Method Acting for Real Patients Who Play Themselves on Pharma YouTube Channels

The InPharm post "Sanofi shifts video focus to YouTube" confirmed my belief that the pharmaceutical industry saves money by using almost FREE social media tools like Twitter, Facebook, and YouTube for its online communication needs. It can scrap expensive, custom-designed, standalone video Web sites, post videos to YouTube instead, and save money.

"[T]he size of YouTube’s community (some 490 million unique users per month) and the potential to trim costs – however slightly - following recent warnings that 2011 revenues could fall by 10% are likely factors [for why visitors to Sanofi's standalone video website -- www.sanofi-aventis.tv -- are now sent to a new YouTube channel.]"

I decided to visit the "sanofi-aventis TV" English YouTube channel (here).

The first video I played was titled "Living in the Shadow of Atrial Fibrillation." The first scene showed a man painting his living room. Suddenly, he falls off the ladder and for several seconds we see him breathing with difficulty, sweating, and grabbing his chest on the floor. Pretty dramatic. The full video is embedded at the end of this post. I assume it's still available when you read this.

I'd like to focus on a couple of frames, however, from the first scene here:

Maybe you think this acting is a bit over the top or too dramatic.

It turns out that the "actor" is actually a real patient whose name is Bob. In other words, Bob plays himself in this opening dramatic scene of the video. The part of Bob's wife, Samantha, however, "was played by an actress and based on her testimonial" says S-A in the closing screen of the video.

I've seen real patients in commercials sitting on a couch and talking and then appearing in other scenes cutting vegetables, planting flowers, riding bikes, taking baths, whatever, while a voiceover talks about the side effects. But these appearances require very scant acting skills. They certainly don't require the "method acting" skills that Bob displays in the Atrial Fibrillation video!

I wonder: Did Bob get paid extra for this acting role? Obviously, S-A saved additional money by hiring a novice rather than a skilled actor such as the woman who played Bob's wife.

I wonder: Did Bob learn his direct-to-consumer method acting skills from an as-yet-to-be-famous reincarnation of Lee Strasberg?

I wonder: Will further falls in pharma earnings lead to more patient method actors like Bob?

It's a fascinating social media era we are living in. Not only are newspaper reporters being replaced by bloggers, but professional actors are being replaced by people playing themselves in online videos! We have Nalts to blame for this!

More Pharma Social Media Pioneers Recognized

As evidenced by the first-ever pharma-hosted Twitter Chat (see "OMG! AstraZeneca Hosts Twitter Chat & World Does NOT End!"), there is still plenty of work for Pharma Social Media Pioneers to do and new pioneers to be recognized.

Last year, I awarded the coveted "Pharmaguy Social Media Pioneer Award" to Alex Butler (see "First Pharmaguy Social Media Pioneer Award Given to Janssen's Alex Butler").

I will continue to search out, find, and promote new pioneers, especially those who are actively using Twitter to engage in conversation. The chart below shows the pioneers I currently have in my database (view that database here). You can also follow selected tweets from these pioneers in the ePharma Pioneer Tweets & Posts Forum.

I have included in my list people who are employed by pharmaceutical companies (or very recently so employed) and who have over 200 Twitter followers.  If you know someone who should be included and is not, please let me know (click banner below).

UPDATE (12 July 2012): I have dropped the requirement that people have over 200 followers to be on the list -- only a few meet that criterium. Nevertheless, I want to recognize all pharma people who have personal Twitter accounts so the world can see what these people are tweeting about and thus get a more personalized view of pharmaceutical employees who can be the best "ambassadors" for their companies. You know, show the human faces behind the corporate curtains.

Use of Twitter by Pharma Company Employees
Use of Twitter by Pharma Company Employees

[Using the above form/survey, you can also tell me whether you agree or disagree with these statements:

Every pharmaceutical employee should be ENCOURAGED to engage and participate in online discussions to help improve their company's reputation as long as they follow guidelines.

  • Every pharma company should have Twitter/Social Media GUIDELINES (rules) for their employees to follow.
  • Pharma employees should ALWAYS reveal their employment status in their Twitter profiles, even if they do not tweet about their companies or products.
  • More pharma companies should host their own Twitter CHATS such as the #rxsave chat hosted by Astrazeneca

Thanks for your input.]

Most of these Twitter accounts are truly personal views and are not meant to speak for the company. They usually include disclaimers such as:
"All tweets are my own and do not necessarily represent my employer's view."

"Opinions tweeted are my own; not those of my employer"

"These tweets=Me and not my company"
A few are sanctioned by the company such as Marc Monseau's @JNJComm.

NOTE: Marc also has a personal Twitter account (@MDMonseau), which is included in the database as well. To be fair, we should really compare this account to the others, which are also personal accounts (except for Rob Halper's, which is @JNJVideo). Marc is kind of a special case. From day 1, his @JNJComm tweets were very personal and mostly were free of "corporate speak" language.

It's interesting to see how some accounts have grown over time (see @Alex__Butler vs. @JNJComm in the chart below).

@TonyJewell, who was responsible for the AstraZeneca #rxsave Twitter chat (see my interview of Tony here), is a recent addition to my list. I notice that before the #rxsave chat, Tony was adding about 1 follower per day. Afterward, he is adding maybe 2 followers a day. Which goes to prove that hosting a Twitter chat can DOUBLE the rate at which you add followers! I don't think, however, that Tony will surpass Alex any time soon.

Although there was an "anomalous" spike in followers of Alex Butler in January, it wasn't as dramatic a spike that @Pfizer_news experienced back in December 2010 (see "How Did Pfizer Get So Many Twitter Followers?").

Addendum: Tweets vs. Followers

Just out of curiosity, I also plotted the number of followers vs. number of tweets for these pioneers to get the following scatterplot:

I notice right away that the top two accounts in terms of followers -- @JNJComm and @Alex__Butler (labeled "A" in the chart) -- have attracted a large number of followers but have not posted very many tweets. Their Follower to Tweet ratio is 4.7 whereas the norm is closer to 0.35 (that is, # followers = 0.35 x # of tweets). The "B" people are also somewhat off the norm. Obviously, it's not about the quantity of your tweets, but could be about the quality.

