Healthcare Agency Roundtable 2013

By Joshua Slatko

Med Ad News: How do you see next year’s ACA rollout impacting the way you do business? What will marketing agencies have to do better or differently under ACA in order to continue to thrive?

Jay Carter, senior VP, director of strategy services, AbelsonTaylor: The biggest changes that ACA is driving are the effects upon our client’s physician customers. The requirements for EHR have driven many practices to either consolidate into larger groups or sell themselves outright to regional hospital healthcare providers. It’s been said that fully one-third of the oncologists in the United States have become employees of such groups since ACA was enacted. That presents changes in the way that specialty products are purchased and distributed, and we’re very focused upon this change.

Jon Sawyer, president and chief operating officer, closerlook: In large part, the ACA is going to mean more patients for physicians and more patients on product for pharma but with increased scrutiny on cost. Pharma can play an important role in helping physicians manage that increased load with more effective and efficient communication and programs that keep patients informed about their conditions, compliant with their therapies and embracing a plan for disease management “beyond the pill” for better long-term outcomes. Agencies can be good partners to pharma by helping industry understand their physicians and patients better so that these programs and their associated communication have as much impact as possible. The belief that the solution to our marketing challenges lies in shiny new tactics must end; investment in strategic programs that enrich the relationships between physicians, payers, pharma and patients in the interest of better outcomes is the answer to what ails our marketing efforts.

Ed Mitzen, partner, Fingerpaint: As a small business owner, we will continue to provide health insurance for our staff. We are expecting that it will cost us more as small businesses bear the brunt of subsidizing the newly covered individuals who didn’t have insurance before. Our clients may reduce their marketing spend to cover the “hit” the firms will take in rising healthcare costs. Obviously, rising healthcare costs is nothing new to any of us. ACA is going to increase pressure to reduce marketing budgets, as companies look for ways to recoup the increase in healthcare spend. Marketing agencies need to be able to find ways to have their clients’ dollars go further. Nothing new.

Adam Gelling, principal, Giant Creative/Strategy: On the surface more insured patients should be a boon for pharmaceutical companies, and stock performances over the past year seems to bear this out, but the ACA will change the way products are marketed. Marketing agencies and their sponsors will need to expand their promotion and support throughout the continuum of therapy. It will no longer be about just obtaining prescriptions. Support and access strategies will be elevated alongside clinical benefits; validating positive outcomes and providing mechanisms to report those outcomes among HCPs, patients, and caregivers will be a necessary component of persistence and brand use. Also, new product approvals will face increased scrutiny from payers to demonstrate a significant benefit over other available therapies, so the number of launches could decrease as compared to prior years.

Dan Renick, president of Precision for Value and Hobart Group Holdings: The ACA, from its passage, has intensified the strategic focus required to help clients navigate the evolving healthcare landscape. Beyond developing a deep understanding of the Act itself, this requires a thorough portfolio assessment to determine what impact the ACA will have on access and reimbursement, and within which channels. For example, next year will primarily see an increase in the Medicaid population (the majority of enrollment observed to date), so posing questions about upside potential and downside risk in this line of business is a natural starting point. Marketing agencies will have to better appreciate how value is assessed by various decision-makers that now hold some level of risk due to the ACA, and accountable care in general, and how to best communicate this at the stakeholder level.

Dominic Viola, management supervisor, ICC Lowe Trio: As the ACA mandates, we’re going to see an increasing need for physician success metrics.
We’re already seeing the beginnings of the shift in healthcare provider compensation from fee-for-service to pay-for-performance. We’re continuing to see the evolution of what’s considered “effective” and “successful” care become increasingly quantified with hard metrics.

Another important way the ACA will apply to the evolution of pharma is ensuring value beyond the drug: Insurance companies and accountable care organizations will continue to influence how and which drugs are prescribed. So a drug itself is becoming just one key part of the overall brand value: the full value also resides in the bundle of services the drug company offers to patients and doctors, including behavior modification tools and techniques, patient and professional education, counseling, and training, to name a few. All these additional measures of success – and more – will need to be factored into brand promises and will drive competitive advantages and brand differentiation.

Wendy Blackburn, executive VP, Intouch Solutions: It’s true that more insured patients in the system means more potential customers for pharmaceutical products. Looking deeper into the pool, many of these newly insured represent younger generations. And we cannot overlook the tech-savvy of these digital natives and the expectations they have for companies seeking to connect with them. That, in turn, places a premium on agencies that offer much more than just basic competence in digital media. Agencies that already know how to communicate two-way, in real-time and responsively will quickly replace others who tend to communicate one-way and build brochure-ware Websites.

We’ll be looking at an even more fractionated landscape and a redefinition of pharma’s “customer.” Brands must learn to speak to managed care organizations; to understand what an ACO is and who the decision makers in ACOs will be. They must talk to pharmacists, hospital systems, government agencies, and consumer watch groups. And brands must understand the diverse needs and definitions of value that each of these influencers hold.

Leerom Segal, president and CEO, Klick Health: This is a sea change in the market and we need to respond by providing more of the information that patients demand: formulary and access issues. Yes, we still need efficacy and safety information, but the one thing missing from patient information, access, is what they crave. Insurance and payment has always been an issue in the background of every physician/patient conversation, but it’s now the dominant agenda item. According to the PwC report Customer experience in the pharmaceutical sector: Getting closer to the patient, patients are paying a greater share of the costs, 250 percent more in fact. This increased “skin in the game” means that patients are beginning to shop for medical treatments in much the same way that they shop for other important “big purchase” items and cost has become the dominant concern. In fact, 89 percent indicate that insurance coverage is the number one issue, with physician recommendations number two at 74 percent.

