Once hesitant – and restricted – to use social media in their communications plans, the healthcare industry is finally embracing the strategy.
The US division of Boehringer Ingelheim (BI) began using Twitter in August 2009 as a way to post news releases and link to stories of interest for its audience, whether a note of condolence to 9/11 victims or the results of a recent clinical trial.
The feed provides a venue for BI to extend the reach of its multimedia newsroom, as well as take the first step in creating an online community, says John Yonsky, associate director of online and social media communications. After five months, the feed had more than 900 followers.
As small a step as it might seem, especially in comparison to the ways consumer packaged goods companies and automakers have used social media for years, the move reflects how the pharmaceutical industry has changed its view and usage of social media since the start of last year.
“We're all kind of dipping our toe and doing pilots,” says Yonsky. “That's the right way for us all to move forward until we actually get some guidance on how we can engage. We're trying to put our foot into social media in such a way that people see we want to start a conversation, even if we can't do it yet.”
Like most highly regulated industries, the pharmaceutical sector has shied away from engaging in social media, both because of the regulatory risks and the inability to control online dialogue, including talk of off-label use of drugs and adverse events reporting.
Despite these restrictions, the Web has become the go-to place for patients, caregivers, and even physicians to search for information about a condition, treatment, or drug. According to a Pew Research Center report released in June 2009, 61% of American adults search for health information online.
WebMD reported in 2009 that it receives about 60 million unique visitors each month. Chatter about drugs and disease has popped up in comment boards, status updates, and online patient communities.
“What has emerged is a lot of pharma companies doing one thing at a time,” says Mark Senak, SVP for Fleishman-Hillard and author of the Eye on FDA blog. “Some companies have stepped in and been pretty bold. They have put together some dynamism in that medium.”
While companies like Johnson & Johnson and Novartis are recognized for how they use the Web and social networks to communicate, many pharma companies did not launch a major social media initiative until 2009.
Pfizer, GlaxoSmithKline, and AstraZeneca introduced corporate blogs and Twitter feeds last year, while other pharma companies created their first Facebook pages and YouTube channels.
“There was a lot of concern about legal and regulatory issues, and I think a lot of companies have been able to overcome that in the past year,” says Rachelle Spero, EVP of digital media for Cohn & Wolfe, whose clients include GSK and Merck. “You'll see more and more faces from the pharmaceutical companies engaged in digital media because the planning phase that has been underway for the past year will start going into execution.”
Just as pharmaceutical companies have found some pathways that ensure their social media communications follow regulation, the Food and Drug Administration (FDA) held its first hearings to address online communications in November 2009.
The information gathered from the two-day hearings, as well as the information submitted through February 2010, will be used to guide the FDA in future policy decisions for how the pharmaceutical, medical device, and diagnostic industries can use social media to communicate.
Many communicators say that if the federal agency releases online guidance, it will be in 2011 – leaving this year open to implement the plans the companies and their agencies orchestrated in 2009.
Like BI, many pharmaceutical companies are expected to build on the online presence they built last year, as well as expand into channels like video and topics like CSR and clinical trial recruitment. Yonsky notes that while the US division of the company has a YouTube channel, it has not yet started to use it.
“It's there as a proactive holder for future use,” he says, adding that in 2010, “every product of ours will surely include some kind of a social media component in the brand strategy.”
In 2009, BI's communications team focused on internal education for its employees and communications staff, listening, and influence mapping.
“We have made strides,” says Yonsky, “but I'd say a lot of it was in those areas. We are hoping to get there quick, but in a very thoughtful and cautious way.”
Finding the right story
Many large pharmaceutical companies have used a corporate story to take their first dive into social media, in part because corporate messaging is not regulated like product communications.
Led by the corporate communications team in many cases, early-stage usage of social media channels has often acted as an extension of the media relations work the company has already been doing.
GSK launched its corporate blog and Twitter feed in May 2009 as a way to create dialogue, tell a corporate story about the issues within the US healthcare industry, and reach online thought leaders and influencers, says Michael Fleming, senior director of social media for the company.
