The Health Engagement Blog

The Changing Media Landscape in Australia

Fri, 06 Nov 2009 12:47:20 -0500

Some of the biggest names in the Australian pharmaceutical industry attended the Edelman Health breakfast, The Changing Media Landscape, with Edelman’s Asia-Pacific President Alan VanderMolen and guest speakers; Roche digital capabilities manager, Arthur Alston; and editor of 6Minutes, Michael Woodhead. Digital media, its role and importance, and the challenges facing pharma in the digital age were the key discussion points. As an overview of the country’s digital capabilities, Australia lags behind other developed countries due mainly to a slow broadband network and the population’s love of traditional media… but things are changing. Data shows that Australians are moving away from TV and print (less so for radio) and towards online for their news, views, entertainment and health information. And this movement is also happening within the pharmaceutical industry. A recent poll by Edelman Health of marketing and communications professionals in the pharmaceutical industry found that online coverage ranked second in importance to print, with TV and radio coverage knocked into third and fourth places. The data also showed pharma is listening online with 61 per cent monitoring the internet for relevant conversations and 52 per cent agreeing that negative comments online about the company or product affect sales. However, 70 per cent of respondents would use digital media more if the Medicines Australia Code of Conduct gave clearer guidelines about online activity. Medicines Australia will be addressing social media in Edition 16 of the Code, which will become effective once approved by the ACCC. But, will it give the industry confidence to use the latest technologies in educating HCPs and patients? The forthcoming FDA discussion into social media will also be worth tuning in for… Technology update: Google Sidewiki’s Impact on PR In late September Google rolled out a program called Sidewiki that allows anyone to post or view comments about any web page they are visiting - even if that site doesn't have any social functionality. The program set off reputation management alarm bells because it's built into the Google Toolbar, which millions use. All comments are posted immediately and are ranked by usefulness. Comment activity for most pages has been relatively light in the weeks since launch. However, according to the Digital Health Team, some pharmaceuticals are seeing negative activity on drug sites. The screen grab below, for example, shows Sidewiki comments for the Seroquel web site. Click here to see more about Google SideWiki

A Peek into Some Presentations for FDA Hearing

Thu, 05 Nov 2009 17:51:32 -0500

Several of the presenters for next week's FDA Hearing have provided their content online for the public to see. All of the available presentations can be found through this aggregated list, courtesy of www.fdasm.com.

Upcoming FDA Hearing on Social Media

Wed, 04 Nov 2009 13:39:51 -0500

Here at Edelman, we are all looking forward to the upcoming public hearing that the FDA is holding on social media. To date, the FDA hasn't given specific guidance to manufacturers of regulated medical products on anything related to the Internet. They have simply directed marketers and communicators to follow the existing DDMAC guidelines which were created for print and broadcast. At the hearing, companies have an opportunity to share their perspective and recommendations with the FDA to help guide their policy decisions. The FDA has identified five issues to guide the presentations: 1. For what online communications are manufacturers, packers or distributors accountable? 2. How can manufacturers, packers, or distributors fulfill regulatory requirements (e.g., fair balance, disclosure of indication and risk information, postmarketing submission requirements) in their Internet and social media promotion, particularly when using tools that are associated with space limitations and/or real-time communications? 3. What parameters should apply to the posting of corrective information on Web sites controlled by third parties? 4. When is the use of links appropriate? 5. Adverse event reporting A draft of the agenda has been posted, and consultant John Mack has created a pie chart to show the majority of speakers come from agencies. There is also an aggregation site which compiles the current Tweets (using the hashtag #fdasm) and blog postings about the hearing. Here on EngageinHealth, we'll be posting recaps and our POV, as well as Tweeting. And although we don't expect to hear anything from the FDA at the meeting, this is a positive first step towards crafting a policy that will provide more guidance to pharma on how to use social media within regulations.

Health policy download, back-to-school edition

Tue, 08 Sep 2009 11:03:38 -0500

With public opinion turning skeptical about health care reform, President Obama will be working next week to grab momentum back for his top domestic policy priority. On Wednesday, the president will welcome Congress back from recess with a detailed health care speech. Administration officials promised that Obama will deliver a detailed prescription for reform despite the risks of spelling out exactly where he stands. To prepare for next week, the Senate Finance Committee’s “Gang of Six,” was expected to have its second conference call of the recess on Friday. Officially, the bipartisan group of senators is still working together on a health care bill and is expected to discuss their meeting schedule for next week, the August recess, and the work of their staffs. They are scheduled to talk for 90 minutes and will meet in-person next week before President Obama’s speech. Recent news coverage, however, suggests that the bipartisan consensus within the “gang” may be unraveling. While some online observers are starting to wonder if Obama has lost his grip on Internet discourse, Thursday’s “Facebook Status Meme” proves the president’s message is still resonant with many. Hundreds of thousands of Facebook users updated their status to read, “"[name] believes that no one should die because they cannot afford health care, and nobody should go broke because they get sick. If you agree, please post this as your status for the rest of the day."

