The Downside of Patient Empowerment

Downside of Patient Empowerment

“I could have had a mastectomy with reconstruction and skipped the part where I got cancer. I feel like the biggest idiot for not doing so.”

Those self-flagellating words made my heart scream like it was stabbed.

I read “The Breast Cancer Gene and Me” by Elizabeth Wurtzel in last Sunday’s New York Times Op-Ed Section. Here is someone who could not have reasonably known that she carried the BRAC gene and was at a relatively high risk of developing breast cancer.

Yet she berates herself for not having a prophylactic mastectomy.

Ms. Wurtzel understands that “the science is ahead of policy” in terms of health insurance coverage. Multiple studies show that as a woman of Ashkenazi descent, she has about a 10-fold higher chance of having the cancer causing BRAC gene. However, “most insurance companies cover testing specifically for Ashkenazi Jewish women only once [they] present with breast cancer.”

But despite being able to point to a flaw in our health care system, she blames herself.

BRAC gene

True, there is now a relatively inexpensive test that women can purchase from Color Genomics to see if they have this deadly gene.  But the most talked about risk factors for the BRAC gene did not point to her genetics as being particularly troublesome. When she found out she had breast cancer, Ms. Wurtzel says, “I caught it fast and I acted fast.”

But still she blames herself for not getting tested.

This despite the fact that testing does not make for black and white decision-making.  Certain BRAC gene mutations are responsible for a substantial fraction of hereditary breast cancers and ovarian cancers among women with Ashkenazi Jewish ancestry. However there are a myriad of BRAC mutations with no clear causal relationship.

Here is where paternalism rears its ugly head. Part of the excuse for not encouraging more BRAC testing is the fear of getting grey-zone results that can cause unremitting anguish for patients. But as Ms. Wurtzel makes clear, no matter how much pain is involved in agonizing over a health care decision, having cancer is worse.

Patient empowerment flag


I’ve been carrying the patient empowerment flag in my work as a health care communicator for over 25 years. Usually stories of medical paternalism make my heart race in anger. But the searing self-blame here made my heart stop in sadness.

What’s needed here is a little compassion. Much has been written about the power of physician compassion in health care.  There is far less about self-compassion in health care. Patients will need more self-compassion for the inevitable mistakes (or non-mistakes, in Ms. Wurtzel’s case) that will be made as they take the helm of their health care management.

So for those of us health communicators cheerfully prescribing patient empowerment to patients, it’s time to add a dose of self-compassion on the side.

4 Ways to Become an Activist Pharmaceutical Brand

Picture of person shrugging. Brand Activisim: What's a Pharmaceutical Brand Manager to do? Yesterday I wrote about consumer’s increasing expectations for brand activism in a post entitled, “Tough Times for Timid Pharma Brands.” In a nutshell, many progressive consumer brands outside of the pharmaceutical industry are increasingly taking stands and acting on social issues.

So why should a pharmaceutical brand manager care about this trend?

Because according the Edelman’s 2014 BRANDSHARE report, consumers are more likely to purchase, recommend or defend a brand if they perceive the brand is meeting an important societal need. Consumers are also more likely to engage with the brand, sharing personal information and forwarding branded content. And Millennials aren’t the only ones with high expectations of brands.  Edelman found that consumers across all demographic groups are looking for companies to be a force for positive change in the world.

Brand Activism: What’s a Pharmaceutical Brand Manager to do?

So consumers want brand activism and there is a real business value in providing it. So how does a Pharmaceutical Brand Manager meet consumer needs for increased brand activism?