Kim Wishnow-Per, president, McCann Managed Markets: The next round of ACA rollouts in 2014 has an impact on our business in several ways. McCann Managed Markets considers the managed markets landscape to determine a medication’s value and place in the market. We work with our clients as their guide, by sharing our access intelligence to develop tools they need to shift the marketplace. The ACA has created new market dynamics, and our clients must carefully consider these as part of their brand planning for 2014. These include essential health benefits (EHB) for pharmaceutical drugs mandated by the ACA for the newly formed Marketplace plans in each state; Medicaid expansion and hospital 340B drug pricing programs; evaluation of opportunities with organized customers, such as Accountable Care Organizations (ACOs) and Integrated Delivery Networks (IDNs); and Medicare and Medicaid electronic health records (EHR) incentive programs – meaningful use requirements.

We educate our clients on the evolving payer landscape and develop strategic and tactical plans to consider how components of the ACA might or might not affect their brands.
Marketing agencies need to understand how the local market payer dynamic affects the prescribing habits of healthcare professionals. It is no longer enough to deliver just a clinical message to the HCP. Providers also need to be confident their patients can afford the drugs they prescribe. Therefore, we must now include a customized local market “cost and coverage” message along with the clinical message. This messaging must be easy for the sales representative to deliver and for the HCP to understand.

This is no small task; the marketplace is becoming even more fragmented with the implementation of the new state Marketplace plans, ACOs, and the evolving benefit designs being deployed by insurers in response to the ACA. It is essential for marketing agencies to understand how these payer market dynamics affect local markets and develop relevant messaging to instill confidence in HCP prescribing.

Med Ad News: The ACA enrollment website launch is a popular topic in the news of late. What do you think went wrong, and how would your agency have handled it differently?

Kyle Barich, president, CDM New York: Of course it’s easy to pass judgment in hindsight, but no agency would be proud of the rollout to date. If we were awarded that assignment and were able to manage through the likely inflexible contracting process, we would have put a lot of effort behind uncovering the user design and experience needs. And we certainly would have built in a more comprehensive testing plan that allowed adequate time for QC and user acceptance testing prior to launch. Perhaps a state-by-state phased approach could have been explored, because if it isn’t cooked, it shouldn’t be served. Once the site was launched, we would have developed broad and compelling drivers to get people to the site. Finally, if things didn’t go as planned, we would face harsh reality with some good old- fashioned truthful conversations with everyone involved.

Jon Sawyer: Politics aside, websites can be very complicated and demand particular conditions under which their development can be successful. The several disparate entities involved in the creation of seemed to erode those necessary conditions for success. The bottom line is, regardless of the scope or the high profile nature of any technical endeavor, there needs to be enough time allocated for quality assurance in the beginning and quality control throughout the effort or problems are almost certainly guaranteed.

Ed Mitzen: It would be incredibly arrogant of me to think that our agency could produce a website that is on this order of magnitude. And we are an incredibly talented digital shop. I would like to think that more time would have been allocated to testing and QA control. The massive integration project between and all of the various insurance carriers (all with different back-end technology) is not something that can be executed without an equally colossal QA/QC procedure.

Christine Armstrong, senior VP, managing director brand experience, Giant: What happened to is not an uncommon problem. It stems from three main pitfalls we face often as an agency that provides digital services. 1) A convoluted procurement process for an unprecedented project requiring many vendors to partner together without one “lead” agency. While it’s not uncommon to encounter collaboration with three to five vendors on complex projects, 55 agencies contributed to (the failure of) the development of 2) Poor program planning. The website was designed as a single launch with a finite beginning and end. No good agency approaches site development in that way anymore. Sites are more than just a single project; they are more like living beings that need to be monitored, nurtured, and evolved. Phased goals needed to be developed and designed with room for user feedback and iteration. 3) Poor communication protocols. The government did not have the right in-house technical “quarterback” to lead the team and call the shots.

Additionally, communication and transparency protocols needed to be established to avoid “coding in a vacuum” with no one taking accountability for how their piece fit into the greater whole of the site.
At Giant, we hold both agency and client accountable for the milestones and validation points along the way. There are many check-ins that allow for more small, iterative success and communication that builds confidence between all parties. This approach allows for greater management of expectations, discussion of risk, and ability to respond quickly to requests or change without causing alarm, effecting scope and timelines. We avoid the “big reveals” which tend to over promise and under deliver.

Dan Renick: While there appear to be numerous technical glitches involved with the website fiasco, the underlying issue is more about how the administration wanted consumers to be presented with information – or rather, how they didn’t want them to be presented with information, specifically the cost of coverage without subsidies included. So instead of consumers simply being able to browse available plans and associated “retail” prices, those exploring coverage first had to provide complete application information, after which plan options and prices were returned less the subsidy amount for those qualifying. While there is some merit to this approach from the standpoint of trying not to discourage those who will be subsidized by not displaying the full price up front, it adds tremendous burden to the system and converts what many thought would be a “shopping” experience to an “application” experience, and to date that has not worked well. The primary thing to do differently is explain the process right up front so that consumer expectations more closely align to what the actual experience will be.