"C" (@shwen) is way out their on his own. Shwen has posted an incredible 13,280 tweets! But he has been doing this probably longer than anyone else.

Addendum: Followers vs. Following

Another factor to consider is how many people these pioneers follow. We always praise those pharma people who follow a lot of other people on Twitter. It indicates they are listening to many points of view. Here's another chart:

There's definitely a "gang of five" pioneers that stand out from the crowd in this regard:
  1. @jimlefevere (Jim LeFevere)
  2. @durbaniak (Dennis Urbaniak)
  3. @shwen (Shwen Gwee)
  4. @JNJComm (Marc Monseau)
  5. @Alex__Butler (Alex Butler)

Addendum: Followers vs. Klout

Another parameter that is often used to rate Twitter accounts is the "Klout" score, which measures overall online influence. The scores range from 1 to 100 with higher scores representing a wider and stronger sphere of influence. Klout uses over 35 variables on Facebook and Twitter to measure True Reach, Amplification Probability, and Network Score. You can find anyone's Klout score by typing "http://klout.com/[twitter name]" as in http://klout.com/pharmaguy.

In the chart below, I plotted # of Followers vs. Klout to see if there was a relation between the two:

There doesn't seem to be much relation between a person's Klout score and the number of followers of that person (ie, having many followers doesn't guarantee you will have a proportionately high Klout score and vice versa).

In this case, there is a "gang of three" pharma Twitter pioneers that stand out from the crowd:
  1. @shwen (Shwen Gwee)
  2. @JNJComm (Marc Monseau)
  3. @Alex__Butler (Alex Butler)
@brainygirlnyc (Zarya Rubin, who works for UCB as CNS Medical Science Liaison) has the highest Klout score of the group: 55

Klout says that @brainygirlnyc is an Explorer who actively engages in the social web, constantly trying out new ways to interact and network. She's exploring the ecosystem and making it work for her. Her level of activity and engagement shows that she "gets it." Klout predicts she'll be moving up.

There must be many other ways to measure the "influence" these pioneers have besides the number of followers, followings, and tweets. What I intend to do is pay closer attention to what these people are saying on Twitter and give each of them my own unique "Pharmaguy Influence" rating, the parameters of which are yet to be determined.

Phil Mickelson "Opens Up" to Arthritis Today Magazine

Top pro golfer Phil Mickelson is featured on the cover of the Mar-April 2011 issue of Arthritis Today magazine (see photo).

Recall that Mickelson announced he had psoriatic arthritis last August in a news story titled "PGA Championship 2010, Whistling Straits: Phil Mickelson Has Psoriatic Arthritis - Uses Enbrel To Help Manage Condition."

In that story, Mickelson was quoted as saying "I have no aches and pains. My back feels great. I feel stronger and more flexible than I've ever been." (see "Is Phil Mickelson Shilling for Enbrel?").

When he made that statement, Phil was obviously demonstrating to AMGEN/PFIZER -- the companies that market ENBREL -- what he can do to help them promote their product. AMGEN/PFIZER were suitably impressed and signed him up a few months later (or so they say).

Now that Phil is a paid ENBREL spokesperson, his remarks are more balanced. Here are some quotes from an article in the Arthritis Today issue that features him on the cover:

"Phil tried taking prednisone [a generic drug], but the side effects were awful, he says." [His Mayo Clinic doctors prescribed "weekly injections of a biologic drug"; later in the article several brand name drugs, including Humira, Enbrel, Remicade, and Simponi, are mentioned, but the article doesn't reveal exactly which drug Phil is taking -- that's already on the record elsewhere. But we now know that he didn't like the generic medicine.]

"I like where I am physically and am optimistic about 2011."

"I might take the medicine for a year and then go off it. Then, when and if it flares up, I'd go back on the medicine. I'm OK with taking medicine the rest of my life if I have to."

At the end of this article is this NOTE: "This interview took place after Phil Mickelson entered into a partnership with Amgen-Pfizer, an Arthritis Foundation sponsor, in November, 2010."

So, Amgen-Pfizer not only has to pay Phil, they also have to pay the Arthritis Foundation to get his story published! No wonder AMGEN has blown its marketing budget (see here).

AstraZeneca Hosts "Take on Depression" Facebook Discussion - Seroquel Lurks Behind the Scenes

You may have missed the tweet by @AstraZeneca yesterday that announced "Join the #depression discussion on the #TakeonDepression Facebook page http://ow.ly/3Zihl". This tweet was posted just a few hours after my podcast of a conversation with @TonyJewell, Senior Director for External Communications at AstraZeneca and editor of AZ Health Connections blog, about the recent #rxsave Twitter chat and plans for future pharma-hosted chats (listen to the podcast "The Future of Pharma-Sponsored Twitter & Other Social Media Chats: A Review of the First Pharma-Sponsored Twitter Chat").

Screen shot of the AZ "Take on Depression" FB discussion page. Click for an enlarged view.

I'm surprised Tony didn't mention this Facebook depression chat during my interview. The "Take on Depression" FB page itself was launched back in October, 2010 along with an @FaceDepression Twitter account. I notice that only 2 of my FaceBook friends "Like" the Take On Depression page.

According to the press release (here) "The "Take on Depression" Facebook page will provide tools and resources to individuals who are struggling to manage their symptoms of bipolar depression and MDD [major depressive disorder]. The @FaceDepression Twitter feed will provide articles, links to Web sites, tips, and community events that will help people learn more about their illness and have a more effective dialogue with their physician."

In the press release, Sandy Sommer, Executive Director and Commercial Brand Leader at AstraZeneca said "With the launch of these Facebook and Twitter pages, AstraZeneca hopes to amplify conversations about mental health and provide important health information in innovative ways."

AstraZeneca includes several "rules" at the top of the FB discussion page, including "please refrain from mentioning specific pharmaceutical products by name" and "all comments will be evaluated by AstraZeneca before posting," etc.

"Want to join the discussion? Chime in on the discussion board or start your own thread now!" says AZ. But there was only 1 topic/post for discussion entitled "Welcome." It was made by "Take on Depression" -- a non-person representing the site -- back on January 4, 2011. It said: "Hey Take on Depression fans! Use the Take on Depression Facebook page to review information and connect with others who have been affected by bipolar depression or major depressive disorder. You can use this DISCUSSIONS tab to post about what you’re going through in order to help others."