  1. Start talking about something other than your brand.  Engage in Content Marketing. Content Marketing is defined as “a strategic marketing approach focused on creating and distributing valuable, relevant, and consistent content to attract and retain a clearly-defined audience — and, ultimately, to drive profitable customer action. I detailed a few ways to get started using Content Marketing in my blog post “Building Great Brands byTalking Less About Them.”
  2. Partner with a governmental or NGO on issues that are important to your customers, whether they be payors or patients. For example, both patients and payors are interested in using big data to understand more about individual health risks and to improve the patient experience. There are many organizations such as PatientsLikeMe or 23andMe that have teamed up with pharmaceutical companies for research purposes, from finding the genetic basis of diseases to better understanding the real world concerns of their patients.
  3. Clean up your therapeutic area’s digital environment. There is a lot of garbage out there, much of it dangerous to patient health. How about assembling experts in your therapeutic area to weigh in on the most egregious misinformation?  A a digital clean up day of sorts.Picture of Digital Highway with Clean Up Crew
  4. Sponsor a healthy debate. Consider obesity. There are those who feel pharmaceuticals have no place in the treatment of obesity. Obviously, pharmaceutical companies who sell medications for obesity feel otherwise. A debate between two reasonable experts in some sort of public forum would be newsworthy and garner much “earned media.” People’s deeply felt views won’t change, but you may convince people sitting on the fence that treating obesity with a pharmaceutical product is the way to go.  Plus your brand will gain added credibility for being open enough to debate the issue.

Picture of 2 people debating. Sponsor Healthy Debate

Certainly, undertaking brand activism is not a “set it and forget it” kind of tactic. But as consumers take an increasingly larger role in health care decisions, it will be increasingly important to incorporate their evolving views on brand activities into your marketing plan.

Tough Times for Timid Pharmaceutical Brands

Tough Times for Timid Pharmaceutical Brands, picture of pill and capsuleConsumers demand more outwardly focused brands

Consumers, driven by mindful Millennials, are demanding that brands take a stand on social issues. It is no longer acceptable for brands to look at the messy world and say, “Not my job!” Certainly Pharma brands are more constrained by consent decrees and regulations. However, that won’t stop consumers from saying, “Not my problem,” when it comes to demanding more from their health care brands.

According to one of my favorite trend spotters, Trend Watching winning brands will start contentious, painful and necessary conversations.”  That means going beyond product claims and bland unbranded campaigns to talk about polarizing topics. Take Starbucks, which recently jumped into the fray about race relations.  One example with particular relevance to Pharma is Pantene India’s campaign that asks consumers to point out ridiculous claims made by beauty products that don’t work. How about Pharma pointing out the ridicules claims made by nutraceuticals?

Picture of Pantene India campaign

Talk is necessary, but not sufficient

But talk is not enough. Today’s consumers demand action. Describing their “Branded Government” trend, Trend Watching boldly pronounces 2015 as “the year for progressive brands to initiate, undertake or support meaningful civic transformation.”

One example of this Private-Public Partnership is the WAZE traffic app’s Connected Citizen’s partnership that exchanges data with local governments around the world with the aim of improving traffic patterns. And it is not just new school companies taking civic action. Volvo is partnering with the Swedish Government to create roads that can charge electric vehicles.

Waze Connected Citizens Campaign

Brand Activism: What’s a Pharmaceutical Brand Manager to do?

Certainly there are enough unmet health needs for Pharma to partner with government to make people healthier. What about a weight loss brand teaming up with local government to promote better eating habits? This initiative may also seem less self-serving, because if successful, the campaign would slim down the market for the prescription weight loss products.

To health care purists, branding has no role to play in the choice of a pharmaceutical product. The product should be chosen based on efficacy, safety and increasingly, price. However in practice, physicians often have 2-3 brands they feel are interchangeable. In categories such as Multiple Sclerosis, HCPs often let the patient chose. Why? Because then the patient has skin in the game.

In addition, research conducted early in the DTC era, found that patients who ask for and are given a specific brand are more likely to be adherent compared to patients not making a request. So to me (admittedly not a health care purist), branding is more likely to be beneficial than harmful to patients.

No more navel gazing for Pharma

Picture of navel caption No more navel gazing for Pharma Marketers

So it pays to do it right. And paradoxically, in today’s socially conscious environment, good branding involves talking less about the product and doing more in the world. No more navel gazing! The key to building great brands, is to talk less about them. The old axiom, “actions speak louder than words” is today’s branding rallying cry!

For ideas on how to apply this trend to your pharmaceutical brand, check in tomorrow for my next post, “4 Ways to Become an Activist Pharmaceutical Brand.”

For Breakthrough Health Care Communication, Try a Visual

For breakthrough communication, add a visual

How one picture turned the tide against obesity

For most people who read the New York Times article, “Americans are Finally Eating Less”, there was exciting news about the fight against obesity. But for alert pharmaceutical marketers, the article contained the key to changing patient behavior: an effective visual!

