The eye of the social storm

By Nick Pryke

As the social media revolution continues its surge of success in the realms of digital marketing and communications, Nick Pryke takes a look at why sailing into the eye of its storm could be the best thing for the pharma industry.

There was a time when your identity was defined by little more than your physical actions and statements. First impressions, demeanour and social astuteness counted for everything in a world that functioned on varying levels of networking, trust and smoke screens. For the social chameleons of both business and pleasure, this meant unbounded opportunities to succeed in almost every context - and for the most part that's exactly what they did.

But then came the internet, and with it ventured the complexity of multiple identities. If you were character-savvy, the chances were you could slip under the radar of being caught out as a master of identity juggling; anything less and you're online profile was likely to be cast out and fed to the wolves of binary as a fake. Either way, the world of social media had arrived and brought with it a third dimension of social interaction. No longer did people need to leave their houses to speak to friends or peers; no more was your 'real life' considered as relevant in a world that functioned on a placebo of online associates helping you carve out who you always wanted to be. Companies could reach new audiences with such relentless immediacy and clarity that it was a wonder how they'd coped in the days pre-web.

Fortunately for consumers and industries alike, social media has evolved exponentially since the beginning of its internet inception - and for all its subjective misgivings, it's allowed the entire human spectrum to communicate on a level platform previously deemed unfathomable. From individuals to Fortune 500 companies, social media has enabled the world's population to be heard en masse and on par, picking up armies of devout followers that can, quite literally, turn you from zero to hero in a matter of hours. Moreover, its levels of transparency have only served to up the ante once again as the business world enters the age of new media and digital marketing. But for all those who have taken that step, many are left wondering why it's taken pharma so long to grab onto the coattails of the phenomenon and join almost every other industry in the online revolution.

Well, to put it simply, the pharma industry has - traditionally at least - contained almost every attribute that goes against the grain of stepping foot into the world of social media. With extremely expensive sales and marketing departments, an intense regulatory environment and companies being overly protective of their intellectual property (IP), the notion that the industry should enter an arena that would perceivably only work to further complicate matters was deemed ridiculous - until now.

In 2008, Novartis stood tall as the only Top 10 company flying the flag for the pharma industry in the world's second largest social media site, Twitter. Fast forward to 2010 and, without fail, you'll find every one of the Top 10 on Twitter - from Pfizer to Johnson & Johnson, Bayer to Merck - all have jumped on the bandwagon in an attempt to open up their online profile to the watching world.

Amongst them, Pfizer has ventured down the right avenue by teaming up with Private Access - a firm committed to developing platforms that permit internet searches for private information - to create their own social networking site intended to bring together patients and clinical trial researchers. Patients have the opportunity to confidentially post personal health information that will only be available to researchers studying their particular condition, in turn offering a reciprocal relationship in which tailored information is currency for establishing deeper bonds.

And with just over 10,500 followers currently on Twitter, Pfizer seems to be leading the way. But it's not just on Twitter that they've taken the lead, with Facebook, YouTube and LinkedIn all also getting the Pfizer treatment. So good job well done then? Well, not quite. For the problem with Pfizer - as well as the industry as a generalisation - is that whilst they have ticked the social media boxes in terms of presence, they still haven't understood that in this new world of marketing and social representation, content is king.

Indeed, instead of focusing on customer communications on the most basic of levels, many firms - including Pfizer - use their new-found social platforms for little more than distributing press releases; hardly the most innovative tool for securing better customer relations and inducing engaging debate. In fact, the only company that seems to have its finger on the Twitter pulse is Eli Lilly, who prides itself on "An official Twitter feed of Eli Lilly & Co.," where "Any O'connor, Greg Lueterman and Rob Smith tweet on public policy, life at Lilly and corporate responsibility."

