Major pharma companies and nonprofits are finding ways to work together toward common goals.An article appearing in the May issue of the Harvard Business Review ends, "We are standing at the threshold of an unusual era. The baby boomers will start to retire in less than a decade, squeezing public budgets even more than they are today. The nonprofit world, historically seen as a collection of locally focused charities, has become an enormous sector, but given its roots, it understandably lacks the managerial processes and incentives that help keep the for-profit world on track. We believe the sector must become more efficient and challenge its traditional concepts of stewardship in order to help the nation cope with the stresses ahead. Doing so will demand fresh thinking, as well as the slaughtering of some sacred cows." The conclusion is drawn based on a study performed by the article's authors and consulting firm McKinsey & Company, which claims that the nonprofit sector could free up $100 billion per year if it tweaked some of its practices to more closely resemble those of for-profit organizations. One way the healthcare nonprofit sector has stepped up to the study's call for increased efficiencies and business savvy is through partnering with pharmaceutical companies - a move that has beneficial as well as challenging communications implications. Boosting resources and reach Whether a pharmaceutical company is actively working with a nonprofit on programming or just supporting the organization through cause marketing or unrestricted grants, resources and reach are enhanced for both parties. Partnerships through which the pharmaceutical companies actively publicize their involvement allow nonprofits to keep their messages out for longer, and in front of audiences that they would not be capable of reaching on their own. Market research and improved measurement standards are additional perks for nonprofits that have access to corporate resources through partnerships. Teaming up with pharmaceutical companies can also open doors for funding from other sources. Sharyn Sutton, president of PR firm The Sutton Group, points out, "Many nonprofits don't have the clearance processes required to receive government funding in place. Being able to tap into the pharmaceutical companies' established communications channels can put less sophisticated nonprofits in better position for additional funds." Even some of the most established nonprofits can benefit from partnering with for-profit counterparts. The Susan G. Komen Foundation, one of the top breast-cancer nonprofits in terms of revenue, made $136 million in its last fiscal year. With a whopping PR agency budget - by nonprofit standards - of more than $500,000, Komen can afford to be less dependent on funding from pharmaceutical companies, but it still makes use of partnerships. Komen's popular Race For The Cure is paid for by Bristol-Myers Squibb, which sponsors the event. Komen also accepts some unrestricted educational grants, meaning it is free to use the donations from pharmaceutical companies in any way it chooses. Additionally, the foundation has developed partnerships through which drug companies' sales forces serve as information distribution channels. Kristin Kelly, PR manager, explains how Komen uses its partnerships to encourage doctors to perform full eight-minute breast exams. "A challenge for us has been how to reach physicians. Pharmaceutical sales forces have access to doctors' offices every day. Working with them for the purpose of provider education is one way we've managed to make a deal work without jeopardizing our credibility." Only 1% of Komen's funding comes from the pharmaceutical industry because it is adamant about not appearing to be influenced by sales objectives. Without having to worry about ulterior motives, "women need to be able to come to us for the best of the best information," says Kelly. Unlike the pharmaceutical industry, she adds, "Our job is to put ourselves out of business. Our only drug is empowerment." Nonprofits need to strike a balance between capitalizing on the financial support of pharmaceutical companies and advancing the organization's mission above all else. "You have to stay in business to move the cause forward, but there is a fine line between that and just becoming a business," says Sutton. Dennis Bowman, SVP of marketing and communications for the Arthritis Foundation, adds, "A nonprofit's number-one asset is credibility, so it's imperative that it be guarded stringently." The Arthritis Foundation, which works with Centacor, Bayer, Wyeth, and Abbott Laboratories, avoids placing its altruistic reputation in harm's way by developing detailed policies about the role pharmaceutical partners play in developing programming and communicating with audiences directly. Written agreements stating the terms, which are reviewed and updated regularly, are drafted and signed by all involved organizations. Establishing strict guidelines Similarly, the American Cancer Society (ACS) has established strict guidelines about its level of involvement with pharmaceutical companies. In fact, it avoids using the word "partnership" to describe its relationships to prevent being seen as actively participating in disseminating for-profit messages. "We collaborate with them in terms of communicating our message," says Cynthia Currence, VP of strategic corporate marketing alliance for ACS, "but we're very careful not to cross the line in terms of pushing products." The ACS works with GlaxoSmithKline (GSK) and Pfizer on its nicotine-replacement initiatives, which Currence says works because the mission of all three parties - to convince people that using nicotine-replacement products doubles the chances of quitting smoking - is consistent. GSK and Pfizer both sell nicotine-replacement products for which the ACS receives royalty payments for allowing the companies to use the nonprofit's logo. There is also a prominently placed disclaimer, however, that clearly states that the ACS does not endorse the products. While nonprofits are concerned about maintaining their credibility, drug companies consider partnerships a way to boost their own. Joining forces also provides the industry - which is often viewed skeptically for its pricing practices - with access to audiences that would otherwise be hard to reach. "Particularly in the area of cancer, we are desperate to get information out to patients," says Gloria Stone, executive director of PR for Novartis Oncology. "We keep our nonprofit partners informed about the most up-to-date clinical trials, and they feed the information directly to patients. A lot of the cancer groups are very sophisticated, and have a deep understanding of their patients." Similarly, when corporate entities partner with third parties, explains Frank Closurdo, director of immunology marketing for Centacor, "the media sees our efforts as more credible because it's not all about a product. A journalist's main purpose is to inform people, so they're interested in the work we do with nonprofits where education is always the primary focus." Centacor is the maker of Remicade, an approved treatment for both Crohn's disease and rheumatoid arthritis, and is a corporate partner of the Arthritis Foundation. In addition to the relationships the nonprofit has with drugmakers, the Arthritis Foundation has an "ease-of-use" program through which corporate sponsors have their products recognized as being simpler to use for someone with arthritis. If the product is deemed helpful, its packaging boasts that it is certified by the foundation. "This generates awareness of the Arthritis Foundation because it gets our logo out there," explains Bowman, "but it is also a direct-response opportunity because it encourages people to contact us for additional information about our services." While it's undeniable that having the Arthritis Foundation logo on a product can boost that company's image, communicators in the pharmaceutical industry maintain that the primary goal lies in helping the cause. Michael Rinaldo, SVP and senior partner in Fleishman-Hillard's healthcare practice, which works with Komen, says, "The majority of people working in healthcare get into it because they want to make a difference. Being affiliated with the nonprofit sector allows you to get involved and work much closer to the ground." MS&L's New York healthcare practice director Wendy Lund agrees. "Anyone doing this does it because they care about people's health. I have staff members lining up outside my door when we get a new nonprofit account," she says, adding that MS&L has done more nonprofit work in the past year than it has in its entire history. Increased competition for accounts The genuine interest in working to better a cause, coupled with the trend of an increasing number of nonprofits having resources to hire external PR support due in part to the partnerships they've formed with drug companies, has resulted in growing competition among agencies for the accounts. Rinaldo explains, "There is prestige in having these nonprofits on your client list. Working with them is also great for making contacts within the industry. The nonprofit pitches that we take part in are very competitive." As is the marketplace in which many of the nonprofits reside. Greater sophistication and creativity become required of agencies as increased business savvy within the sector results in a growing number of successful organizations. "Getting people to care about the issue is only the first step," concludes Kelly. "Motivating them to take action by choosing your particular organization is where the real strategic communications challenge lies."