Sophy Regelous, chief digital officer, ICC Lowe Trio: When developing any type of digital environment, the creation of user-case scenarios is a critical step in the discovery and design phase ... especially when lots of users are expected to visit the site.

When working towards hard deadlines of high profile sites, it is often difficult to manage and meet all expectations. There is a tendency to rush through or skip steps in a standard software development life cycle plan, however taking time to follow the correct process almost always results in shorter development and QA cycles, leading to more successful launches. User case scenarios and a functional prototype tested by sample users can head off any usability issues, resolving them prior to code being started.

In addition, based on the ongoing progress and tracking of projects, when it becomes clear that the appropriate amount of time for load balance and thorough QA testing is not possible, it is worth creating a plan B failsafe, to roll out as soon as a site starts reporting issues. For example, a redirect URL with an advising page that the site is experiencing heavy traffic or a sign-up form to receive a time to return when they can be guaranteed service, may have been appropriate.

David Windhausen, executive VP, Intouch Solutions: To me, it sounds as though they approached the project all wrong. They approached it like other big development efforts in the past: spend an eternity documenting requirements in a vacuum; build, build, build; and then test late. You end up delivering something that doesn’t meet the customer’s needs. A better approach would have been an iterative one – one that included real-end users – those that would be signing up for insurance. Then the cycle becomes launch, test with users, plan, launch again, etc.

It also feels there were way too many “cooks in the kitchen.” A lean approach would have been much better than the approach they took. It seems as though they had an inordinate amount of time and budget. (I wish we had that kind of time and budget for some of our projects!) Think of all the time and resources consumed by just trying to keep all of the parties on the same page. This was brought out a bit in the hearings with all of the back and forth finger pointing between agencies involved.

The final thought was because they approached this project in a very traditional waterfall manner, they didn’t begin testing until way late in the cycle. That led to an inevitable timeline crunch and the bad decision to launch when the site wasn’t working.

Leerom Segal: We have a view of what went wrong on (see our blog), and from our perspective, this is another example of bigger is not better. The code base has been estimated at an obscene 500 million lines of code. Anything that big is just poorly designed, usually because there are too many, not too few, people on the project. A smaller team of highly skilled individuals will always create a better product than a huge team of moderately skilled people.

Med Ad News: From where we sit, it appears that the general trend of consolidation in marketing services procurement – i.e., clients demanding more services at lower cost and the big guys merging or buying themselves bigger in order to meet that demand – appears to be accelerating. What is your response to that point of view?

Jay Carter: When consolidations happen, it’s big news, whether the announcement comes from a victorious agency network or a happy procurement group. It’s not so big a story when the pendulum swings the other way, and nobody shouts about it. In 2013, our agency was approached by two different large pharma organizations who were contemplating elimination of their network consolidation efforts due to diminution in services. One resulted in a new business win. At the same time, we partnered with a very large agency network for a client consolidation, because our relationships aided in the network’s chances of a win. Net/net, I think that there’s going to continue to be change in the way that agency services are acquired, all along the continuum from single agency network to a different agency for each brand in a portfolio. All of those options offer opportunities for the independent agency.

Kyle Barich: Indeed many of our larger clients have already consolidated their marketing services at the holding company level while others are carefully observing before joining the trend. At the same time however, several are in the process of unraveling their earlier consolidation efforts. That being said, consolidation has taken hold in our industry and is having an influence on the ways agencies behave and are structured. For it to work on the agency side, the holding company offering has to be authentic, with not too many moving parts, and where everyone in the mix ultimately benefits by participating. On the client side, we are finding that this requires a huge degree of behavioral and structural change as well. We, and our partners in procurement, are seeing that consolidation is not the right answer for every situation. The manufacturer’s organization needs to have patience and be committed – senior management, global marketers, and local units around the world. There needs to be some level of stability; if clients restructure several times in a year, it is unlikely that the necessary cultural and behavioral changes will happen. Otherwise the consolidation pendulum can easily swing away from these models. The industry is searching for a perfect and cost-effective answer to the complexities of modern communication and consolidation can help. But only if all parties involved are willing to take on the necessary organizational change.

Jon Sawyer: Certainly it’s a macro event facing our industry, and we don’t blame clients for wanting value for the investment they make in procuring services. However, we believe that great efficiencies can be gained through partnership and honesty with the smaller independent firms as well, and that the conglomerates don’t have an exclusive lock on delivering greater efficiency, strategy and creativity or – at the end of the day – lower cost. Profoundly good work is the result of great working relationships between client and agency based in trust. Both parties need to feel like they are in that partnership willingly and only as long as they can do great work together. When it comes down to the actual people doing the work, these large roll-ups often put agencies and clients together that are unwanted bedfellows. This often doesn’t lead to the best output or the most cost-effective approach.

Ed Mitzen: Both large pharma and large advertising conglomerates are in a tough spot. They can’t save their way to prosperity, and they are creating a huge talent drain. More senior staff are bolting (voluntarily or involuntarily) to smaller firms where they can do great work and avoid all the corporate bureaucracy.

