What challenges are they facing today?
With Moderator David Ormesher, CEO, closerlook, inc.
Our Panel of Experts:
HEATHER ATON Chief Innovation Officer, Dudnyk
STEPHANIE BROWN Strategy, Fingerpaint
ERIN BYRNE EVP, Managing Partner, ghg Healxx Digital
MIKE HUDNALL Global Leader, WPP
David Ormesher: We’re here to talk about business, the agency business. Is the commercial model for pharma changing, and if so, what does that mean for us?
The FDA approved a record number of drugs in 2014. At the recent JP Morgan Healthcare Conference in San Francisco, all I heard was widespread optimism over the quality of the biotech pipeline of specialty drugs. Does this mean there will be a new era of “blockbuster specialty” drugs? What does this mean for the so-called evolution of the commercial model?
These questions represent just a few of the challenges and opportunities for marketers in what is shaping up to be an ongoing environment of change in the pharmaceutical industry.
Q. To begin our discussion, what do you see as the major challenges to pharma agencies today?
Erin Byrne: The healthcare system is going through significant change designed to provide better care for patients, yet the experience is still very disjointed and fragmented. Technology is a friend and a foe for the professional, and the consumer seemingly has the ability to have more control of their healthcare decision-making. However, accessing the value and credibility of information is a challenge, and the sheer quantity of content makes it difficult to discern fact from fiction.
Mike Hudnall: A great agency must be strategically relevant, deliver flawlessly, and add true value to our clients. To do that, an agency must intimately understand the dynamics in the healthcare industry and the forces causing disruption and transformation in our clients’ business, like government and pricing pressures, evolution to specialty, patent expirations, empowered patients, etc. These forces combine with key trends like the empowered consumer, globalization, agency consolidation, technology, data, content, and production decoupling to create a whole new set of competencies for agency leaders.
Stephanie Brown: As pharmaceutical marketing becomes more data-driven, niche-based, content-centric and even social-facing, agencies need to find focus. A traditional agency model can’t deliver value for clients while developing the level of specialization that drives successful outcomes in many of the channels in play.
Erin Byrne: Our challenge is our opportunity. Now is our moment to elevate communications as a potential cure for what ails us. If we create meaningful healthcare conversations and drive dialogue between all of the key stakeholders, we have an important opportunity to improve the experience and improve the outcomes – for patients, for professionals, and ultimately even business outcomes for the clients we serve.
Q. Does this mean that agencies need to rethink their positioning or even their business model?
Heather Aton: I think pharma agencies struggle to establish a clear value proposition with their customers and don’t specifically define their competition. Are they doing what management consulting firms can do for their clients? Are they strategic consulting firms? Are they communications planners? Are they flawlessly executing their client’s promotional plans? Is it clear what they stand for and believe in?
Do they have the commercial expertise to really build pharma brands across integrated marketing channels? Do they try to do it all? How effective are they at collaborating with other agency stakeholders? What do their clients ultimately want to buy from them?
The biggest challenge for some time now has been the disconnect between what clients actually want to buy from their healthcare “advertising” agencies and what agencies actually want to sell them.
Mike Hudnall: The great agencies “get” the business strategy and they truly leverage it in how they partner with their clients to deliver smart and innovative solutions. Fundamentally, I believe we are at the beginning of a radical evolution in the healthcare marketing space. As our clients’ business transforms, so must marketing and the agencies.
I expect these market pressures will cause bio/pharma companies to place more value on marketing and communications as a driver of top-line growth. This will pressure agencies to up their game and bring more sophisticated strategy and solutions. It’s really an exciting time to be in healthcare marketing and communications.
David Ormesher: I agree that it seems we are on the cusp of a major sea change in how we market and what we market. So let’s talk about the “what,” the product mix. Are you finding more of a focus on biologics? Orphan drugs?
Heather Aton: Yes. Bio and orphan are a huge focus in planning and prospecting, as well as scientific and clinical development for obvious reasons. Certainly this is where the most exciting marketing stories can occur.
Mike Hudnall: Absolutely. Most of our clients are all pivoting to fuel growth and innovation via a new pipeline of products like biologics, specialty and orphan drugs. Biosimilars are an exciting growth area as well. Longer-term, gene therapy is gaining real traction and focus.
Erin Byrne: We are certainly seeing a balanced approach to investing in treatments for diseases that affect a wide population, while also a concerted effort around specialty care and rare disease. They are both critically important to creating a healthier population, and we continue to invest in unique communications opportunities around both.