There were no responses, so I decided to post a reply asking for a definition of bipolar depression and MDD. The following notice popped up (click on image for an enlarged, readable view):

This is pretty typical stuff; ie, absolutely no mention of product names will be tolerated. There's one small problem, however.

Seroquel Lurks Behind the Scenes
I noticed that it took a long time to display the discussion page and posts. During the minute or so the application was loading, I also noticed the following URL being accessed: http://www.seroquelfbdiscapp.com/, which contains a product brand name; ie, Seroquel!

In fact, you can type that URL in your browser and you will see the "naked" app without the surrounding FaceBook stuff, as in this screen shot (click to enlarge):

Most users would never notice the URL, but there it is. Will the FDA notice? Will it matter? It's a small issue, but I can't explain why AZ would need to use the trade name in the app URL when it could have just as well done without it. If AZ has changed the URL by the time you read this, Nevermind!

I'll keep you posted about my attempt to get the discussion going.

Meanwhile, I also checked out the @FaceDepression Twitter account. That account is "locked," which means @FaceDepression's Tweets are protected and only confirmed followers have access to @FaceDepression's Tweets and complete profile." You need to send a request before you can start following this account. I sent a request.

I'm not sure why AZ would do this. "When you lock your Twitter account," says wiki.answers.com, "only your followers can see your updates. Also, you will have to approve any new followers. It's like as if only your friends have the option to see you, kind of like being a king, you approve and see who can do stuff, but only a few people can see you."

Being the "King" these days is not very popular with the populace as we are witnessing in the Middle East. But I suppose pharma companies are comfortable sitting in their media throne issuing edicts for the populace to read, but only the elite, chosen members of the populace are invited into the conversation!

UPDATE: 2/20/2011. Tony Jewell emailed me soon after this post was published and said "I have directed your questions about take on depression to brand corporate affairs, which handles these subjects (I handle the corporate stuff). Let me know if nobody gets in touch." It's the weekend, so I haven't heard anything yet.

Meanwhile, I notice that the URL for the discussion app was changed after I made my post to www.takeondepressionfbdiscapp.com/, which proves that I provide useful insights.

I did a little WHOIS search on these domain names to get some idea who was responsible. It turns out that Edelman PR Worldwide registered both domains (see WHOIS results in the composite screen capture below; personal information has been redacted from this image at the personal request of the person whose name was used to register the domains. As I recommended below when I first made this post, the domain registration is now private. See here.).

Edelman is an Advertising Age "Top Ranked PR Agency" with 3,600 employees in 53 offices worldwide. I did not know that this agency had an office in Brooklyn Heights, NYC, one of the many New York neighborhoods I lived in. So I used Google maps to see exactly where their Brooklyn office was located and found an unassuming townhouse on a (nice) side street (I removed the image of the building I found upon request from the person who lives at the address). I was expecting something a little more impressive!

Here are a couple of reasons why I find this interesting:

(1) AZ used a PR agency, which may have "farmed out" the Take On Depression discussion board programming to another agency; ie, [redacted], "a next-generation digital marketing firm that designs and executes integrated digital marketing programs enabling clients to achieve scale in their digital marketing." I discovered this by finding the domains' administrative and technical contact person on LinkedIn, who -- according to his LinkedIn profile -- was Edelman's SVP of Interactive Solutions and is now CEO of [redacted].

NOTE: This person contacted me by e-mail and claimed "My credit card was used to set up all manner of accounts over those 11 years [that he was at Edelman; beginning in October 1998, ending in September 2009]. It appears that after I left in September 2009 that some of the accounts were not updated, hence the WHOIS data shows my address and name." But the WHOIS entry was created on 18 October 2010, more than a year after this person left Edelman. Why Edelman was still using his credit card and private address a year after he left the company is a mystery. I also do not know why it was used AGAIN just a few days ago to create the new WHOIS entry for the takeondepressionfbdiscapp.com domain.

(2) Using someone's private home address in domain registrations is NOT cool! As noted in wikipedia (here) "Currently the Internet Corporation for Assigned Names and Numbers (ICANN) broadly requires that the mailing address, phone number and e-mail address of those owning/managing a domain name to be made publicly available through the "WHOIS" directories. However, that policy enables spammers, direct marketers, identity thieves, or other attackers to loot the directory for personal information about these people."

When registering a domain name it is possible to use a "private registration" proxy so that your personal information is not readily available in the WHOIS database. Godaddy, which was the domain registrar in this case, offers that service. But, unfortunately, the cat may be out of the bag.

P.S. If Edelman does make the above domain registrations private, then I will -- if formally requested -- update this post and remove personally-identifiable information (but not corporate information).

NOTE: The person whose name is being used

P.P.S.  Wow! I no longer have the "creds" to view the discussion on AZ's #TakeonDepression Facebook page. Maybe nobody does!

UPDATE (2/21/2011):

I received this email today from Stephanie Andrzejewski, AZ's Director, Brand Corporate Affairs:
Hi John -

AstraZeneca is aware that the name of one of our products, SEROQUEL, was inadvertently included in coding in the Take on Depression Facebook page. No product name was ever included in the actual contents of the page and the Take on Depression Facebook page is not intended for the promotion of products. As soon as we became aware of the error, we immediately amended the code. AstraZeneca is fully committed to open, honest, transparent, and ethical social media practices.

I responded:

Thanks for getting back to me. I am impressed that this error was corrected in a timely fashion considering it is a holiday weekend!

But this error could have been averted if -- as suggested by commenters to my blog -- AZ had chosen a more regulatory-savvy agency to handle at least the technical aspects of its social media campaign. The problems I cited indicate that this important AZ social media initiative may not have been given the attention necessary to convince people that AZ is committed to open, honest, transparent, and ethical social media practices, IMHO.

OMG! AstraZeneca Hosts Twitter Chat & World Does NOT End!

Despite dire predictions of "PR failure," the #rxsave Twitter chat (see "AstraZeneca to Host First-Ever Pharma-Sponsored Twitter Chat!") hosted by @AstraZenecaUS last night was, IMHO, a great success and proof that a pharmaceutical company can indeed host meaningful Twitter chats. Read the transcript of the entire chat here.

