John Gisborne, Hill & Knowlton: A matter of risk and reward

If we want the reward of being treated as partners by our clients, we need to share the risks

John Gisborne, Hill & Knowlton: A matter of risk and reward
John Gisborne, Hill & Knowlton: A matter of risk and reward

 Being on the same page as their clients and immersing teams seamlessly into their business is what all agency communicators claim to achieve. Do they practice what they preach in these difficult times, and is it going to be enough? Even if pharma hasn’t yet arrived at the door of Number 10, cap-in-hand like others, it is likely the industry will never be the same. Indeed, it has changed radically since the 1980s and 90s, when blockbusters such as Zantac, Prozac and Losec ruled in an era of big budgets that spilled over to statin mania in the late 90s.

Historically, there had been a straight-line relationship between promotional activity and sales. Products were designed to sustain a global sales force and PR activity was focused on keeping customers sold. Launch events, PGEA meetings (Post Graduate Education Accreditation – the old system of GP continuing education) and media articles in a wide variety of publications emphasised efficacy first, safety second and cost or compliance third. Successful strategies built brands and agencies just charged by the hour. Client relationships were rooted in a ‘them and us’ mentality and, although the rewards weren’t shared, nor was any real risk.

Communicators complained they were not at the table when big decisions were made, being treated as service providers rather than business partners. Leading agencies only began to rethink their approach around the time the biotech promise came good, when anti- TNFs (drugs to treat inflammatory conditions) and monoclonal antibodies (biologically targeted drugs) came of age, albeit at phenomenal cost.

Pharma companies adopted valuebased pricing models to commercialise these advances and smart healthcare communicators noticed that, although the same customers were making decisions, the way to reach them had changed. They now had NICE, postcode prescribing and legal challenges to keep them busy. Agencies that hadn’t noticed continued charging by the hour.

Today, NHS managers’ first move to protect the bottom line is cutting the drugs budget. Value-based purchasing of generics gives purchasers greater control of budgets. Where new products are deemed expensive, companies offer risk-sharing schemes to gain a foothold. A recent example is the agreement between NICE and Novartis, manufacturer of the treatment Lucentis for wet agerelated macular degeneration. The NHS picks up the cost of the first stage of treatment and the company pays for additional therapy, where necessary.

To achieve valued partner status, then, should agencies put their own intellectual capital at risk to demonstrate solid understanding of the client’s new business model? It is no longer possible for agencies to be remote from clients. This goes beyond simply understanding clients’ business – it is about the very foundation of how we work together.

Sharing risk doesn’t mean betting the farm on the success of products in clinical development, although it does mean choosing to operate in a way that may feel uncomfortable. Moving fast and implementing programmes that fit pharma value – where R&D, product licensing or marketing are handled by different divisions or firms – are prerequisites. So are providing staff to fill inhouse gaps and offering innovative solutions to hard-pressed clients.

Critically, communicators must be collaborative and comfortable working with other agencies in an increasingly complex business model. This provides the chance to shape the future of clients’ business, achieving reward by getting closer to equal partner status.

Recommending ‘Twitter with everything’ is no substitute for sound business understanding and an appreciation of what is genuinely at risk.


Views in brief


Tell us about an unsung hero in healthcare
Lord Robert Winston. Although he is well known, his contribution to helping
medicine to be clearly communicated and understood is understated.


What did you learn from the most challenging healthcare comms task
in which you have been involved?

The best comms programmes that achieve real change are challenging and
often hard to get approved. But they are really worth pushing for and everyone
loves the outcomes (and you have to make it look easy).

John Gisborne is senior associate director, healthcare, at Hill & Knowlton

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