Heather Aton: Smaller commercial teams and less organizational layers make for leaner, faster decisions and more flexibility. And huge opportunities remain in marketing and commercialization. Ironing out kinks in specialty pharmacy service and delivery, linking communities and support networks with HCP advocates and decision makers. Surmounting patient and provider access issues. All motivated by the profound impact these kinds of therapies can have on people and the healthcare landscape.
Q: How is marketing for these new specialty drugs different than the blockbuster playbook?
Heather Aton: Specialty drugs mean opportunity for deeper audience understanding, more specific data and customized, targeted communications.
Stephanie Brown: Specialty drugs offer different commercial challenges than mainstream brands, and marketers have to shift their approach accordingly.
Patients with rare conditions often feel isolated and seek a connection with others who have the same symptoms—through advocacy groups, social media and well-crafted unbranded sites like PubertyTooEarly.com.
David Ormesher: My sense is that this opens up the opportunity for a new kind of relationship with patients and their caregivers, especially if they feel the outreach from the brand is authentic and not just promotional. And with healthcare professionals if we are providing content that is valuable and not self-serving.
Stephanie Brown: Sometimes patients are more open to a direct relationship with a brand—but only if that brand clearly provides a sense of community. Physicians need to be educated about disease states or drugs, too, but there are fewer resources available for them. The opportunity here is to own the knowledge pool by providing content that’s evidence-based and led by key opinion leaders to keep stakeholders in the know. Bottom line? Less promotion, more information.
Mike Hudnall: Marketing for specialty drugs is much different than for the blockbuster playbook of the past. The therapies and the science behind them are more complex. The patient populations are smaller and professional audiences more specialized. The needs of these customers are vastly different than those of the mass patient populations and primary care physicians.
The blockbuster playbook centered on selling and advertising to activate large populations. Today, marketers and agencies need to understand how to bring sophisticated programs and services that help customers deal with the complex issues of managing their condition, securing access to drugs and supporting adherence. Additionally, we need to understand the role and strategy of pricing, outcomes, policy and advocacy.
Erin Byrne: Marketing specialty drugs allows you to be more targeted in messaging and media spending. It requires finesse, and a push/pull approach. As opposed to spraying the market, we want to be very targeted and selective about identifying the most relevant channels to engage patients and professionals, and then create meaningful experiences in those spaces.
Q. Does this change the types of capabilities and expertise that agencies need to offer? Or is it just marketing with new window dressings?
Mike Hudnall: Marketing itself is so much more complex today. Marketers and agencies need to consider how to leverage data, technology and content to connect with customers on their terms. We need to understand the role advocacy, policy and access play. We also need to apply highly specialized expertise in customer experience, consultative selling, patient support programs, teledetailing, MCM, social media, etc. Frankly, it’s a lot to understand and it’s easy to lose sight of the endgame.
Great agencies simplify the process by acknowledging that the customer is in control. Our job is to listen and understand. We use data cross-functionally to identify powerful new insights. Then we are able to execute to better help customers and accelerate value and impact for our clients.
Erin Byrne: Beyond putting content in appropriate channels for target audiences to find, we are more proactive about reaching out to them directly with appropriate communications. This includes contributing to patient communities to demonstrate an understanding of their situation and show our deep desire to support them.
This approach of contributing to the community is relevant for professionals as well. It is even more critical among rare disease categories to engage professionals across their entire workday and to create content that moves from device to device. A physician may engage with a brand on their mobile on the commute to work, via EHR during a patient consult, on their laptop during a break, and again on mobile later in the day.
Creating a persistent presence is critical to supporting the busy professional, especially when dealing with rare diseases when the HCP may rely even more heavily on digital content and education.
Q. The reimbursement model is changing for physicians from fee-based to value-based. Doctors need to show outcomes. How important have outcomes data become to your marketing message?
Erin Byrne: In the past, data and value were considered independent from marketing messages. Today, value has to be integrated into the DNA of a product as the new definition of value includes BOTH efficacy and experience. We believe that value is critical as a component of an integrated communications approach and consider value as a core element in driving brand planning and decision-making. This includes considering outcomes data from the perspective of patients, professionals, payers and manufacturers and working with our team of clinicians and health economists to support impactful marketing messages.
Mike Hudnall: Outcomes data is hugely important. That’s a really broad topic that I think the industry is still coming up to speed on but the reality is that clinical outcomes influence every aspect of strategy and message across all customers to some degree. Agencies, though, have a widely variable understanding and expertise around outcomes. We see a big opportunity to connect outcomes data and messaging to core strategy and message, uniting stakeholders around a common value-proposition for every product.