There were a few attempts by two or three "malcontents" to "hijack" the conversation as I warned about in a previous blog post (here). But despite their attempts to ask "the tough questions" about off-label promotion of drugs and Seroquel side effects, everyone completely ignored the hijackers and the conversation continued as if these people were not even there. [Perhaps there should be Twitter chats on these other topics. Pharma companies will not host these, but patient advocates can and should invite pharma people to listen at least.]

Unfortunately, the way influence is measured in social media such as Twitter, those people who make the most posts -- even if those posts are irrelevant to the discussion and ignored -- get the highest ratings. "What the Hashtag," for example, creates a list of "Top Contributors," which is a misnomer because the top two "contributors" (see figure below) are the "malcontents" who contributed nothing of value to the conversation.

What the Hashtag Chart: See here.

The data shows that there were 144 other contributors who actually contributed to the conversation. It's impossible to know how many "lurkers" were listening without contributing.

One thing is clear: AstraZenecaUS did not pick up very many new Twitter followers as a result of the chat. Before the chat it had 4,715 followers and afterward (this morning) it had 4,758 followers. There were signs, however, that AZ met some people and organizations in the chat that they will team up with in the future.

So, it's not all about the numbers when you measure the ROI of a Twitter chat!

AZ's goal -- I believe -- was to get answers to some specific questions such as the following:
"What is best way to increase awareness of prescription savings programs?"

"[Are there] Any pilot programs to drive adherence among uninsured?"

"Are people aware of our healthcare facilities program?"

"Top 3 suggestions for reaching eligible patients? Think outside the box..."

"[Any] Ideas on reaching caregivers of seniors?"

"With health care reform covering millions more, what will demand be for #rxsave"

"How do you think #socialmedia channels like #Twitter could help with patient outreach?"

"Anybody using text messages with patients?"
AZ received some good input and answers to those question, which you can find yourself by reading the transcript.

AZ also provide some nuggets of information, such as:
"In 2010 AZ helped more than 545k patients save $947mil on 4.1mil prescrips through these programs"

"AZ&Me Rx savings programs saw 7% increase in patients helped in 2010 over 2009. What are advocates seeing?"
More pharma-sponsored Twitter chats are on the way. Near the end of the one-hour chat #rxsave session, AZ asked "Was this chat of value to you and should pharma do more of them?" To which I answered: "Definitely, pharma shld do more Twitter chats. U proved that it can work despite hijack attempts!" My opinion was shared by several others who participated in the session. AZ had this to say about that:
"re next tweet chats @soulflsepulcher will we host one? let's see how this goes - and how FDA guidance on social media turns out"
 Maybe FDA was "lurking" and will issue some guidance by warning letter.

Listen to My Interview of AstraZeneca's Tony Jewell:

Listen to internet radio with Pharmaguy on Blog Talk Radio

Questions I Hope AZ Can Answer During Tonight's #rxsave Twitter Chat

By now everyone should know that AstrazenecaUS is hosting the first-ever one hour pharma-sponsored Twitter chat tonight starting at 8 PM Eastern Time (for details, see here). Many of my Twitter colleagues -- not all of them friendly to me or to AZ -- are already engaging in the chat using the #rxsave hashtag (follow the Twitter #Rxsave tweet stream here).

I raised a few hackles when I suggested that the chat may be "hijacked" by "anti-Seroquel folks & pharma critics". Pharma has some experience with "disgruntled" patients who have "hijacked" their social media efforts (see, for example, "Disgruntled Patient Shuts Down sanofi-aventis Facebook Page").

As with any social media conversation, this one will be controlled by the vocal minority -- those people who actually post something. We know that about 98% of participants will be listening only; ie, "lurkers." I hope that the conversation stays somewhat "on topic." AZ probably hopes they can keep the discussion laser-focused on their prescriptions savings programs such as AZ&Me™ Prescription Savings Program.

I hope to broaden the discussion to prescription drug prices in general. To ensure that, I plan to do a bit of "hijacking" myself. But I plan to be open and transparent about it; ie, not lie in wait and spring a trap.

My plan is to use SocialOomph to schedule automated posts at specific times during the chat. Here are the posts I have scheduled so far:
Can u tell us which drug Rx's received most support frm AZ's Rx savings prg? If u cant mention drug names, then disease category? #rxsave

What percent of AZ's 2010 US sales does AZ's Rx savings plan represent? #rxsave

With so many ppl unemployed should drug industry freeze or lower Rx drug prices for everyone? See survey: http://bit.ly/fUBASI #rxsave
I will also participate in the live discussion and may modify my automated postings if necessary. Meanwhile, I will send my questions to AZ so they have an opportunity to prepare answers that will pass their internal legal/regulatory review.

This is a bit of an experiment to demonstrate how an organized person or special interest group can use social media technology to get their voices heard. If many people do this, real conversation will be impossible. It will just be a social media clash of the cyborgs!

If you have any questions you'd like me to ask -- either via SocialOomph or in real time -- post them as comments to this blog. Of course, you would do that ONLY if you wish to remain anonymous and not use SocialOomph or post anything live yourself.

AstraZeneca to Host First-Ever Pharma-Sponsored Twitter Chat!

Back in November, 2010, I asked "Will a Pharma Company Ever 'Host' a Chat on Twitter?" (see here). I just learned that AstraZeneca (US) will be the first pharma company (that I know of) to do so according to this @AstraZeneca Twitter post:
AstraZeneca to host Twitter chat on Rx savings. 8p EDT Wednesday. Details here http://ow.ly/3W3G7 #rxsave #socpharm
Here are the relevant details:
AstraZeneca (@AstraZenecaUS) will host a one-hour chat on Twitter at 8 p.m. EDT on Wednesday, February 16 to raise awareness about helping patients save money through prescription savings programs.

The chat will be led by Jennifer McGovern, the director of the AZ&Me prescription savings programs. She will answer questions while offering ideas about how patient assistance needs are evolving and how social media can be used to reach eligible patients.