While study after study had described the magnitude of the obesity problem, it wasn’t until a researcher put up a set of bright blue maps did people begin to grasp the magnitude of the problem. These maps graphically depicted the dramatic rise in obesity rates in all 50 states from 1991 to 1998.

Power of visual

The article points to the blue map visual as sparking the turning point in the fight against obesity. In the article, Hank Cardello, senior fellow at the Hudson Institute, is quoted as saying “People became more aware of it in a very visual and impactful way… That created a lot of attention and concern.”

An underused tool in pharmaceutical communications

In Pharmaceutical marketing, each word directed at the patient is scrutinized endlessly. Visuals or videos are often an afterthought, if they exist at all. While Pharma has embraced the concept of health literacy, its execution has been incomplete, with a narrow focus on grade level.

But visuals are critical to driving health behavior change. For example, in one instance with a low-literacy population at particularly high risk for pneumococcal infection, the group that had viewed a simple visual communication aid was five times more likely to have received the pneumococcal vaccine than those who had not received the visual education tool.

Not just for low literacy populations

But it is not only the low literacy population that gets more out of visualization. Consider Cisco, a world leader in IT, which found that 96% of its customers watch videos for business.  So Cisco started creating videos, over 1,000 new videos a year.

And visualization doesn’t have to be expensive. According to Cisco’s Leslie Drate,“it doesn’t really matter how much we spend on producing the video. The results for what we spend $100,000 on could be similar to what we spend $1,000 on. It just has a lot to do with content and audience.”

                                 Picture Source: Movie CLIP

So to paraphrase the famous phrase from the movie The Graduate, I want to say one word to Pharma marketers responsible for changing patient behavior. Just one word, Visuals!

To meet patient’s need for speed, Pharma needs more lawyers

What kind of crazy talk is that? Everyone knows that it is the legal and regulatory teams and the whole review committee process that keeps Pharma moving at a lugubrious pace. Certainly that’s the biggest excuses I hear for why patient complaints languish in the blogosphere or why websites aren’t updated on a regular basis.

It can’t be the shear size of the pharma organization that slows decision-making. Larger companies have shown they can be nimble when it counts. Take Apple, the largest company in the US and how their rapid fire response to the Taylor Swift incident. It took Apple less than one day over a weekend to reverse a policy about paying royalties during the Apple music trial period. And Apple’s senior vice president of Internet Software and Services, Eddy Cue, communicated it simply with a tweet.

Moving faster requires real teamwork, the type of teamwork highlighted in Fortune magazine’s recent profiles of the small teams within big companies like Nike, Starbucks and J&J. And it is shared goals that fuel these integrated teams’ stellar performance.

In my opinion, Pharma’s sluggishness comes down to the antiquated brand team structure. Most teams are comprised of three marketing sub-teams (HCP/Patient/Payer) overseen by a legal/regulatory/medical review committee with an entirely different reporting structure. Operating in siloes, these different departments often have different, and often, conflicting goals. The legal and regulatory departments are charged with protecting the company and the brand marketers are charged with growing the business.

But what if the Pharma brand team was a fully integrated team—with marketing, legal and regulatory all aligned around improving patient outcomes?

More crazy talk! What if reviewing patient comments, whether online, over the phone and deciding how to respond, was a daily job shared by all? What if lawyers attended focus groups? How about the regulatory team member meeting with patients at an advocacy event? What if everyone was co-located? What if marketing/legal/regulatory acted as a unified SWAT team dedicated to listening, responding and creating new ways to improve patient health?

For the SWAT team concept to work legal and regulatory colleagues must function as full members of a brand team, not just as a panel of judges at weekly review committee meetings. That’s where the idea that Pharma needs more lawyers (and regulators) comes in to play. Moving faster means brand teams should include marketing, legal and regulatory expertise to make decisions on a daily, if not hourly basis.

With consumer expectations regarding company response time rising across all industries, speed needs to be the rule in Pharma rather than the exception. And contrary to expectations, moving faster requires ongoing, rather than foregoing legal and regulatory input. Simply put, Pharma needs more lawyers (and regulatory experts) to move at the speed of patients.