Kennedy….and health care

Mon, 31 Aug 2009 12:25:30 -0500

With summer holidays, personal health priorities take hold, so it’s been awhile since we’ve posted. But now, with August nearing its end, and all the incredibly important news in the health policy space these days, we’re going to get back into gear and spend some time (and ink!) dedicated to what’s happening in DC, and the impact on doing business in the business of health. Some thoughts follow… The death of Democratic Sen. Ted Kennedy of Massachusetts on Wednesday colored most of the news media coverage about health care legislation. Some Democrats are suggesting Kennedy’s death ought to advance health care legislation, saying Congress should “win one for Teddy.” Public polling, however, shows much skepticism about health care legislation, especially among seniors and political independents. The Economist magazine’s survey Aug. 16-18, for example, showed a plurality think Congress is moving “too quickly” on health care reform (see Q. 29). And Sen. Russ Feingold (D-WI) told a home state crowd on Tuesday that there wouldn’t be a health care bill before Christmas, or maybe not at all – an opinion that actually drew applause.

The Weight of Health Engagement

Tue, 28 Jul 2009 17:29:30 -0500

Here are 10 thoughts to stimulate the health engagement we all practice as individuals, community-members and enterprise leaders. They stem from yesterday’s inaugural CDC conference on obesity prevention and control, Weight of the Nation:

Let’s put the ‘P’ back into the name of the US Centers for Disease Control and Prevention, says Dr. Tom Frieden, Director, CDC.
Taxing unhealthy products works; let’s take a page from tobacco and nudge people to make better decisions about their personal health and wellness.
The default status of the human body is health, while the default status of our society is anti-health; we need to reinvent ourselves as a wellness society – reimagining how we live together in this world.
View health holistically: it needs to be considered in all policies, not just government ones.
A taste of budget disparities at the CDC: $1.6 billion per year is spent on anti-terrorism initiatives vs. $40 million per year on those surrounding nutrition and physical activity.
There’s a paradigm shift away from being squarely hell bent on academic performance, to physical fitness also being key to long term performance and wellbeing.
Ten years from now people will not be asking, “How do I get more health care?” but rather, “What can I do to stay healthy?”
Health and wellbeing is local. Take a look at the approach that Kaiser Permanente is taking to building healthy communities (via farmers markets). What if farmers and school systems team up in local communities to bring fresh produce directly to kids?
Take the obesity problem as evidence of the fact that health needs to be considered in all aspects of life (according to former President Bill Clinton).
But of all these interesting and thought provoking comments I heard yesterday at this conference, the one from Dr. James Marks of the Robert Wood Johnson Foundation struck the loudest chord. He responded to a comment about other organizations needing to follow their lead, to which he replied – I’m paraphrasing here - the key to addressing the health and wellbeing of America is for every organization to take leadership in the movement.

Health Technology: Health Reform’s Trojan Horse

Fri, 10 Jul 2009 18:15:32 -0500

Colleague Steve Roy recently paid a visit to MIT’s health technology symposium and shares some insights about the intersection of health and technology. As a veteran of health technology forums, last week’s MIT’s health technology symposium was remarkable – both for the passion of the stakeholders who believe health technology’s day has finally arrived and the absence of the change agents needed to make it a reality. Most of the dialogue focused on EMRs (electronic medical records) and the current debate about the “meaningful use” stipulation that comes with the EMR funding contained in the Recovery Act, otherwise known as the stimulus bill. Despite all the glowing hopes for EMRs supported by the $19 billion in stimulus money, the devil is in the details. To receive reimbursement, providers will need to demonstrate “meaningful use” – a dangerously vague term. It’s akin to the IRS making us all prove “appropriate consumption” to get our tax refunds. Below the surface though, this was a conference about reform. As the administration envisioned it, health IT support amounts to a down payment on reform, with the idea being that it will be impossible to sustain 21st century health care using 20th century technology. The conference was highlighted by: • David Cutler, the Harvard health economist who told us we employ more admin workers than nurses and more financial managers than doctors in the US. See slide 11 in his presentation. • David Blumenthal, the government’s man in charge who inspires confidence despite being fully in touch with the daunting challenge he has assumed. • Gartner analyst Wes Rishel who feels this space is ripe for a game changing technology. • Researchers from the Harvard Public School of Health who pegged the current rate of EMR usage in hospitals at 7.6%. (That’s not a typo.) • AMA Board Member Joe Heyman who provided a preview of a one-stop shopping technology portal the AMA is building for physicians. Finally, what was most interesting was what was not said and who was not there. There was virtually no discussion about the importance public support could play here. It’s hard to champion change on this scale with a disengaged public. And the technology change agents that have revolutionized other sectors (the big name established players and innovative start-ups) continue to remain on the fringes of the core debates that are shaping this new field. For some enterprising company out there, there remains a major opportunity to galvanize public interest in health technology that will in turn have customers beating a path to their door. Steve Roy is a senior vice president in New York who specializes in health technology.

