors, a provider of customized benchmark and advisory services for pharmaceutical companies that enable them to evaluate their ­commercial operations against a confidential ­industry peer-set. For more ­information, visit tgas.com or e-mail [email protected]. Marc Weiner. Managing Partner, Ogilvy CommonHealth Worldwide, part of the Ogilvy & Mather network and a WPP company, one of the largest healthcare communication networks with 65 offices across 36 countries. For more information, visit ogilvychww.com.

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