As the blog and Twitter feed gathered readers, it provided GSK a way to tell the story it wanted to, as opposed to through the lens of a media outlet. It also created a way for the company to share news about its CSR efforts and its nonprofit partners with a growing online audience.
In October 2009, GSK invited a handful of mommy bloggers to tour a vaccine packaging plant in Marietta, PA, to educate them about the facility and talk about some of the issues relating to pediatric vaccination. The event was covered by GSK's own blog and included links to the women's blogs.
“These are women who are influential in their circles and do occasionally write about healthcare issues,” says Fleming, adding that it was the first time GSK has held such a blogger event.
Companies trying to raise awareness about a disease or condition are also finding that social media can help them address the changes in the media landscape, as well as expand on coverage for conditions that are less well-known.
Maryellen Royle, president of North America for Tonic Life Communications (formerly Dorland Global), notes that social media is important for clients who want to create a tailored message or experience for a patient community.
The firm is working with Centocor Ortho Biotech on the “New Way RA” program, which includes an online talk show aimed at people with rheumatoid arthritis (RA). Topics include nutrition, relationships, and career advice. The program launched in July 2009.
“Oftentimes, they are diseases that don't get a ton of traditional media pickup,” she says. “We find that when you have programs and educational information and make it available online, it's very well-received by the community.”
Traditionally, mainstream newspapers like The New York Times and USA Today might not have covered smaller patient populations, especially as the reporting staffs get smaller at news outlets across the US and health reporters become less specialized.
Royle says that informational health and news sites like WebMD and Everyday Health are becoming a larger part of the overall media strategy.
“The engagement is much more in depth because you're really hitting your target audience,” she adds. “Getting a hit in a daily or a national newspaper still draws a lot of coverage, but we're finding that the quality of those visits tends to be shorter and less in depth.”
From an external standpoint, the pharmaceutical industry appears to be working with a social media model that the technology, auto, and CPG industries surpassed years ago. Internally is where many companies are choosing to pilot the more innovative of their social media efforts.
Yonsky says BI is using everything from internal blogs with employee avatars to Yammer, a kind of internal Twitter for people who share the same e-mail address, to develop employee expertise and expose people in the legal, regulatory, and medical divisions to the benefits of social media.
“One of the best ways you can really learn about how to handle social media is to focus on internal tools,” he says. “That would start demonstrating to you how this can be effective in reaching people, how it will add transparency and speed to your communications.”
Pfizer, which does not have a corporate blog, does have an internal blog, says Ray Kerins, VP of worldwide communications for the company. Topics have ranged from healthcare reform to the company's use of water bottles to executive speeches.
“The challenge,” he says, “is how do you make sure you empower people who are not directly involved in communications to feel comfortable getting into the dialogue?”
Pfizer now has more than 100 employees blogging, including some through the “Think Science Now” program, which includes an external blog featuring some of the company's scientists and medical experts.
A group of Pfizer staff, led by leaders in colleague communications, corporate communications, and other divisions, acts as a council on social media, says Kerins. He adds that the company consciously made an effort not to create a social media point position.
“There really can't be any one owner of social media in a corporation such as Pfizer,” he notes. “I think that's the case across the board. There needs, however, to be some level of policy and understanding of what can and can't be done appropriately if you're to do it on behalf of the company.”
Other companies like GSK and BI created social media-specific positions for Fleming and Yonsky. GSK created an informal group of advisers, including agency leaders like Spero at C&W, for the launch of its blog. Its social media leadership team includes people from legal, marketing and communications, and commercial analysis.
Andrea Levin, UCB's communications and PR manager, says no one person handles social media at the company.
“It's happening so quickly,” she adds, “that we have different people with different skills working on different components of it.”
Many communicators point to this inconsistency – who actually handles social media and online communications for a pharmaceutical company and why it differs from company to company – as one of the top challenges in entering the space or developing a new program.
“Somebody must have the authority to move decisions in a process that normally moves at snail-mail pace,” says Senak. “There needs to be some sort of interdisciplinary approach that evokes an ongoing process for evaluating, analyzing, digesting, and making decisions on how things are dealt with.”