To join the discussion, participants just need to use their Twitter account - and follow the discussion through the #rxsave hashtag.
 This is quite gutsy of AZ considering that anyone can "join" the chat simply by posting a message containing the #rxsave hashtag.  And anyone can post messages about AZ drugs and mention side effects too even though AZ might say that it will not respond to questions about specific drugs.

In fact, the details provided so far by AZ do NOT include any "ground rules" about topics that it considers out of bounds. The AZ Health Connections Blog, for example, has an extensive "Comment Policy" (see here) that says, for example, "This blog is not the place for your questions or comments about our specific products and we will not publish comments about AstraZeneca products." It also says "We reserve the right to edit or even to not publish comments that are off-topic, obscene, inflammatory, disrespectful, contain profanity, or that we deem are otherwise inappropriate. We may not publish comments that could be misleading or confusing, or thinly disguised sales pitches for other products or services."

In a Twitter chat it is not possible to "edit" or "not publish" comments made by participants. And the conversation can actually be hijacked by "disgruntled" patients or employees. I hope that doesn't happen.

But it is a fact of life for pharmaceutical companies that they are not well-liked by the general public, especially when the price of drugs is a topic for discussion.

So, it will be interesting to see how this chat unfolds Wednesday night with regard to the above.

As I mentioned in the above cited post, there can be several reasons why I haven't seen Twitter chats hosted by pharma companies:
  • There are no guidelines from the FDA regarding how that agency will regulate Twitter chats hosted and/or "moderated" by pharma companies. A "moderated" Twitter chat is one where the discussion is lead by a person who sets the agenda (see, for example, "On Being Voted Off the Social Media Island").
  • Pharma companies are concerned about being overwhelmed by adverse events that may pop up in tweets during a chat session that they host and/or moderate.
  • Pharma companies are concerned about "off-label" promotion that may be made by chat participants.
  • Organizing and moderating a chat requires too much effort and is too risky.
  • Once you start a chat, it's very hard to control the message.
  • Consumers don't really want to chat with pharma companies.
It seems AZ has confidence it can overcome or avoid most of these problems. What remains to be seen, however, is if consumers actually participate. But perhaps AZ is not really trying to get consumers to participate. Rather, they may be more interested in getting patient advocates, bloggers, news reporters, etc. to participate. That way the messages it puts out via the chat can be filtered by these people and/or passed along to their followers. That viral aspect of Twitter hashtag chatting is valuable.

P.S. Having found out about this a bit late, I notice that there already has been quite a number of Twitter comments posted using the #rxsave hashtag! Here are a couple of posts that give us an idea of how the conversation may be hijacked:
Twitter chat 16th led by @AstraZenecaUS take a look at retired doctor's opinion of Seroquel http://tinyurl.com/4lw47wk @TonyJewell #rxsave [That doctor doesn't have anything good to say - JM]

Why AstraZeneca's white paper on social media is a crock! #rxsave http://bit.ly/ghoa6D #pharma @astrazeneca @astrazenecaus #MDchat #bioceo
P.P.S. Tony Jewel, Editor of AZ Health Connections Blog, sent me this message:
John -

Thanks much for the notice of the Twitter chat.

We decided to sponsor this discussion for a simple reason: We believe it
is important to spread the word about the availability of our
prescription savings programs. Today, Twitter and other social media
channels are invaluable tools to do so.

We will, however, be limited as to what we can respond to during the
chat. For example, we will be unable to discuss specific medicines
and/or diseases on this chat to ensure all communications are
appropriate and meet current regulations (an issue you have covered

If others would like to discuss different issues with the company,
AstraZeneca can be reached at 1-800-236-9933 Monday through Friday 8
a.m. to 6 p.m.

We look forward to an engaging conversation on prescription savings
programs and, hopefully, other issues in the future.

Google's New OneBox Rx "Ads" Steal Clicks from Organic Branded Rx Search Results

At last week's ePharma Summit, John Mangano, comScore's Marketing Solutions Vice President, presented data suggesting that Google's OneBox NIH Rx ads "effectively reduces organic search visitation driven to pharma sites pushing the traffic to NIH content instead" (see chart below).

To illustrate the OneBox format, I did a search on Lipitor and the result is shown below (click on image for an enlarged view):

Just below the paid Lipitor ad at the top is the NIH OneBox "ad," which is not really an ad because it is not a paid placement. But I'll just call it an ad because it looks like one and perhaps Google users may think it's an ad.

When the OneBox "ad" format was introduced in June, I asked "Will these NIH ads compete with drug company's paid search drug ads, not to mention natural search results? Or can the two work in concert to increase the clickthrough rate on the paid ads?" (see "Finally, A Google Drug Search Ad Format That Has All FDA Could Want... But Pharma Can't Use It!").

Mangano did not mention any effect that OneBox Rx ads may have on paid search Rx ads. But it is logical to conclude that Google stands to gain paid ad revenue when pharma marketers have to compete with OneBox ads by buying more paid search placements to make up for the loss of organic search visits.

Breaking the 140-character Limit of Twitter Opens the Door to FDA-Compliant Branded Tweets

"Say Hi to longer posts with Deck.ly" Deck.ly is a new technology that allows Twitter posts much longer than the standard 140 characters. Deck.ly is currently available for TweetDeck, the desktop, Android, and Google Chrome. It will soon be available on the iPhone and iPad.

Deck.ly has enormous potential for pharmaceutical marketers who have been chaffing at the bit to post meaningful branded messages via Twitter but who have been stymied by lack of guidance from FDA regarding how to provide fair balance within the 140-character limit of Twitter. The best the brightest minds in pharma marketing have come up with so far is sleazy Twitter spam as in the Levemir tweet discussed in this classic Pharma Marketing Blog post: "Novo Nordisk's Branded (Levemir) Tweet is Sleazy Twitter Spam!".

Here's how Deck.ly works. Using TweetDeck, I can type in this 477-character tweet:
"This is the age of taking action. Many men over 40 have experienced some degree of erectile dysfunction (ED). There's a treatment for ED that you should know about. It's VIAGRA (sildenafil citrate). Get answers at www.viagra.com. Do not take VIAGRA if you take nitrates, often prescribed for chest pain, as this may cause a sudden, unsafe drop in blood pressure. In the rare event of an erection lasting more than 4 hours, seek immediate medical help to avoid long-term injury."
The input box of TweetDeck will automatically change color and say "Long update using Deck.ly" I can then press the send button and the tweet will be sent.