David Ormesher: My sense is that outcomes data will become integral to all pharma marketing in the near future. Products won’t make the formulary without clear outcomes data and brands will be compelled to develop patient models that demonstrate which patient types respond the best to a treatment regimen. Providers who will bear the biggest brunt of an outcomes-driven reimbursement framework will demand to know that products work.
Q. I’d like you to describe some incidents – you don’t need to name names – that represent the kinds of changes you’re facing with clients.
Erin Byrne: One meaningful change we are facing with clients is a move away from a focus on quantity to quality instead. One recent launch brand wisely focused on creating digital assets, including high-impact video, to focus on qualified patients online as opposed to spending significant media dollars on a television buy that would result in millions of dollars of wasted spending. By understanding the information-seeking habits of key consumer audiences, we can place the right message in the right place to be accessed at the right time that is most likely to drive a brand interaction and request. This recognition of quality trumping quantity, especially for more common therapeutic categories, is a change in how pharmaceutical marketers are engaging brand promotion.
Heather Aton: Certainly there are constraints on what clients can afford and yet they want more and more for the dollars they have to spend. This puts a tight noose on traditional agency staffing models. Which again gets to the question of what clients really want to buy from their agencies.
David Ormesher: Exactly. Which is why brands continue to experiment with digital. They are trying to do more with less and see if they can achieve reach and frequency with a more cost-effective channel. But the dance with digital is not just to save money. We all know that this is where our customers are, and if we want to provide value and build relationships, we need to meet them on their familiar turf.
Stephanie Brown: Many of our clients are looking for new ways to reach and engage rare disease audiences—and finding solutions with inbound marketing. The “holy trinity” of search, social and content is highly effective, but most corporations aren’t set up to support this marketing framework. The move from brand promotion to content publishing, for example, requires regulatory teams to rethink the way they operate. They have to get comfortable with unencumbered science and “straight storytelling,” that isn’t branded but might live on a brand-sponsored platform. For that to be effective, they can’t heavily control or heavily brand the content.
And then there’s the subsequent shift in distribution channels, from paid to earned, which involves a raft of new regulatory challenges to keep in mind from an FDA standpoint. So there’s plenty of change going on!
Q. There is plenty of change going on, both for digital and traditional agencies. Do you think there will there be an eventual consolidation of digital and traditional agencies, or will the division continue to be the norm for the near future?
Mike Hudnall: That’s a great question. Ultimately, I think we’ll see some significant convergence of digital and traditional agencies. We have to. I hope it happens soon. Clients will not be willing to pay for multiple agencies or repetitive staff or tolerate agencies that aren’t multi-capable for the long term.
I anticipate that the agencies that can do it all will start to take over. The reality, though, is that the industry is not there yet. Many times, specialist digital agencies have the chops that traditional agencies struggle to match. This affords them significant advantage. But those digital agencies also struggle to match the strategic and scientific and “big idea” capabilities of traditional agencies. I predict we’ll see some strong players start to emerge from both sides: digital agencies expanding “offline” and traditional agencies really embracing digital at the core.
Heather Aton: I think the gap is rapidly closing. But this does get back to the point I raised earlier regarding value proposition. For agencies, it won’t be so much about digital vs. non-digital, but strategic planning, brand building and recommendations versus executional capabilities.
David Ormesher: This gets back to your assertion, Heather, that the fundamental question for agencies to ask is what business are we in? Is it strategic and brand development, or is it tactical execution? There’s room for both, so the difference may ultimately be less about digital vs. non-digital and more about strategy vs. tactical delivery. I personally think that there is more value to create as brains and not just hands.
Stephanie Brown: The consolidation is already happening. So much of the work we see really requires a combination of online and offline tactics to be effective, and agencies are going to have to adapt.
Erin Byrne: As clients get more sophisticated in their marketing, they expect their agency partners to keep up, or even lead them, which convinces me that consolidation will continue to be a trend. That said, while digital is largely wholly integrated into creative agencies at this point, there will be specialty services that are often sourced from specialty or boutique agencies. We like to consider ourselves savvy agency marketers, and to that end we have elevated digital competency across our staff, and have also developed a specialty digital firm, ghg Healxx Digital, to address the most innovative, cutting edge technologies for clients.
Mike Hudnall: Three important things to remember, though: 1) It’s all about the leadership and talent; 2) For an agency to win, it has to build significant cross-functional capabilities; 3) It’s hard for one agency to do it all, so I do think there will always be a role and benefit for specialization.