What Lilly has very astutely realised is that people make connections with people using social media - the company name remains more of a beacon to those looking for the mouth of that company. That's not to say that the company doesn't matter, as after all that's the sole reason they're online, but by putting people at the forefront of their Twitter feed, talking about what they and their company do in real time, they've successfully lifted the veil on a traditionally closed industry.

Unfortunately for pharma firms worldwide, let alone in the European market, this is about the best they'll get until the overly intense regulatory environment currently being employed loosens its grip around the industry. Anything above implementing staff to update fluffy pieces with PR-related statements is a serious no-go area, as bodies like the FDA and EMEA continue to patrol the hardest hurdle to social media implementation for pharma: Adverse event (AE) reactions.

Officially defined as "any adverse change in health or side effect that occurs in a person who participates in a clinical trial while the patient is receiving treatment, or within a pre-specified period of time after their treatment has been completed," companies looking to sink their teeth into product-centric social media will have to contend with incessant reports back to the FDA and EMEA every time a self-identified patient tweets/blogs/comments about an AE - even if the AE isn't published online. In this context, pharma's obligation to its regulatory bodies has, without doubt, stifled its progression into the nucleus of social media.

In an ongoing debate about who owns what when it comes to information and the passing on of AEs in the online social realm, a patient - in discussing the merits of a recent and prominent case - put forward the main crux of the problem for pharma companies. He said: "As a patient, I can choose to disclose my medical records or history to anyone, essentially setting aside the HIPPA security rights that providers and payers must follow. Why can't I similarly, as a patient, waive my right to have a pharma company comply with AE rules before posting to a public pharma sponsored social network? It surely still requires some judgement by patients to understand that wisdom of non-medical crowds gathering regarding pharma issues may be wrong more often than right."

And while in an ideal world, the above statement would reign true - the reality of the retort proves that it's anything but. In essence, the problems stem from two overlapping areas. First off is understanding who owns the responsibility to report an AE. Any pharma company, in getting permission to market an Rx drug, incurs the responsibility to keep its information reasonably up to date. It therefore makes it irrelevant whether a patient wants to "waive" the responsibility to report an AE - as much as it would be beneficial for both patient and company alike. Thus, it's understandably not best business practice to invite casual, anonymous complaints that will only lead to vast amounts of man-hours being spent on researching potential updates on a product gripe. The bottom line: the benefit of social media has to outweigh the expense.

Conflating this is the bigger picture of marketing practices pertaining to labelling. Posts of comments in any blog or twitter feed that end up having a product mentioned or discussed causes that blog, or at least that post, to be a form of labelling for the product. And, as a form of labelling, it means that all content has to pass through a medical, legal and regulatory review before dissemination.

Furthermore, promotional labelling and advertising must be submitted to the FDA and EMEA on a "2253 form...at the time of initial dissemination". This requirement alone makes it nigh on impossible for companies to do any real-time social blogging relating to any of their products. As if that wasn't already enough, pharma companies have to maintain processes to ensure that the content is submitted to the necessary regulatory body at least simultaneously with the posting, if not before.

But it's not just within the confines of regulation that pharma faces problems with its social media anxiety. In having to adhere to the FDA and EMEA, expectations have to be set with relative audiences that are sure to disappoint. For example, patients and readers will both want to engage in discussions - such as asking for medical advice or making outlandish statements about a product - that simply cannot be upheld in the context of a pharma blog or Twitter feed. Even if patients are considering doing something good for the product in question, such as submitting positive testaments on the product, the regulatory bodies could construe that as an unsubstantiated claim - resulting in a warning letter. Hardly an easy sail for pharma firms floating themselves out of port and into the open ocean that is social media.

When it comes to the crunch, there's no doubting that big pharma is attempting to break free from its regulatory shackles - 'attempting' being the operative word. For all that pharma is currently doing, there's no doubt from both marketing and social media experts that the industry has only taken a few baby steps towards where they need to be.