Adam Gelling: Sponsors commoditizing the strategic and creative product through heavy-handed procurement is extremely short sighted and ignores the forest through the trees. Switching or excluding agencies over a nominal discount in hourly rates discounts the investment a brand makes in a true marketing partner and ignores true performance metrics such as total time and cost of project and overall brand performance. Our model to put senior staff on the front lines of client business to ultimately reduce client budgets and accelerate brand performance gets lost in a straight procurement rate comparison model. We believe in the role of procurement and appreciate their support and guidance, but encourage them to re-evaluate their success metrics or else risk lagging behind their competitors who have a holistic view of their marketing objectives and partners.

Dan Renick: It depends on where you sit. If you are a leader in a highly specialized space like payer marketing, focused on access and reimbursement needs in a complex market, consolidation may be viewed as a positive since it will drive even less differentiation among the giants. While a lower blended rate for consolidated services appears attractive on the surface, not receiving the necessary strategic support and related exceptional execution to secure profitable formulary access will cost far more than any procurement exercise will ever save. Marketing support is like any other area of purchasing – you get what you pay for.

Joe Daley, president, GSW: Pharmaceutical marketing and commercial organizations are under significant pressure to bring forward the level of innovation that has been the cornerstone of R&D – and to do so with ever increasing efficiency and productivity. Leaning into this dynamic requires our bringing together ever broader complementary, non-duplicative skill sets and knowledge that allows us to complete a tight, focused partnership team with our clients; a simple, single team that works in a connected fashion across all customer segments driving a high value, consistent, impact brand experience. In my opinion, it’s going to be difficult to address this environment without accelerated evolution and change that includes combining resources in more aggressive ways, including mergers.

Renee Wills, president, ICC Lowe Trio: Agencies that are consolidating to achieve cost efficiencies and round out their capabilities must keep this in mind: Bigger isn’t necessarily better. While change is accelerating across the industry, it’s important to think carefully about what mergers can promise, and what they can’t.

The fact is, all shops are making moves to better position themselves to handle current and future client demands: as procurement wants greater efficiencies, and brand directors want to leverage new and emerging technologies, some shops have consolidated. For example, a few traditional, full-service shops have merged with specialty digital agencies. Some that started out as digital shops are now part of bigger entities.

Searching for efficiencies through large-scale consolidations seems to make sense – on the surface – but when clients are seeking bigger and better ideas and more creative solutions, those ends may be better achieved in other ways, for example, through resource sharing and inter-agency collaboration.

The danger with consolidation is that there are so many variables affecting the outcome, the agencies’ joint specialties could get “lost in the sauce.” Agencies also need to make sure our work product doesn’t become a commodity. After all, we don’t make widgets.

In our business, the currency is still great ideas: there will always be tremendous value for agencies that come up with novel ideas that connect brands with target audiences, and drive the preference for and selection of those brands. Delivering those great ideas is still predicated on agency talent, philosophy, and culture.

Faruk Capan, CEO, Intouch Solutions: As an independent firm, this is something we watch closely. We have seen the trend wax and wane for the 15 years we’ve been in business, with mixed results both ways. The mega-merger of Omnicom and Publicis has again put this procurement trend back into the spotlight.

The reality for us is, we have continued to grow 30 percent or more year over year, and that growth is coming from both existing and new clients. Over time, clients find the consolidated services or “preferred network” model doesn’t always meet their needs. And they discover they aren’t saving any money after all, because those contracted networks aren’t incentivized whatsoever to be efficient. So clients find ways around it. That’s where some of our most recent growth has come from – from clients looking for innovative ideas and specialized digital consulting that they are just not getting from their arranged-marriage agencies.

Leerom Segal: The issue of cost is a red herring. It’s not about cost, it’s about efficiency, efficacy, and quality. If you make the right decisions based on the right information, then create the right artifacts, and place them in the right places, you can have the effects on the market that you need. If you don’t, then no amount of money will save you, it will just be wasted. Right message, to right person, at the right time might sound like old news, but it’s more important than ever and it ultimate comes down to a predicable and consistent execution capability.

Kim Wishnow-Per: Will the consolidation trend continue? Yes. Will it accelerate? I think so. For our clients, the trend is less about “more for less” and more about “better more efficiently.” The ability to get best-in-class resources under one umbrella is one that intuitively makes sense. Connected experts in each core discipline is a powerful tool for today’s marketers. Our clients have broken down their internal walls and agency networks have followed suit. This approach sets up fertile ground for better thinking, but does so in a way where organizations can realize cost savings through team efficiencies. Bigger networks don’t necessarily translate to bigger teams. They foster connectivity allowing for more focused teams providing better overall solutions.

Med Ad News: What are clients asking for today in the mobile marketing front? The social media front? What will they be asking for next year? What do you think are the keys to successful mobile and social strategies for pharma brands?

Kyle Barich: Most of our senior clients grew up in a world of controlling the message, reach and frequency, share of voice, and outbound marketing. And then most everything changed. For brands to be recognized and relevant in a digital world, they have to engage in social media. So we started with social listening, whether passive or active (research). Then we helped some braver clients launch corporate Twitter accounts and YouTube channels. But the magic two-way conversation about our brands or disease content across social media channels remains elusive for the most part. While the ideas reside in most tactical plans, so many barriers and fears remain. As policies evolve and we find “safer” and more compliant ways of engaging with HCPs and patients, we will decrease our sense of risk and increase our collective sophistication in healthcare social marketing.

