Optimising the e-Channel

Significant case studies from UK Pharma

e-communications is the "buzz-word" for 2008, with UK pharmaceutical companies increasingly making use of web-based technology for marketing, education and patient support. On Tuesday 14th October the PM Society held a meeting at the Pfizer UK offices in Tadworth, that delved into the detail of a number of recent initiatives to understand the dynamics of the initiatives and discover just how successful they really were and why.

From left to right: Annie Wheeler (ICR UK), Jon Vernon and Matt Colman (PM Society), Simon Halliday (Baxter), Rachel Farrow (PM Society), Dr John Probert (Novartis), Claire Payne (ICR UK) and Richard Smith (Huntsworth Health)

The first presentation of the evening was given by Richard Smith from Huntsworth Health.  He was presenting on behalf of Pfizer on 'Rise and Shine' an endocrine care patient support initiative which was developed to help support patients prescribed Pfizer's paediatric growth hormone (somatropin).

There are currently six products in the UK market that are all molecularly identical so the challenge was to differentiate the drug to both the patient and healthcare professionals. It was agreed that aside from the difference in the injection device the main point of differentiation would be in the patient and healthcare professional educational and support resources that would aid patient concordance.

The objective was to build a long-term support and concordance website for paediatric Genotropin patients and their carers which was reliable, professional and met real need; engaged the family's interest and involvement in treatment and supported a long-term concordant relationship between the family and their healthcare professional.  It would also provide an online tool for healthcare professionals to support them managing their Genotropin patients.



The web based programme was about patient choice, it was important that all developed materials were targeted to a range of patients needs as 'one size doesn't fit all'.  It was also vital to get the tone of the website correct; it needed to be engaging and interactive to ensure repeat visits to the site.  To address this, the site was designed to be a fun, educational site for children with a personal section to allow patient growth tracking. Information is provided to help each patient throughout their patient journey.  Importantly it was designed to allow engagement with the healthcare professional outside of clinic visits. The starting point is when the nurse registers the patient and carer on the site, through to allowing patients to request a home visit from a Pfizer nurse.  Patients can also let their HCPs know how they are feeling and coping with treatment, so it becomes a valuable insight tool for the clinician.
Whilst the website is the main component of the project it is also supported by printed materials that are tailored to the patients needs as they grow and their needs change



As with all patient programmes there were a number of challenges that needed to be overcome:

• Data protection  -   the database is held outside of Pfizer and Pfizer has no access
• Code compliance  -  patients can only be registered when on Genotropin and the site is password protected
• Potential for adverse-event reporting  -  there is no white space instead it features check-boxes and drop down lists
• Customer IT capabilities  -  uses widespread simple technology
• Customers' IT skills  -   there are initial training workshops and ongoing support via a sales team if required

 This initiative continues to evolve but so far around 500 patients have now registered with the online programme, this represents a quarter of all patients.  In 2007 a survey was conducted and the results were very positive with 67% of patients and carers saying that Rise and Shine really helped their understanding of GH therapy. 

Next to speak was Claire Payne the Media & Projects Manager with ICR UK.  She provided an insight into an e-comms project that was commissioned by AstraZeneca and implemented a couple of years ago in Ireland.

IMI Irish Medical Information is a company that has been involved in conference reporting for the Irish market over the last five years.  In 2006 AstraZeneca commissioned a series of reports from international conferences with the aim of producing a free e-journal for doctors that would cater for the Irish market.

A .MED e-journal is not a website.  It is an interactive journal delivered by email.  Used as a permission marketing tool it offers a channel through which key messages for a brand, therapy or disease area can be sent to a targeted audience.

The E-Journal software is a very sophisticated reporting tool that provides information on:

• Number of Drs reading the e-journal
• Most popular editorial
• How many doctors have passed the journal on to a colleague
• Number of undelivered journals

Claire explained that if you have an e-journal you also have the ability to run on-line surveys.  It is very transparent and the feedback you get helps you fine tune the material you are supplying to your target audience.  Permission marketing is also one of the strongest tools available to the marketer.  By having permission and email addresses from doctors and building an e-community, IMI is able to send key messages on brand, disease or therapy area in a request format.

For each edition of AstraZeneca's .MED publication a KOL was appointed as guest editor. This was important to maintain the independence and credibility required for this type of journal.  A community of doctors was built amongst those who expressed an interest in receiving this journal.  Reporting on the readership is a function of the software.  This is greatly appreciated by product managers who are then able to assess interest in certain topics and tailor the content to the needs and interests of the subscription base.

On this particular initiative doctors spent an average of 21 minutes reading the e-journal printing off an average of 4-5 articles to read at a later date.  The readership statistics impressed all stakeholders and the project was considered a success by both AstraZeneca and the Irish Cardiac Society (ICS). In fact ICS adopted the publication as the official communication tool for its members – prior to this it had been a printed paper newsletter.  The journal is now in its 11th edition and features both local and national news.  Recruitment has increased to more than 1,500 with primary care now receiving the publication.

The next stage of the project is to deliver CME modules through e-journals. The first pilot goes live in November 2008 and will be relevant for both primary and secondary care teams.

Simon Halliday from Baxter was next up to present on the topic of 'Tablet Selling – is this the future?'  Simon shared with the audience an innovative approach utilising the very latest e-technology currently being employed by its sales force.

Simon started his presentation by sharing some data on population preferred modes of learning:
40% - Kinesthetics. Some people learn better by touching and feeling
25% - Auditories. Some people learn better by analysing sound
35% Visuals – Some people understand something better if they see it.

Whilst this seems to be quite clear cut unfortunately the reality is that people do not have only one preferred learning style so the challenge for those in pharma marketing is to find a tool that suits everyone – but is this possible?