Daniel Siddle, writing for headshift.com back in early 2010, said: "When the industry is still fearful of adverse event reporting, which should be a simple automated process, they'll find it very tough to deal with any of the much bigger issues: the breakdown of organisational silos to enable sales and marketing to be something the whole company can do; the decisions around intellectual property and what is more valuable inside the company versus outside; and how to deal with the privacy and protection of their employees in the new era. These are all logarithmically more difficult to solve than AE reporting."

What Siddle highlights is the importance in looking beyond social media merely as a tool to boost product sales. Instead, view it as a forum to interact, for the first time, with patients and end-users. Use it as a free marketing tool. Employ it to do the groundwork in finding out how products are really being received. Whether it's brand sponsored or not, build a patient community. Build a healthcare community. Go viral and intrigue a new generation of consumers. The possibilities outside the realms of regulatory burden are practically endless. Whatever the end goal, one thing is certain: a one-size-fits all approach is not the answer the industry is looking for.

Lisa Emrich, from the well-respected Multiple Sclerosis (MS) blog site Brass and Ivory, describes the MS social media community as: "...Like blood cells which flow through the human body. If we all congregated around one hand within the body...the rest of the body would die. And if we isolate ourselves and never venture back to the lungs where we find personal nourishment and rest, we would individually die off. Although my travels online may never take me to the left foot, I am comforted to know that others feed that community and it thrives."

While to some this may seem like an overly self-indulgent and unnecessary metaphor, Brass' underlying message reigns true for all healthcare social media and networking initiatives: depending on the communities being engaged, activities could be welcomed or rejected by the communities "anti-bodies". Thus, the industry as a whole has to be very clear which parts of the 'body' it wants to engage with, how it should engage with them and on which topics. But for all the inherent risks needing to be taken, having a social network that functions as a real-time, open network will serve to expand and integrate the social media approach that the industry has been yearning for.

And in relation to the groundwork that has already been done by the industry, social media is revealing some interesting truths to pharma companies both already involved and waiting in the proverbial wings. For starters, process designs need to be radically reviewed and rebuilt as traditional communications continue to lose their value. Secondly, social media and networking sites have proven time and time again that people are far more willing to share their stories now than they were a decade ago. Finally, and perhaps the most glaringly obvious - regulatory promulgations need a complete overhaul to allow companies to begin ticking the above boxes.

In spite of all the realities of today's communicative mediums, it's more important than ever for pharmaceutical organisations to develop their internal framework if they are to become remarkable externally. Having better ways for life scientists, biologists, nurses, doctors and engineers to network and research will go a long way in creating the pipelines of products needed to sustain the industry. The social media storm has been brewing on the horizon for a while now, and for the pharma industry sailing around it isn't an option. The only way to fully understand how important social media is for the industry is to sail directly into the eye of its storm. Only then will potential routes towards a safe harbour for the industry be realised and mapped out accordingly. That is, after all, what makes the best captains.

Roche has recently upped the pharma social media standards by publishing its '7 Social Media Principles' to all relevant employees. In doing so, it's facilitated an environment in which employees explicitly understand the do's and do-not's of social media, from both a professional and personal perspective. With such a simple yet effective framework in place to minimise risks for both the company and individuals, it's surely only a matter of time before the rest of the industry follows suit.

Seven rules for personal online activities speaking 'about' Roche:

• Be conscious about mixing your personal and business lives
• You are responsible for your actions
• Follow the Roche Group Code of Conduct
• Mind the global audience
• Be careful if talking about Roche. Only share publicly available information
• Be transparent about your affiliation with Roche and that opinions raised are your own
• Be a "scout" for sentiment and critical issues.

Seven rules for professional online activities speaking 'on behalf of' Roche:

• Follow the Roche Group Code of Conduct and Communications Policy
• Follow approval processes for publications and communication
• Mind copyrights and give credit to the owners
• Use special care if talking about Roche products or financial data
• Identify yourself as a representative of Roche
• Monitor your relevant social media channels
• Know and follow our Record Management Practices

Source: Roche