What will they be asking for in 2014? Mobile Apps, Social Gaming, Responsive Web Design, Virtual Conference Support, In-app Branded Experiences, and continued improvement of the iPad personal selling experience top the list. Clients want more seamless integration of digital into their broader plans. They want better and more cost effective ways to develop and deliver digital marketing globally. Relationship marketing is enjoying a renaissance with immense improvements in data collection and analysis. Clients are pushing us to better leverage interactive visualization of data, to explore content marketing strategies, to customize and personalize content to drive relevance and engagement, and to integrate more deeply with our digital media partners. Frankly, it’s exhausting but exhilarating.

Jon Sawyer: Look, mobile and social are just channels. They’re certainly remarkable in that they are almost ubiquitous today, but ultimately they are just channels. Our clients are asking for sound counsel on when and where to leverage mobile and social and are no longer feverishly clamoring to get on the bandwagon just because they’re there. Fundamentally good strategy calls for digital content to be at least mobile friendly and even better enabled to serve a mobility-driven purpose. Social has far-reaching, important implications for patient connectivity – perhaps less so for HCPs, but pharma is just beginning to understand the respectful and appropriate role it can play in social. We believe next year mobile and social will evolve and be contextualized into broader strategies and be less of a stand-alone focus of attention.

Erin Keefe, senior VP, group director, digital strategy, and Michael Pruskowski, VP, group director of strategic planning, Draftfcb Healthcare: One mobile question we’re being asked more frequently and from a broader array of our clients is what should my brand’s iPad 2.0 or next generation strategy be? It’s an exciting question to hear because it signals an increased demand for more than just front-end only focused iPad-based applications, especially when it comes to the rep-based sales tool. Both reps’ and physicians’ expectations for the iPad continue to rise. They tell us they’re looking for the “ experience.” They want iPad experiences that offer more customization, utility, and convenience. So the task at hand for the next generation of pharma’s iPad applications is how to best leverage both the front- and back-end technology. This means the continuance of strong creative and story-telling along with a steady increase in more data-enabled marketing capabilities including better collection and use of customer intelligence; more targeted and personalized content; more closed loop and relationship-oriented marketing. The end goal is an experience that leaves the physician and rep more satisfied while improving the marketing performance of iPad-based marketing efforts.

Another mobile question we hear from clients, especially those in organizations where there’s been a clear mandate to prioritize mobile, is how can I get access to mobile innovation while not breaking the bank? We believe the answer is collaboration, funding and creating new partnerships with third-party technology companies. With the implementation of the HITECH Act of 2013, there is an increasingly larger world of technologies accessible to every developer as well as Pharma. This will fuel a surge in technology entrepreneurship and innovation within and outside of Pharma. We believe for our clients and ourselves that more efficient access to these technologies and energetic partners will expand pharmaceutical companies’ mobile offerings and lower the opportunity costs related to innovation.

Regarding social, there is an interesting evolution of ask here. For our clients, especially on the DTC side, the question is no longer focused on how can I do social in the current regulatory environment, but where, when and with what messages that will align with a broader integrated marketing strategy? Two-way, pharma sponsored social has been proven in the unbranded space. Gated/moderated is happening in branded. In 2014, we expect these trends to continue along with greater social media marketing experimentation and activity.

Ed Mitzen: Clients continue to look for innovative disease awareness programs that can be implemented through mobile and social. While FDA ambiguity continues to be a concern, companies seem to be more open to different ways to reach their potential customers. Responsive-design sites are the standard now as well, as are well-thought out landing pages. It’s been encouraging to see clients’ understanding of mobile and social increasing, and they are open to us teaching them best practices.

Jonathan Peischl, senior VP, director of innovation and digital marketing, Giant: Mobile breaks out into three key areas: tablet detailing, point-of-care access, and patient/consumer/caregiver information access. On the tablet, specifically the iPad, each of our clients is moving in that direction; some have gone so far as to nearly eliminate paper from the sales call, while others offer the sales force the choice. Regardless of the mix, the convenience of a single point of access for all brand and disease education messaging, as well as program promotion and enrollment, has won over sales organizations. Meanwhile, access to rich customer insights via engagement metrics has won over marketing and business analytics. Once tablet detailing is off the ground and embraced by the sales organization, the hunger for new content and fresh features keep our teams busy day and night.

Point of care access to drug and disease information is alive and well. Physician adoption of mobile is off the charts, and HCPs have a wealth of resources they rely on every day in their practice. The opportunity for pharma is significant, from the simple step of mobile brand site optimization to HCP toolkits offering features that may not be found on some of the third party sites and apps that are commonly used. Additionally, with HCP adoption of tablets we see great opportunity for patient education tools that can be used in the practice, ultimately replacing the printed HCP-to-patient education pieces.

For patients, consumers, and caregivers, the need is there. Consumers expect to be able to find what they need in mobile-optimized form, whether it be banking, travel, dining, etc. Why shouldn’t our industry address the need as well? This is the greatest area of opportunity for our industry. Apps are nice for chronic conditions, but consider the waiting room or exam room scenario where a patient is faced with a diagnosis or prescription that they immediately need to know more about. The iPhone comes out, and the search begins. We must be there for them.

Social remains somewhat of a one-off area for pharma. It’s important that we listen and use the information we hear to make smart decisions, and participate or drive the conversation only when the need is clear. Transparency is essential in social media, so anything less than a genuine interest in helping a community will result in failure. We need to be present, but we cannot be leaders in the conversation, it’s simply not in keeping with the nature of the media.