Q. Agency consolidation has provided some companies with the reach to service global brands. How do internationally-based clients differ from U.S.-based companies in the way they approach marketing?
Heather Aton: Quite differently. Internationally-based clients place a huge emphasis on localizing assets. They are not set up with the same marketing or sales resources as U.S.-based companies. Also, there is certainly a difference between marketing in developed markets and emerging ones, and this is a significant brand strategy consideration.
Cost structure, more socialized environments, different regulatory checks and balances, access or lack thereof to certain technologies and language differences all have a marked impact on how to sell a brand. And though it’s changing in the world of social media, certain approaches that can be taken in the U.S. to link patient/caregiver/end-user with physician cannot apply in ex-US markets where healthcare communications to consumers are much more restricted.
Erin Byrne: The regulatory environment often drives nuances in international marketing. Notably, the most important difference for U.S.-based clients is the ability to market direct to consumers/patients. That is prohibited in many parts of the world, which is unfortunate as the desire for information and engagement is a global trend. Global marketers are struggling with how to satisfy consumers’ desire for information while remaining compliant with local regulatory requirements.
Mike Hudnall: U.S.-only marketers tend to develop strategy and execution approaches at the brand level because they only have to deal with one set of regulatory guidelines and typically have a large target market. Global companies that practice true global marketing have found efficiency and effectiveness by adopting global strategic toolkits that can be customized by local markets in accordance with local regulations and budget parameters. Oftentimes, they aggregate and offshore tactical execution to minimize production costs and gain volume efficiencies
Q. Social media seems to know no boundaries, and yet as agencies and brand teams, we have to live with constraints. How have you had to adjust to the new FDA social media guidelines?
Stephanie Brown: We actually haven’t had to adjust greatly. The guidelines largely confirm the extent and limits of a company’s responsibility for all portions of any discussion they start—whether they say something or whether another participant in the conversation does. For most brands, and in most situations, ramping up to handle that is an enormous undertaking. We’re continuing to help companies understand when the investment is worth the potential return—and when it’s more effort than it’s worth.
Mike Hudnall: The biggest impact for us was that it clarified some of the responsibility and risk for non-client influenced UGC that contains misinformation. This has opened things up for us. There’s more appetite and more ability to try new things.
The guidelines are essentially adjusting to meet the demands of an increasingly empowered consumer. One great outcome that we are seeing is more collaborative relationships between marketing, legal and regulatory teams at our clients. We see legal and regulatory teams engaged earlier in the strategic development process. Our clients recognize that new technologies and marketing approaches require them to be innovative and flexible and always keep the needs of the customer first.
Erin Byrne: While the current guidelines are stacked against fair balance, I do believe that having clearly defined guidelines is critical to helping patients sift through the tremendous amount of content that can be created. For example, the current FDA guidelines say that you can’t mention the brand without ISI in the same post – and it can’t be in a link. While this is being revisited with the 21st Century Cures proposal, for now that effectively eliminates Twitter from any use with any of our pharma clients. Yet consumers and professionals are dropping brand names on Twitter left and right, and linking to content that may not always be accurate. We have helped our clients learn how to engage within the guidelines as they currently exist, but we are constantly evaluating how the future may evolve and how brands will be able to participate.
Another major factor in the practice of healthcare in the US is the ACA. Does the ACA affect your marketing, and if so, how?
Erin Byrne: As the ACA has leveled the healthcare playing field, we believe that communications plays a more essential role than ever. New customers who are buying health insurance for the first time are often looking for help to learn a new vocabulary. The doctor is no longer the sole source of influence in healthcare decision making. Patients can and will access information and resources to inform their decisions.
Advertising cannot diagnose each consumer, but it can provide a wealth of information in a condensed, easily digestible format that can help guide patients to better decisions. We believe that communications is the cure and we focus on driving meaningful healthcare conversations across all stakeholders. While we have always believed this, the ACA environment makes it even more critical.
Mike Hudnall: I think the biggest impact of the ACA has been to accelerate the focus on outcomes. This impacts strategy; creating a strong value proposition is now a more central element for all stakeholders. Specialized agencies that used to be siloed around advocacy and policy now play more important and more integrated roles.
David Ormesher: The challenge for pharma is that many brands are still playing the role of vendor. Most deals with PBMs and hospital systems are based on volume discounts not outcomes. If we are to serve our brand clients properly, we need to help them craft new value propositions around prevention and management to they can begin to position themselves as business partners to the health ecosystem. This is how marketing becomes a strategic voice at the business table, not just the promotional arm of the brands.