A standard social media program will face regulatory, legal, communications, and marketing teams before a launch. The role some firms are starting to carve out has to do with the development and implementation of social media guidelines.
“I think you're going to see guidelines become normal,” says Bob Pearson, chief tech and media officer for the WeissComm Group. “Every company will have guidelines.”
The firm worked with Pfizer on its social media guidelines and strategy, first with the company's corporate story on Twitter and now with its other social media initiatives that extend to disease awareness.
“That's where guidelines have the first purpose because it's much easier in pharmaceuticals to start with the corporate story,” notes Pearson. “The second phase of guidelines, which many companies are working on now, is the actual engagement from the brand perspective. That takes a lot more work because you have to be very careful in how you do it.”
More than 20 pharma companies are now on Twitter, with each using it slightly differently. Merck, for example, posts job openings. Yet many established social media programs still don't engage with key communities. “It's been predominantly a one-way conversation,” says BI's Yonsky.
Video, with its ability to tell a story simply and educate and inform about a condition or disease, is a channel less reliant on conversation and is where many pharmaceutical companies plan to focus their attention this year.
While some companies have created and are using YouTube channels, many others will turn to the medium to reach patients, share information about dealing with chronic diseases, and even communicate with physicians.
“Video, I would actually argue, is the most important way for a brand to tell its story,” says Pearson. “That's why YouTube is the second largest search engine in the world. People are rapidly moving to video to learn.”
Videos are also being used for clinical trial recruitment and to communicate CSR efforts. It's a medium that still shows the benefits of providing content, but it is not de-pendent on engagement to be successful.
“If we can't talk to people, how else can we engage with them?” asks Emily Downward, SVP of digital healthcare for Edelman. “Are there tools or applications we can give to people that provide utility, but not have actual words exchanged?”
Along with video, Downward predicts that the pharmaceutical industry will place a greater focus on the development of mobile applications that can assist with chronic conditions and voting systems for social networks like Facebook, which remains a difficult channel for many companies to navigate.
In fact, most pharmaceutical companies turn off the wall or any commenting mechanisms.
Status updates on Facebook are similar to Twitter –there's not enough space for fair balance. Yet, asking a community to “like this” or “dislike this” could be the first step in engaging with them.
“You can get some engagement with the community, but it's not going to trigger any regulatory bells,” says Downward. “There's definitely a lot of caution, still, because no one wants to do something completely wrong. We, of course, don't want warning letters.”
In April 2009, 14 pharmaceutical companies received letters from the FDA, warning them about “misleading” and “misbranded” Internet ads. The letters triggered a change in how the companies had used paid search for years as part of their overall communications strategy and were a major topic of concern at the November hearings.
“The FDA has to figure out how to allow conversations to occur and information to be shared between the experts and the customers online,” says Pearson. “If you constrain those conversations through regulation, you actually create a safety issue, a public health issue.”
Ritesh Patel, a digital and social media leader for Chandler Chicco, says he expects pharmaceutical companies to increase their usage of Facebook, Twitter, and paid search in 2010.
“The spend on search will start again,” he predicts, regardless of the development of online guidance from the FDA. “Anything concrete that our clients may point to may not arrive until 2011.”
While pharmaceutical companies and their agencies have taken steps to develop guidelines for bloggers, Facebook, paid search, and video, it's the unexpected changes that have taken place in the social world that have caught the industry off guard.
The launch of Google Sidewiki in September 2009 was one example where many companies were criticized for how they reacted, says Senak.
Sidewiki allows anyone to comment on a company's Web site, which could be particularly damaging for a pharmaceutical company because of the possibility of adverse events reporting and comments about off-label usage. Without a social media policy in place, Senak notes some companies did not acknowledge the new tool.
“That took everybody by surprise,” he says. “Only one company acted – and that was AstraZeneca – by putting in a landing page on the Sidewiki. That's the first thing that everybody will see when they come, rather than seeing the most recent comment.
“The communications environment has changed dramatically,” adds Senak. “There's such a focus on what we can't do in marketing that there has been a failure to focus on what we can do everywhere else.”