Leigh Householder, chief innovation officer, GSW: Multi-screen marketing is a critical new skill set our clients are focusing on this year. Specifically creating the right experience for every context that involves a screen. Depending on the audience, that could mean snackable, scannable content a physician can browse on his tablet during morning coffee, a debate-ending video that a daughter can pull up on her smartphone to show her mother, or even a smart rep-training tool that delivers a different experience when he’s looking at the screen vs. when he’s driving to a meeting.

On the social front, video is huge this year. It earns more attention in social than any other type of media plus it already earns 50 percent of mobile traffic. In healthcare, video can play a key role in motivating people. Disease makes people feel isolated and alone. Video lets us bring them inspiration from people who are dealing with the same decisions, the same therapies, the same disease, in documentaries and storytelling that are authentic and peer-driven.

Dan Renick: A significant key to success in these areas will simply be understanding the rules and regulations as they are generated and applied, and then being as creative as possible within that framework. We have seen that each of these areas presents novel creative challenges, and one-size-fits-all solutions have been shown not to work well. Right now, clients are actively trying to figure out the right balance – too much investment in high-growth areas like mobile and social media at the expense of more established methods runs the risks of losing touch with traditionalists, while too little suggests an overly conservative approach that is out of touch with the realities of today’s digitally connected world.

Andrew Thorn, digital strategist, ICC Lowe Trio: The principles of “mobile-first” design have worked their way into the fabric of professional marketing, which is a great thing. Our clients are increasingly more interested in evolving their Web-based content so it can respond to immediate customer-centric needs – in their location, in context, and in more conversational language. Pharma companies can no longer “re-apply” Web content for mobile media: We all need to think “mobile first,” not simply adapt one to the other.

While many of the most enticing aspects of mobile marketing (location-based services, augmented reality, experiential design, social immediacy) remain untapped in the professional landscape, there is an ever-growing number of professionals who use mobile platforms to satisfy their need for information, so the potential in this channel is huge.

Social media continues to be another difficult nut to crack in the professional side of pharma, for well-documented reasons. The increasing awareness of the role social networks play within the Customer Life Cycle is inspiring us to work even harder to find manageable ways to leverage these channels.

According to a 2013 report by Wildfire, the No. 1 way a customer discovers a new brand/product/service is by seeing ads on social networks. That’s almost double the rate of online ads. Moreover, search engines (40 percent) barely edge out social networks (37 percent) as a platform for researching brands/products/services.

Vital to successful mobile and social strategies for 2014 is exploiting analytics to help pinpoint the best way to connect the right messages with the right professionals. Equally important, however, are customizing experiences for different platforms and developing content strategies that truly reflect how professionals consume information within these channels.

Wendy Blackburn: With FDA issuing final guidance, much of the uncertainty around mobile medical apps has evaporated. Now we can determine with some level of clarity if FDA would consider a certain mobile app as a medical device, and plan accordingly. We have heard a collective sigh of relief, and innovation is opening up again.

Meanwhile, social has become mainstream, even without guidance. Slowly but steadily, we are seeing interest in long-term engagement programs vs. one-off campaigns, which is good for everyone. We’re seeing clients hire full-time in-house social media staff. And we continue to see an uptick in utilization of our social media products that help pharma companies engage in a compliant manner.

Pharma companies are seeing that social media is here to stay, they are getting more comfortable with it and they are finding ways to engage.

Leerom Segal: Mobile is no longer a separate issue, it is just the current reality. If your site does not display well on mobile then you are late to the party. Doctors and patients do not care about your MRL process, they care about information that is clear and readable on the device they are using. So, mobile is no longer an afterthought; it needs to be a consideration in everything we do.

Social on the other hand is still in regulatory purgatory. There are a lot of experiments being tried, but there are still a lot of questions. I don’t expect the FDA guidance scheduled for 2014 to really change much for the industry except it may provide those moving slowly, permission to experiment.

Eric Pilkington, executive VP, digital strategy, North America, McCann Health: 2013 was certainly an important year for pharma, as their embrace of digital came front and center. 2013 was a remarkable year for McCann Health too, as we perhaps began working with our client to better leverage digital as THE CHANNEL by which to establish and extend relationships with critical customers and organizational stakeholders. Based on this demand, I think that there are five critical trends to follow as we move into 2014.

1. Increased personalization/customization of ad messages
While dynamic ads have been around for some time in other verticals like retail, we see them as becoming more prevalent in the pharma space. Ads will be customized based on users’ behaviors observed both on advertiser-owned properties as well as publisher sites. Dynamic ads enable pharma advertisers to create multiple creative variations using a single ad template, which increases marketing performance.

2. Mobile becomes a basic
The year of the smartphone has come and gone in other industries, but 2014 is poised to be the year of mobile in Pharma. And as more and more people move away from the desktop towards mobile devices, mobile advertising (search and display) will become a standard element in digital media plans.

3. Pharma gets social
Pharma companies have struggled to harness the power of social media given the concern with adverse events (AEs) being reported in online forums or networks. For this reason, they have adapted their approaches to find ways to engage in social in a low-risk way; for example, adding voting mechanisms or social sharing features to websites.