Note that this statement contains the brand name (VIAGRA), its indication (erectile dysfunction), AND fair balance information (major side effects). In other words, it complies with FDA regulations (or should comply).

But what do my followers see, especially if they do NOT use TweetDeck and Deck.ly? They see this 138-character post on Twitter.com:
"This is the age of taking action. Many men over 40 have experienced some degree of erectile dysfunction (ED)… (cont) http://deck.ly/~xxOn9"
This does NOT include the brand name. Therefore, it is not regulated by the FDA and there are no regulatory concerns.

When readers of the post click on the deck.ly link, they see the full post on the TweetDeck.com site, which looks like this:

The post in the TweetDeck application looks like this:

It also includes at least a bit of the fair balance. When you click on "Read more," this window pops open:

There seems to be room for lots more information in this window.

Thus, by deftly designing the post, it can be FDA-compliant no matter what application is used to read it. The question i, however, Will the FDA think there is enough fair balance in the various forms? For that marketers still need guidance from the FDA. But that's a whole 'nother issue (see "Is It Time for Abrams to Leave?").

P.S. Another question is whether or not marketers feel that they catch the attention of their audience in the first 140 characters so that they click through to the branded message/Web site.

Is It Time for Abrams to Leave?

There were rumors at the recent ePharma Summit that DDMAC would come out with social media guidelines sometime in the next few months -- maybe by April, 2011. The crowd who gathered the following day in the great hall was at first jubilant in anticipation of the speech by Thomas Abrams, Head of DDMAC since 2000.

The crowd's mood changed dramatically, however, when Abrams did NOT mention any specific date during his presentation. Instead, he stated his allegiance to FDA's "Good Guidance Practices," which govern the orderly process of issuing guidance.

It seems that Abrams will remain as head of the hated DDMAC regime for some time to come. But his promises may no longer be enough to stem the growing frustration of the crowd.

P.S. I urge all my readers to support the demands of the Egyptian people for democracy and the ouster of the dictator Mubarak! You can get the best coverage of events by watching the live streaming video with commentary via Aljazeera English here.

FDA's Abrams Spends 4 Minutes Discussing Social Media Guidance at ePharma Summit!

This just in: FDA Won't Issue Specific Guidance for Youtube, Facebook, or Twitter. Claims These Media Are Just Passing Fads! Now Back to Your Regularly-Scheduled TV Ad.

Tom Abrams, the Head of FDA's Division of Drug Marketing, Advertising, and Communications (DDMAC), apparently believes Twitter and YouTube are passing fads.

During his presentation at the just-concluded ePharma Summit in NYC, Abrams said FDA would NOT "do guidance on specific technology platforms such as YouTube, Facebook, or Twitter. Those things are really big now, but you know what, two years from now who knows what the next thing [will be]?" Abrams also pooh-poohed Groupon

Meanwhile, both Google and Facebook (valued at $50 billion) are courting Twitter, which so far has rebuffed their offers to purchase the company. According the the WSJ, people familiar with the matter say potential suitors put an estimated valuation of Twitter "in the neighborhood of $8 billion to $10 billion."

Abrams devoted exactly 4 MINUTES of his 45-minute presentation to "Social media in prescription drug promotion"!!! In contrast, Abrams spent about 7 minutes on TV drug promotion regulation.

Abrams then threw the ePharma Summit audience a bone by spending several minutes analyzing one specific internet-based drug promotion: the Derma-Smoothe website. Using several colorful screen shots, Abrams drove home the point that NONE of the violations -- Omission and minimization of risks, Overstatement of efficacy, Unsubstantiated superiority claims, Broadening of the indication -- had anything to do with the Internet. It was all about the message, not the medium.

Unfortunately, the Derma-Smoothe site that Abrams used as an example was nothing more than a printed brochure repurposed as a web site.

We are being conditioned by the FDA and other regulatory experts not to expect much guidance regarding specific Internet technologies such as Twitter. "It is unlikely," said Paul Savidge, General Counsel at BMS, "that the FDA will move away from the regulations that apply currently to print and broadcast media. If the expectation is that the FDA is going to somehow carve out electronic media or social media, that's probably unlikely." Instead, Savidge suggested the guidance will merely reiterate the basic rules that apply to other media.

I asked point-blank why the "media-agnostic" approach is expected for Internet guidance, when the FDA "carved out" TV -- actually "television, radio, or telephone communications" -- as a special case in 1999 when it released specific guidance on how to adequately inform consumers where to get complete prescribing information. The FDA recognized that it was impractical to include the complete prescribing information in a 60-second TV ad. The guidelines said providing a web site, 800 number, or magazine ad within the ad would be sufficient.

My question was why wouldn't the FDA also publish SPECIFIC guidelines for social media SUCH as Twitter where space is also limited?

What followed was a complicated discussion about why TV deserves special guidance whereas the Internet does not. One regulatory expert said that TV ads are "limited by time and space" (ie, the 60-second ad), whereas the Internet is NOT. "It seems," this person said, "that there is limitless amounts of information that you can put on the Web."

Nowhere in that discussion did the experts mention Twitter or Google Adwords, which cannot include "limitless amounts of information."

P.S. Meanwhile, in a white paper released today (find it here), AstraZeneca said: "The FDA should recognize that social media is a new communication channel that both distinguishes and can appear to intermix the dissemination of information and advertising in the digital space." That doesn't sound media-agnostic to me!

The Socialisation of the Internet is Bogus

"The whole web is now socialised..." said Alex Butler in a pharmaphorum interview ("Psoriasis 360: How pharma can do social media").

Alex does NOT mean that socialists have taken over the Internet, although, if you think about it ... hmmm. I digress...

"We live in a post-advertising age where messages no longer resonate without dialogue, and where information is best exchanged through community," said Butler (see "Social media doesn't really exist" and listen to this Pharma Marketing Talk podcast interview of Alex Butler: "Is 'Social Media' a Distinction Without Meaning in Today's World?"). "But although it is tempting to think that contact is now king, in fact high value dynamic content, valued by the consumer, has never been more important...there is little of value on the internet that is not socialised in some form, even if it is just the capacity to comment and share. So how as an industry can we influence the exchange of ideas and information if we are not prepared to be where our audience and communities exist?"