Baxter has a strong heritage in the haemophilia market with a 30 year old brand called FEIBA, which has continued to go from strength to strength.  In advance of the launch of its new brand called Advate Baxter wanted to establish their position as the leading partner in haemophilia.  The challenge was to provide new sales materials that would:

• Generate access opportunities
• Provide tools needed to confidently sell Advate and Feiba and raise awareness of Baxter in haemophilia
• Engage the customer through a novel approach
• Encourage the customer to share experiences
• Drive interactive dialogue as a means to communicate key messages
• Enable differential messaging for key audiences: doctors, nurses, payers and KOLs.

Baxter has developed and introduced an innovative 'tablet' sales aid for laptop use by the sales force which incorporates:

• Differential selling messages
• Key data presented in 3D form
• Ability to input information provided by the customer
• KOL  talking heads short films
• Patient testimonials
• Mini documentary films
• Flash animations including MOA
• Cost calculator

There have been many benefits to the sales team since the introduction of this new innovative tool:

• Impactful and memorable sales calls
• Expanded call durations
• Improved clarity and comprehension
• Improved message recall through increased interaction
• Increased credibility, delivering perceived unbiased (EBM) information
• Instant access to additional resources such as clinical papers, product-based quizzes and research
• Segmentation of customers through the electronic detail and delivery of targeted messages according to segmentation.

The new Tablet allows the sales calls to be far more interactive and tailored to the needs of the individual customers.  Simon felt strongly that as an industry the pharmaceutical sector spends thousands of pounds on developing value added programmes but not enough on promoting them.  The functionality of the tablet allows greater flexibility in promoting these programmes.  Data can also be updated quickly and the metrics behind the system can also be measured so that product managers can better understand the needs of the customers.



The main considerations when considering this type of e-communication channel are the careful selection of the hardware and ensuring there is expert IT support. Setting out an approval process for updates is imperative if the 'up to the minute' USP of the tablet is to be utilised.  It is also vital to ensure that the users receive appropriate training.

Feedback to date has been very positive.  Clinicians feel that they receive a higher quality call from a Baxter Account Manager than other companies' representatives and they really appreciate the enhanced interactivity in calls and meetings.  Baxter is also perceived as forward-thinking and keeping abreast with the latest technological advancements.

Dr John Probert, Senior Brand Manager, Novartis gave the final presentation of the evening.  He shared with the audience a very new and exciting e-channel programme that is still in the final stages of development.

Novartis has developed a 'Virtual Clinic' to help with a number of challenges surrounding the treatment of wet age related macular degeneration (wet AMD).  Pre 2000 clinicians didn't have a great workload in this area because there was very little treatment that they could offer. In 2000 the first pharmacological treatment was launched into this disease area and clinicians saw their workload increase as they were now able to treat about 1/3 of the elderly patient population and they would see them 3-4 times a year.  The method of treatment was very different to anything that was done previously and so new clinics had to be developed.

Post 2006 there has been the introduction of Anti VEGF (Vascular Endothelial Growth Factor) treatments which has seen a subsequent nine fold increase in the number of patient visits (3x the number of patients can be treated and they are seen up to 12 times a year).   The new treatments involve an injection directly into the eye.  The injections need to be carried out in a "clean room" the biggest risk is associated with the procedure and relates to bacteria being introduced into the eye with the injection.

This development in the treatment of wet AMD has been swift but as a consequence there has not been the time or opportunity to sit down and think through the patient treatment pathway and the physical clinic requirements. The treatments require patients to move around the clinics to different consulting and treatment rooms.  This elderly group of patients are being expected to move around between rooms and even go to different levels in the hospital to receive treatment.   As a consequence this is having a serious impact on the timing and efficient running of each clinic. 



As such there was a need to look at how patients moved through the clinic and identify potential bottlenecks.  Excel spreadsheets were proving ineffective in engaging customers and so Novartis took the decision to provide help in this area and see if there was something that they could do.  They looked at computer simulation models and how these were being used in R&D to look at modelling molecular interactions and developing virtual clinical trials, to see if there was a way to develop a virtual clinic.

It was important to understand different groups of patients and recognise the difference in treatment pathways that they follow such as the difference between new and existing patients.



The key learnings from the initial research was that every clinic is different.  Whilst they were able to work with average timings from the hospitals it was important to build in flexibility into the software to allow consultants to make changes and have flexibility to alter their processes to cater for individual patient and clinic needs.

Being able to demonstrate clearly to clinical management teams at each hospital/clinic how the layout of the consulting/treatment rooms and current resources are impacting on clinic times has been very powerful.  The tool allows a clinic to see by how much they are going to overrun based upon the number of patients and current clinic set up.  This will also aid the clinicians, if they want to change the current model and present a case to the management team on how any extra resource could affect the number of patients who can be treated in a clinic session.  This type of information is becoming increasingly important especially in light of Payment by Results.

In summary, Novartis is in the final stages of developing a virtual clinic model which will simulate an actual clinic.  It will be able to identify bottlenecks and have the ability to make suggested modifications to the clinic to improve patient throughput and clinic efficiency.

This programme is very new and the critical success factors have been ensuring that all members of the team from marketing and IT through to medical and legal are involved in the project from the start.

The meeting closed with the conclusion that multi-channel communication to HCPs and patients is now critical to successful brand planning.  The e-channel has opened up a new and exciting range of opportunities to engage with stakeholder groups and provide valid and valuable information and education programmes.  Marketers must embrace this new technology and look at innovative ways they can utilise it. However, it is wise to note that as these channels are so new they are almost certain to take longer than anticipated to develop, get approved and bring to market and importantly they usually cost more than originally budgeted for! 

We would like to thank the generous support of Pfizer for hosting this meeting and for our panel of speakers for participating in this event.

Held on: 14/10/2008