4. Online video as a replacement, or to companion DTC advertising
TV advertising continues to be a mainstay in the pharma marketer’s toolkit. However, with the extra airtime required to add in the mandatory safety language, pharma advertisers take a hit on TV media buying – unable to buy the shorter, cheaper spots. Unless you have a blockbuster product, cost can be prohibitive. With the rise of online video advertising and connected TV, more and more advertisers are running their commercial spots in the online space. Our clients are beginning to take advantage of the additional targeting available with online video that is not usually available with traditional DTC buys.

5. Pharma finally embraces mHealth/Digital Health
Consumers are managing their weight, improving exercise routines, modulating stress levels, and tracking their behavior through a host of smartphone applications, wireless devices, and wearable technologies. Many of our clients today are beginning to look at how they can best leverage this trend – how apps and technologies can extend better service and support to patients and physicians alike, while leveraging the cohort of data to better understand customer behavior and trends and more individualized levels.

Med Ad News: With digital moving to the center of most brand marketing plans, it seems that the good old-fashioned journal ad or physician print piece may be going the way of the dinosaurs. What is the proper place of print in a modern brand marketing strategy, and what are clients seeking – or not seeking – in this area?

Jay Carter: Ad Age says that in 2012 one-third of agency revenues came from digital services. Our agency was a few percentage points higher than this, but certainly at least 60 percent of revenue came from other sources. Journal ads remain, in our estimation, vitally important. Physicians still read them, and journal media remains one of the most cost-effective ways to deliver frequency to physician audiences. This allows pharma to more effectively “brand the sales call” and remind physicians of their most recent persuasive sales call by a rep. Print remains an important component for patient education as well … we need to be mindful that an enormous portion of the medicine consumed in the United States is among patients who are less likely to go to the Internet (though they almost universally have it available).

Kyle Barich: Paper is not dead. Rather print is evolving to be part of a holistic multi-channel experience. Print can serve as a reminder, a driver, or a connector. We just released a print leave-behind with a tag that launches an immersive augmented reality experience to help explain a complex mechanism of action. We are developing journal ads that are repurposed on ipad journal apps that link to engaging and relevant video. Print can act as a physical door to a digital world.

Jon Sawyer: We believe that all channels including print will eventually settle into their proper place with their proper intent and purpose to help customers along their continuum of adoption. Certainly print is challenged because it provides little feedback or opportunity for learning, but we all read or interact with something physical and tangible from time to time for different reasons under different circumstances. The objective is to determine when and where print is appropriate. However, the stampede to digital hasn’t necessarily revolutionized the impact beyond print. Most interactive sales aids deployed today on tablets or laptops are simply digital versions of paper-based sales aids, and many don’t provide much tracking of feedback or comprehension beyond the event that a sales call took place. This will need to improve dramatically to realize the vision of true CLM or CLP, in which case the day of the paper sales aid may truly be over. But the industry is not there, yet.

Ed Mitzen: There is still a place for “traditional” media, as long as it is integrated with the larger objective. The percent mix is really dependent on the target audience and product profile. We have a client now that has a product for a very socially awkward sexual issue, and patient anonymity is a big concern when self-diagnosing. In this case, more than 90 percent of our efforts are online. It really varies by marketing challenge.

Jonathan Peischl: We’ve seen data that shows that tablet detailing is not the end-all, be-all and that the combination of a tablet-enabled discussion and a print leave behind is more successful when it comes to message retention. Print media is another issue altogether. We know that physicians continue to rely on medical publications for information, but more and more that information is consumed via a tablet like the iPad or a laptop (sometimes even a small format device like a mobile phone). That said, we see variances by disease state and specialty, so it’s important to take a close look at media consumption habits before you rule out print advertising as an effective tool in our industry. Overall, our clients are simply seeking our guidance on where they should invest their marketing dollars.

Bruce Rooke, chief creativity officer, GSW: There is no place left for an old-fashioned print ad. There is, however, a place for a new-fashioned print ad; one that can drive readers, through both the content of the message and OCR/AR technologies, to a fuller, more interactive experience. The old-fashioned print ad expected readers to get every single bit of information necessary to make a brand decision right then and there (as if it were the only brand communication there was,) which was unrealistic anyway, and perpetuated by equally unrealistic executional research methodologies.

But think about it. There are print magazines and newspapers that continue to thrive, way beyond the expiration dates of pundits, due to the content and rewarding experience they create. The same can go for print ads. Clients would be smart to ask themselves two questions: “What could being in print do for my brand?” (Could you own the book, now that your competition is running away?), and “What would make that print ad a compelling, engaging experience?” (versus the usual, how do we fit all of this stuff on the page with our branding colors?)

Dan Renick: We are definitely seeing an accelerating trend for journals to offer digital (ie, ebook) as well as print editions. Either way, digital or print, the publishing houses will continue to compete on the metric that matters most to advertisers – readership. The digital space presents unparalleled opportunities for our clients to create customized engagements with their customers, and a more efficient way of controlling frequently updated content such as label changes, access changes, and updated value propositions. But print can do things that digital can’t – sometimes a tangible piece that ends up on a decision-maker’s desk for a few weeks could be what gets the message through. For advertisers, the question is therefore not one of print or digital, but print and digital, both providing the opportunity to cater to customers’ disparate preferences. It does not matter how you deliver a weak message, so focusing on creating the strongest value propositions unique to specific customer segments is the most important thing we do.

Catherine Jones, management supervisor, ICC Lowe Trio: More than ever, our clients are seeking the most effective ways to engage with their audiences. We still have to find ways to make better connections between those brands and their audiences, and build a trusted relationship between them. That starts with a strategy that takes into account all the channels in which we will be engaging with that audience.