When all is said and done, what Alex is really saying is that commenting, sharing, and all that community stuff really is second fiddle to content. Throughout his comments to pharmaphorum, Alex refers to Facebook, Twitter, etc. as "channels" through which he reaches his audience to deliver valuable content.

Some agencies and consultants are telling their pharma clients that social media is NOT a channel -- it's a different way of interacting with people online. Frankly, I think that is bogus.

First, VERY FEW PEOPLE on the Internet -- and that includes Facebook and Twitter -- are social. I mean VERY FEW are socializing with entities like brands and corporations or even real people from companies, publications, and other corporate entities.

For example, there are about 20,000 individuals that VISIT (and presumably READ) this blog every month. Maybe 12 or so submit comments and perhaps a few dozen tweet (share) the content with their friends online. I suspect the ratios are similar at publications that receive a lot more comments and shares. That is, at least 98% of visitors to blogs, Facebook, or Twitter followers are "lurkers" -- they don't socialize, they read.

Which is just fine with me! I don't have time to socialize with 20,000 visitors to this blog and I'm sure you don't have time for that either! (Which is the #2 reason why the Internet is NOT social. Or is that part of reason #1? Whatever!)

Questions I Intend to Ask DDMAC Director Thomas Abrams at the ePharma Summit

I've noticed that FDA's DDMAC Director Thomas Abrams has been making presentations at several recent drug industry conferences. At the 10th Annual ePharma Summit that begins today in New York City (see here), Abrams presentation is titled: "Regulation and Oversight of Prescription Drug Promotion: Update from DDMAC," which is similar to presentations he's made at other conferences.

Of course, as I mentioned in a previous post ("11.5 Things I'd Like to Learn at ePharma Summit"), most attendees of the ePharma Summit are looking for updates on FDA's guidelines for use of the Internet and social media by pharmaceutical companies; ie, Where are they? When are they? What are they?

From a preview of Abrams' Powerpoint presentation, it appears that he will have very little to say in answer to these questions. Only 3 out of 46 slides concern social media guidelines. Two slides merely summarize what we already know: how many people made presentations at the November 15, 2009 public hearing and how many comments FDA received to the public docket.

The third slide describes the FDA's guidance sausage-making process (shown below; click for enlarged view):

Again, nothing new: Abrams, for example, has said before that FDA will issue "multiple guidances." We are somewhere in the "Prepare a draft guidance document and vet through internal clearance process" stage; ie, the sausage is jammed in the machine.

Here's what I hope to ask Tom Abrams at the Summit (if he allows questions from the audience):

"Tom -- I hope I can call you 'Tom'; I've seen you at so many of these conferences that I feel we should be friends on Facebook or Twitter if not in real life, but I can't find you on these social networks, so maybe I should stick to Mr. Abrams: What's holding up the process of releasing SM guidance? For example:
  • "Has President Obama's recent executive order for government agencies to review all regulations old and new to determine if they hinder economic growth thrown a monkey wrench into FDA's 'Social Media Guidance Process'? That is, is the FDA's guidance process slowed down because of this extra internal review that is required?
"Any comments at all about this issue that might be affecting the FDA's guidance process will be appreciated."

BTW, look for me wearing a special shirt, which may or may not be this one:

Should FDA Have Approved Contrave for Obesity Because Docs Are Too Stupid to Use the Generic Components Off-label?

As reported in the WSJ Health Blog, FDA said it wouldn’t consider approving the experimental weight-loss drug Contrave without another clinical trial. FDA's decision comes after an FDA advisory panel voted in December to recommend approval of the drug.

Many pundits consider this another example of how risk-averse the FDA has become and how its decisions are hampering innovation. Even critics of the drug industry like Dr. Carlat claim that FDA's Contrave decision was a "Big Mistake" (see here).

Why does Carlat think it was a mistake when Contrave "is simply a combination" of two generics -- burpropion (Wellbutrin) and naltrexone -- that have been available for a long time? He says "Combining Wellbutrin and naltrexone was not something the average doctor would have ever thought of for an obesity treatment, so this counts as an uncommon example in which a company had a bright and non-trivial idea for a combination of two existing products."

Carlat didn't exactly say that doctors are too stupid to combine generics but a commenter said "the fact that the average doc might not have thought of it implies we need more effective dissemination of such info, not a new commercial product. Or are you thinking the inevitable TV ads might be a good way to get us all up to speed?"

Ha Ha! Good one! As if branded TV ads would alert doctors that the drug is actually a combination of two generics. They'd have to read the small print of the package insert to realize that. But advertising ANY treatment for obesity might make doctors who prescribe the treatment appear smarter.

BiDil is an example of a failed combo-drug the FDA DID approve (for heart failure). It didn't sell well despite advertising (see "BiDil Sales Disappoint: Blame Genes or Marketing?") perhaps because doctors were already smart enough to prescribe the cheaper generic components of the drug.

Carlat also said "The good news is that patients can ask doctors to prescribe them the constituents of Contrave, both of which are available in generic form -- burpropion and naltrexone. Presumably, this generic combination will be much cheaper than Contrave's pricing anyway!"

Obesity is a big problem here in the U.S. and elsewhere. The drug industry is looking to capitalize on that by introducing new drugs to treat obesity. Unfortunately, instead of investing in research, many companies are going after low-hanging fruit like combo drugs or actually cutting their research budgets to shore up stock prices (see, for example, "Pfizer Inc: Working Together for a Healthier Investor™").

11.5 Things I'd Like to Learn at ePharma Summit

Next week I'm investing a lot of money to travel to NYC and stay at a fancy hotel to augment my HiltonHonors points in order to attend the 10th Annual ePharma Summit. Sorry, but it looks like it's all sold out, which may be thanks to me being paid to promote the conference (Pharma Marketing News is a Media Partner for the event).

I'll be seeing a lot of friends like DJ Edgerton (@wiltonbound) of Pixels & Pills, who promises to have a birthday surprise for me at the Monday night Pixels & Pills ePharma Summit Tweetup & Phone Drive.

