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From Messaging for Many to a Conversation with One

November 2010

Major pharmaceutical manufacturers are taking over twitter.

Between accounts for hiring, news, regional offices, PR, pricing assistance, account land grabs, consumer products and even livestock news updates, large pharma is well on its way to breaking through 100 separate twitter accounts. You can go online and tweet about your favorite compounds to your favorite compounds now, and you can follow links they post on Facebook to Youtube channels of testimonials from “average patients,” learning about ongoing clinical trials in the same place as you chat with friends and family. Such utilization of social media in marketing strategies for industry parties is nothing new, but the ascendance of the medium as a widely-adopted and increasingly commercial space may also signal the beginnings of a new stage in corporation-consumer interface where pharma can interact with customers more directly than has ever been possible, but must tolerate new and serious risks to do so.

Increased targeting of online consumer activity is not a surprising phenomenon: sources such as Pew International Research regularly show that a significant majority of adults in America are searching for health information online; adults over 55 are outpacing all other age groups in joining Facebook; finally, while traditional advertising and consumer outreach has been increasingly regulated, social media access is still relatively unfettered (and inexpensive).

Pharma has jumped on the opportunity, and their use of these outlets frequently takes one of two approaches: direct advertising campaigns of various designs, or educational outreach to support and empower patients. AstraZeneca’s recent “Take On Depression” campaign represents a recent example of the latter type, which may represent the most interesting shift in tactics. The effort is composed of a Facebook site with information about depression and bipolar disorder, news of contests and rallies, and a link to a Twitter account, which is private (only accessible by “followers”) at the time of writing this. The privacy of a public campaign account is an interesting phenomenon which, if intentional, may provide a way to reach patients and address concerns without sharing it across the entire internet.

There are serious risks to this type of online activity. On these sites, outreach is a fundamentally-interactive experience, giving consumers a chance to speak directly with industry, at scale, for the first time ever. This would be great if they weren’t a) talking about private medical information b) on hard-to-monitor/censor website and c) with people lacking the necessary medical credentials. Social sites are becoming more transactional, with apps and games that collect user information and occasionally deliver that information to third party advertisers without fully-informed consent (frequently reported, recently in the WSJ). Astra Zeneca had an experience in April with these privacy risks, when a blogger acquired company information detailing their program of monitoring online activity related to Seroquel. If pharma campaigns adopt this trend to win consumer attention, these persistent privacy issues become still more serious, as they introduce the risk that sensitive medical information may be exchanged or even implied through posts or other participation.

Furthermore, these campaigns represent a dissolution of anonymity for consumers compared to a search on WebMD or RXlist; users in social media are searching as themselves, rather than as an IP address. When they post on Facebook or @Twitter, it is linked to their friends, family, and career. The game also changes for company sponsors: social sites meticulously record and store activity history, producing a body of testimonials and advocacy linked to a compound or company. This can be fantastic when customers are happy, but catastrophic when they are not. Just as United Airlines learned the hazards of a broken guitar¹, pharma runs the risk of high profile negative press from a grassroots source. Most sites allow a company to edit this data, but a customer could always open another Twitter account or blog to spread their message. Visceral examples of this, such as Sanofi-Aventis facing off (and potentially meeting its match) with a single patient named “Shirley” over Taxotere², demonstrate how a company creating a footprint on social media can do more harm than good. Therefore, even if we assume that privacy issues can be managed, there is still a critical risk when pharma enters a world of independently-curated, user-generated content where a single patient may have 100 times as many people reading their messages about a drug than the maker of the drug itself.

Some clarity may come when the FDA releases regulatory guidelines on advertising in social media, expected at the end of the year. They have already shown concern over information shared over social media platforms, as evidenced in their censure of Novartis over “share” information for Tasigna on Facebook describing efficacy claims without risk information. Proactive regulatory guidance may prevent future events, however online interfaces are constantly changing. Sharing on Facebook and Twitter forces regulated text through a sieve of frequent website redesigns and constant new feature integration. New outlets are also born regularly, making it immensely challenging for the FDA to offer comprehensive regulations and monitor their adherence. Possibly as a result of this complexity, the FDA has signaled that it will refrain from issuing guidances specific to a social media platform (so rules will be the same for the character-delimited Twitter as they will be for the sophisticated interface of Facebook).

While these issues should stir concern moving forward, they must be balanced with the potential benefits. Even the FDA panel considering future regulation acknowledges that social media has great potential to benefit public health. A presence on Facebook or Twitter could help convince a patient to seek treatment, to adhere to their medication, or to seek needed assistance. This leads to improved treatment rates and better patient capture. The challenge will be in maintaining a clear vision as to the voice of each party – what it represents, what it can and can’t say, and who else might be listening in. For future companies considering a new social media strategy, precedents will only provide so much guidance; decisions will need to weigh the possible benefit of reaching new or underserved patients against the risk of negative or critical responses, whether or not they are merited, and will need a clear execution strategy with several contingency plans to manage an unpredictable, changing landscape.




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About the author: Jonathan McEuen, PhD is an Associate at the Frankel Group, and has direct experience in social marketing, most recently from organizing city-wide speaker series in the Pecha Kucha format. To contact him regarding this post, email blog@frankelgroup.com.

1: For more information, see media reports such as Fast Company “Broken Guitar Has United Playing the Blues to the Tune of $180 Million,” July 28, 2009

2: March 15, 2010 Pharma Marketing Blog article “Disgruntled Patient Shuts Down Sanofi-Aventis Facebook Page”