In the healthcare space, while there’s often a lack of success metrics in some of the newer channels, the metrics remain solid in print.

Journal advertising and print media should always be a part of your brand’s communication strategy. The metrics are solid, and according to Manhattan Research, physicians still rely on printed journals 93 percent of the time, versus 89 percent of the time with online journals.

Plus, in the digital realm, it’s easy for professionals to be distracted and miss the message, whereas in print, there are fewer distractions. In both print and journal advertising, strong calls-to-action and tracking mechanisms help confirm the ad’s effectiveness. Using print to gain brand awareness and support digital activation will remain a key part of any effective communications plan.

David Windhausen: Traditional offline media outlets continue to merge with digital. For instance, with the emergence of smart TV technologies, TV advertisements can now be targeted via the same predictive analytics models that we are using through other channels. In addition these ads are bridging the gap between the offline and the online through interactive and second-screen technology experiences that drive greater engagement outside of the ad. The same is true for print. Print in pharma is still a big avenue for gaining awareness, especially when it comes to healthcare professionals who still consume a large amount of their content through normal print channels. The challenge for digital marketers is to find the opportunities to cross over to interactive engagement. Opportunities like interactive embedded ads within the digital version of a traditional journal are just the first step.

Leerom Segal: Reports of the death of printed journals have been greatly exaggerated. Print is important and will always be an important onramp to digital programs. Once there, the basics of HCP communication haven’t changed for 20 years.

Med Ad News: What other trends and changes have you observed in your clients’ respective promotional mixes?

Jon Sawyer: We are seeing a wholesale trend toward data-driven marketing and relationship marketing programs that meticulously track behavior, engagement and results. All tactics are tied to individuals, with the ultimate goal of substantially increasing the level of insight and understanding of customers. This is leading to highly customizable and effective campaigns that not only communicate more effectively but deliver a meaningful value proposition to physicians and patients. This is affecting the marketing mix in that all tactics are being assessed as to their ability to contribute to the relationship marketing effort, namely 1) Does the tactic reach a specific known target? 2) Does the tactic capture behavior and attitudes that may be attributed to an individual target? and 3) Does the tactic provide an opportunity to leverage that interaction into another that is part of the coordinated mix? We’re seeing that tactics that don’t meet the above criteria are being rapidly deprioritized if not discontinued.

Mike Sperling, principal, Giant: With the Sunshine Act, ACA, and greater competition we’re seeing a shift towards greater sales rep responsibility and the need for programs that enable them to solidify their customer relationships, to differentiate themselves from the competition and for them to feel comfortable with a changing healthcare marketplace. The leaders in the pharmaceutical/biotechnology space recognize the importance of educating and explaining to the sales force why they are doing what they are doing. How this gets communicated in a motivational way is all about what agencies do – deliver sound strategy and communicate it in an exciting and impactful manner.

Leigh Householder: One big trend we’re seeing with our clients is a big shift in the promotional mix from primarily rep-delivered messages to an innovative, and uniquely personal set of not-in-person marketing strategies. Peers are huge players in this new mix. Data-driven marketing is, too.

Dan Renick: The main trend we have seen is towards using iPads for customer interactions instead of traditional printed pieces. Yet many underestimate the training needs for their customer-facing teams in taking the greatest advantage of this medium. Digital interactivity allows for unparalleled gathering of customer insights, which ultimately leads to the growing role of health outcomes. This includes field support personnel and allows for incorporation of endpoints relevant to payers earlier in clinical development programs, though that has not been consistent and is easier said than done. The enactment of the aggregate spend reporting regulations in the Sunshine Act has an increasingly significant impact on the development and dissemination of educational materials, though it remains to be seen how strictly the pharma and biotech companies will interpret the requirements.

Sandra Szlachtianchyn, account planner, ICC Lowe Trio: Despite the “fumble” of the Obamacare launch, healthcare professionals are bracing for an unprecedented wave of new patients and policies to pour into their offices next year, fueling tremendous opportunities for health care marketers. In response to these evolving physician needs, health care marketing will continue to shift toward a more service-oriented mix, and away from a purely product-selling role.

The channels and tactics through which our messages are being delivered will increasingly include value beyond the drug – bringing brands more in line with preventive medicine and patient-centric healthcare.

Further, there’s a growing trend in professional communications to better leverage the value of PAs/NAs, as well as implementing strategies that enlist the help of pharmacists in driving drug adherence. As these trends continue, we can also expect to see a growing service offering within pharmacies – from MinuteClinics to virtual doctor visits conducted via Webcams.

As physician prescribing behavior and treatment locations continue to evolve, health care marketers are going to have to deliver more targeted content – in both message and channel selection.

Faruk Capan: Big data is coming of age, and clients are showing interest in new ways it can be used. Our programs are becoming more and more sophisticated with the use of data, including customer profiling, personalization, customization, predictive modeling, real-time responsiveness, and program optimization. The possibilities are exciting and endless, but we also must stay mindful of privacy concerns.

Leerom Segal: The biggest shift in thinking is towards digital first programs with every element of the increasingly complex ecosystem being better instrumented for personalization and systematic optimizations. At Klick Health, we’ve also been investing heavily in building deeper capabilities in both clinical recruitment and managed markets.

Posted: December 2013

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