But I have learned that to get the most from conferences like these, you must set goals. So, without further ado, here are my goals, or things I'd like to learn:

(1) Will Thomas Abrams, Head of FDA's DDMAC, actually have something new to say? Hello! We all just want to know about those social media guidelines. Where are they? When are they? What are they? On the ePharma Summit blog, Marc Dresner likens the FDA to a plumber who doesn't know how to unclog pharma's social media pipes! (see "Where’s A Good Plumber When You Need One?")

(2) Are patient advocates really consumer opinion leaders and what do they really want from partnering with pharma marketers? Will they help or hurt pharma's image? Is it like partnering with the devil? What part of their "souls" will they have to give up? For more on the issue of online patient opinion leaders, see "Pharma Collaboration with Online Patient Opinion Leaders" (pdf).

(3) Kevin Nalty, you magnificent basterd, I read your book on the iPad ("Beyond Viral: How to Attract Customers, Promote Your Brand, and Make Money with Online Video (New Rules Social Media Series)" Whew!). Actually, I downloaded it on my Kindle, but haven't read it yet. I hope Nalty is giving away free, signed hardcopy editions. I probably won't read that either. I have run into Nalty at many of these conferences, but never heard him speak. I wonder if he's any good? I think I will bring my Flip video camera and make money online showing a video of me interviewing him. Maybe we'll pull some famous Nalty pranks in the audience while he speaks? BTW, I made Nalty famous when I exposed him as ADHD Boy! (see "Nalts Talks About His Days at J&J, His ADHD, and His Merck Performance Review").

(4) Does Pfizer really have anything to add to my knowledge? David Ryan, Senior Director, Multi Channel Planning, Pfizer, Inc. will give a keynote titled "Achieve Personalized Professional Marketing at Scale." I have no idea what the hell that means, but I think it means "you know, there's more out there than just social media, which we stink at. But we are great doing the other 'multi' stuff and that's what I will talk about." Anyway, I am willing to learn about multi-channel planning.

(5) Why is Wired Magazine giving a keynote titled "The Future of Health is in the Hands of the Consumer"? Is that magazine still published? I guess I'll find out.

(6) I want to learn more about "Pharma's Headline Catchers" and what that has to do with "ROI Drivers Online" from Comscore. Will it feature the kinds of headlines I caught in the 2010 Pharma Marketing Yearbook?

(7) I am all excited about "The 2010 MM&M Awards," which James Chase will present at the conference. Who are the winners? It's a closely guarded secret! I hope they allow live tweets while James does his thing. I don't much care for these kinds of awards but I do love the parties (see "MM&M Award Winners Announced at Gala NY Event!").

(8) I'm looking forward to hearing Lucy Rose lead a discussion about "Addressing Internal Regulatory and Legal Concerns and Challenges." She is dynamic and knows her stuff and will keep the audience awake during what would otherwise be a dull session.

(9) Social Media: "Wish I'd Done That!" This is one session I won't miss, although I think it should have been called "Wish I didn't do that" -- I notice, for example, that sanofi-aventis isn't on the panel (see "Disgruntled Patient Shuts Down sanofi-aventis Facebook Page"). Novo Nordisk's Craig DeLarge, however, will be there. I hope to ask him if other pharma companies wish THEY were first to post a branded tweet (see "Novo Nordisk's Branded (Levemir) Tweet is Sleazy Twitter Spam!").

(10) What's Tried, Trusted True, and New in search engine marketing? Google's Maryann Belliveau will tell us. No, she's not That Girl from Google who advised everyone to use the "one-click rule."

(11) Is this REALLY "The Year of Mobile"? No matter how many presentations I hear about mobile technology in healthcare -- and I've been to many starting about 6 years ago -- it's always "the year of mobile" for someone, somewhere. I'm just not sure it's pharma's year.

(11.5) I also hope to learn if there's an underground, secret passageway between the Hilton, where I'm staying, and the Sheraton, where the conference is, because I hear it's going to snow again next Tuesday!

Pfizer Inc: Working Together for a Healthier Investor™

Pfizer's corporate slogan -- Working Together for a Healthier World™ -- may be "commercially unpromising" and in need of restructuring.

"[Pfizer's research] employees worldwide - along with patients awaiting breakthroughs in therapeutic areas that have been deemed commercially unpromising such as urology, allergies and respiratory ailments - are the losers in a reshuffling of priorities by the world’s largest drugmaker," reported the Financial Times (here).

Pfizer's incoming chief Ian Read plans to continue along the shareholder-pleasing path established by Jeff Kindler, the company's outgoing CEO.

During the past 5 years, "Pfizer returned about $45bn in cash to shareholders while continuing headcount-shredding mergers, most recently with Wyeth," said FT. "Now it will cut an additional $2bn from planned research and development spending to return the savings, and then some, to owners. Already having one of the highest dividend yields in the S&P 500, Pfizer will add $5bn to an existing $4bn share buy-back plan. The move pleased Mr Read’s most important constituency - shares rallied after the announcement."

In light of this, I suggest that Pfizer's new corporate slogan should be: "Working Together for a Healthier Investor™". But that wouldn't sound so good coming from @Pfizer_news, Pfizer's TwitterMeisters, who claim that Pfizer applies "science and our global resources to improve health and well-being at every stage of life." These days it's less about science and more about [financial] resources that power Pfizer.

Why Doctors Shouldn't Use Twitter for Patient Care

There's a lot of buzz about using Twitter and other forms of social media to improve health care (see, for example, "More Patients Meeting With Doctors Via Web Programs Such as Skype", and "Is The Future Of Healthcare Communications In Social Media?"). In particular, physicians are being encouraged to use social media -- Twitter in particular -- to help them deliver better health care.

But it seems that physicians are reluctant to do it for a variety of reasons (see, for example, "Are Doctors Avoiding Twitter Because of 'Doctor Bashing'?"). If doctors DID become big fans of Twitter, we might see the scenario depicted in the following New Yorker cartoon*, which appeared in the recent issue:

*Note: I changed the caption, which originally read “We’d like to start out being very involved with you but eventually be drawn away to much more interesting cases down the hall.”