Changes affecting pharma companies and their corporate communications teams are also altering how firms operate.
The concept of the “digital land grab” for the PR industry is just as relevant in healthcare communications as agencies grapple with who is the social media point person at a company and which division leads social media.
“Trying to own everything is one of the challenges that many of us in the PR space have,” says Spero. “Not only do we need to partner with our clients, we need to partner with the other agencies and partners who are helping to develop a strategic social media program that's going to tie back to the company's business objectives.”
While working with other agencies is not new for communicators who work in the pharma industry, what is unique is that some agencies are being brought in to work with other divisions in the company on social media initiatives.
Pearson says WeissComm is working with teams in communications and marketing, as well as human resources, IT, and research and development.
The firm's interactive team was created in 2009 and now employs a staff of 20, while other healthcare firms like Chandler Chicco launched a new digital offering in January 2010.
As healthcare agencies and practices become more specialized, the need for strategic counsel will grow, which could alter the way that companies have worked with some agencies and filter out others that do have not have the online expertise.
“Agencies that will lead in this space are agencies that are true partners,” says Pearson.
But there is also growth potential as companies look to syndicate the consumer-facing and b-to-b content they post to channels from LinkedIn to YouTube, Twitter to Facebook. Pfizer has been seeing a “statistically significant return” on its social media efforts since Q2 2009, says Kerins.
“There's a significant fiscal return in the way that it's being approached,” he notes. “We scratched the surface and now the challenge to the entire industry is to keep this alive.”
As strategies get refined and the FDA gathers information about the possibility of online guidance, the industry is positioned to build on the small steps it made in 2009.
“The regulatory environment we play in is always going to restrict us somewhat, but I think we have to be more creative,” says Downward. “We must work something in the box rather than outside of it.”
Stepping into social media: Pfizer
Pfizer quietly launched an online blog community called “Think Science Now” in June 2009, which features 100 of the pharmaceutical company's scientists and medical experts.
The site features profiles of these individuals, as well as their blog posts, recent publications, professional affiliations, and key areas of research, says Ray Kerins, VP of worldwide communications for Pfizer.
It also includes video interviews with scientists on issues like the H1N1 virus and the personal genome, through a partnership with news site Big Think.
“We'll call it a significant group of our medical and science team, blogging about interesting things that they find to be important to their work and to the people that they're serving,” adds Kerins.
The goal has always been to have the scientists communicating directly because they are the ones with the deep knowledge of the science behind Pfizer's products.
What makes the launch of the site unique is that the communications team at Pfizer chose not to publicize it through traditional media relations. Understanding the social media space and the audience it is trying to reach was a change for the pharmaceutical giant from how it has communicated in the past.
“I'm not going to turn around and publicize every time we do something different or innovative in the space,” says Kerins. “In this environment of social media, I think there's a lot more gained from discovery versus sell.”
Stepping into social media: UCB
UCB, which develops drugs to treat conditions like epilepsy and Parkinson's disease, is primarily using social media to educate and raise awareness about care with the patient communities it serves.
The biopharma company launched its first Facebook page last November as part of a larger effort during Epilepsy Awareness Month, says Andrea Levin, manager of communications and PR at UCB.
UCB has also been working with PatientsLikeMe, a social networking site for patients, to create an epilepsy community that it sponsors. The site, founded in 2004, has communities for 11 other diseases, ranging from mood disorders to HIV/AIDS.
The format of the PatientsLikeMe community isn't controlled by UCB, so concerns were raised about the discussion of drugs and treatment, which is common in such online communities, as well as adverse events reporting.
“We are actually working on an entire pharma vigilance program,” says Levin, “to make sure we have a drug monitoring platform in place.”
To address concerns and ensure that the company was aligned with regulations, PatientsLikeMe hired a full-time employee to monitor the page and handle adverse events reporting.
“We're exploring every opportunity in epilepsy, Parkinson's disease, Crohn's disease, and rheumatoid arthritis,” says Levin. “We will look into employee and corporate communications, as well, but I think we're more focused on disease right now.”