In closing, I want to thank my colleagues, Erin Byrne of ghg Healxx Digital, Mike Hudnall with WPP, Stephanie Brown at Fingerpaint and Heather Aton with Dudnyk for their insights. We are all navigating a challenging but very exciting period in marketing in the pharmaceutical industry, and I believe our best years of providing value are ahead of us.
MEET OUR MODERATOR
DAVID ORMESHER, CEO, closerlook, inc.
David provides leadership and direction for closerlook, inc., a digital marketing agency serving the pharmaceutical industry. As founder and CEO, Ormesher has grown closerlook into a recognized leader in creating innovative relationship-marketing solutions that help pharmaceutical brands build and maintain meaningful relationships with their most valuable healthcare professionals. In addition, David continues his leadership of Bigger Future, a nonprofit business and leadership-training program based in Rwanda, and serves on several boards including the XPRIZE Foundation, physIQ, the Lurie Children’s Hospital Foundation, the Poetry Foundation and the Lyric Opera of Chicago. • firstname.lastname@example.org • @ormshr
COMMENTMEET OUR EXECUTIVE PANEL:
Chief Innovation Officer, Dudnyk
An industry veteran with 15 years’ experience, Heather has built successful brands at several agencies, working on AstraZeneca Respiratory, Genzyme MS, Merck Women’s Health and others. As SVP Management Supervisor at Havas, she led strategic business alignment and collaboration among portfolio stakeholders and global partners. At Dudnyk she plans the path for the agency’s future success, embracing the “new normal” of volatility, uncertainty and complexity. Dudnyk prides itself on its ability to create fresh, compelling brands, and values how Heather brings her team together and helps to draw out great ideas across disciplines. • email@example.com • 267.532.1073
Stephanie literally wrote the book, Local Online Advertising for Dummies, to help businesses navigate today’s digital landscape. She has been evangelizing Internet marketing since 1994, with a roster of names such as Calvin Klein, Kinko’s, KPMG, Visa, Bank of America, Chase Bank and Capital One. She began her career as a copywriter and creative director before shifting her focus to eMarketing strategy and development. Stephanie has won the American Marketing Association’s Mark of Excellence and B2B Magazine’s ACE Award for website design, among other awards. But perhaps one of her greatest accolades was when Bill Gates featured an intranet application she designed for a client in one of his presentations. Fingerpaint is a full-service marketing agency committed to original thinking and uncommon collaboration. The firm specializes in brand development, strategic planning, digital and multichannel marketing, audio and video production and public relations. • SBrown@fingerpaintmarketing.com • 518.693.6960 ext. 1703
EVP, Managing Partner, Chief Engagement Officer, Grey Healthcare Group (ghg)
Erin Byrne leads the agency’s client services team and oversees the agency’s digital client work. With 20+ years of experience, she is a sought-out counselor to C-suite executives looking to leverage integrated communications in the highly regulated and rapidly changing healthcare environment. She has a strong focus on the patient/provider relationship with the goal of improving the experience and outcomes. Erin is a member of ghg’s Executive Committee, sits on the global WPP Digital Advisory Board, and serves on the Text4Baby National Steering Committee and Board of Directors of InMed Partnerships for Children. ghg (Grey Healthcare Group) is a full-service, global, integrated communications agency capable of driving innovation in every aspect of healthcare communication. With offices in the Americas, Europe and Asia, our 650 healthcare and communications experts–including physicians, PhDs, GPs, pharmacists, nurses, vets, as well as top creative and digital talent–combine their clinical experience, scientific intelligence, and strategic insights to ensure that every program, no matter where in the world, delivers optimal results. • firstname.lastname@example.org
WPP Global Client Leader
As Global Client Leader, Mike leads one of WPP’s top 10 global clients. He guides the strategic vision for the partnership with client and leads the mobilization of WPP’s global network (across all marketing and communication disciplines) to accelerate client’s brands and business units and their patients and customers around the world. Mike is accountable for ensuring that WPP provides the highest level of service for Pfizer and for the overall commercial viability of the partnership for client and for WPP. Mike’s 19-year career includes experience in healthcare and is complemented by his work across other industry verticals with clients including GE, FEDEX, Pizza Hut, CVS/pharmacy. Mike also brings 13 years of pure digital experience. Prior to WPP, Mike co-founded and led the boutique digital agency evoke interaction. • email@example.com