Process as Important as Product

Wed, 24 Jun 2009 10:42:14 -0500

My Washington colleague Tucker Warren, follows up on my earlier post about health reform with thoughts about how much the environment has changed in Washington since the last pitched battle over health care reform in 1994. Recent health reform discussions in Washington make it easy to be skeptical – a sentiment aided by the controversy about draft legislation that carries a price tag of more than $1.6 trillion while still leaving 15 million people uninsured. But a symposium on Wednesday reminded me just how far we’ve come on discussion around health reform. The National Pharmaceutical Council (Edelman client) brought together key players from government, industry and advocacy to discuss reform and the role of comparative effectiveness research (CER) and evidence-based medicine (EBM). Everyone agreed that quality and consistency of care must improve, cost must be reduced, and evidence and comparative effectiveness play a key role in determining what works. And while there was spirited debate about how to accomplish these things, there was much agreement among people who not long ago found little common ground. It’s important to remember that in 1993, the health reform process focused primarily on engaging Washington policy wonks and the tone carried a very strong partisan flavor. Fast forward 16 years and we are seeing a much more engaging level of discussion. All stakeholders, including the general public, are being asked for input. And having all parties at the table willing to “lose a little skin” gives us our best shot at a system that places the patient at the center. During this summer and fall, there will be plenty of posturing by all sides that will challenge even the most optimistic; but I believe health care reform will happen because voters want it (see this week’s Kaiser survey) and because the process has been much, much better. And in some ways that’s as important as the product itself. Tucker Warren is a senior account supervisor in Edelman’s health practice in Washington, D.C.

Taking a Proactive Approach to AE Reporting

Fri, 19 Jun 2009 16:10:13 -0500

One of pharma's biggest concerns with social media is adverse event (AE) reporting. But for an AE to be reportable, it must meet the four criteria: 1) an identifiable patient, 2) an identifiable reporter, 3) a suspect drug, and 4) the side effect. Most often online, #1 and #2 aren’t met. Last year, Nielsen even produced a report quantifying this. To handle AE reporting responsibly, companies that have created a presence in a social media property -- such as JnJ's Health YouTube Channel -- monitor their comments before posting in order to route any AEs appropriately. Some properties, like Facebook, don't allow for monitoring of comments before posting to the Wall, so companies may choose to turn off that feature. Not great for engaging with their audience, but it does avoid the risk. This week, UCB announced a partnership with PatientsLikeMe to launch an epilepsy-focused patient community, and will report adverse events to the FDA through round-the-clock surveillance. The community is expected to launch in early 2010 and is designed to to collect, analyze and reflect information received from people with epilepsy, regardless of their diagnosis, prognosis or treatment regimen. Sounds like a great step towards transparency and providing patients and the pharmaceutical company with valuable information and tools while maintaining FDA regulations.

Engaging the Public – A Priority for Health Care Reformers Who Want to “Bend the Curve”

Thu, 11 Jun 2009 11:01:46 -0500

Washington is buzzing about a recent article in The New Yorker that lays at least part of the blame for increasing health care costs on the overuse of tests, surgeries and other diagnostics without regard to whether those procedures bring us better care. Even President Obama is said to have read it. The article has energized the debate about what’s called comparative effectiveness. In short, that’s using additional research methods and/or money to target care where it’s most effective. It’s controversial because some fear it could be used mainly as a means to use costs as a reason to deny coverage. Getting into that debate requires too much space for this blog. But what is clear is how often policymakers who want the health care system to do a better job delivering quality care are already thinking about how to engage with the people who matter most: patients. That was obvious on Tuesday at a session at the Brookings Institution, where several speakers mentioned the need for patient engagement at its most personal level. Leading that emphasis was Carolyn Clancy, the physician who runs perhaps the most important obscure agency in health care, the Agency for Healthcare Research and Quality. Dr. Clancy’s agency could be given increased authority under some plans for comparative effectiveness. “We have to engage the patient,” for that policy to be effective, she said. (AHRQ has a website to help providers talk to patients about improving quality: http://www.talkingquality.gov/). “We must meaningfully engage every stakeholder,” added Dr. Sean Tunis, a former chief medical officer at the Centers for Medicare & Medicaid Services. And the AARP’s John Rother said implementing new regimes that link research with medical treatment must make sure they are relevant for “people like me.” What does that sound like to you? Almost like it’s lifted out of the New Rules of Health Engagement. Especially rule #8 – be personal. Washington likes to use trendy phrases like “bending the curve,” when talking about slowing health care costs. But those involved in the health business – and maybe an increasing number of regulators and policymakers – understand that it’s probably more important to talk directly to consumers about what matters most to them, and to do it frequently. The long-term success of any health care reform effort, before and after President Obama signs legislation, could depend on it.

The Latest from Pew on Health and the Internet

Thu, 11 Jun 2009 10:06:21 -0500

The Pew Internet & American Life Project released a new report today on “The Social Life of Health Information" in conjunction with the California HealthCare Foundation. Many of the findings support previous research, but this report focuses more on Americans use of social media content for health information and highlights shifts from previous studies. For example, in 2000, 46% of American adults had access to the internet, 5% of U.S. households had broadband connections, and 25% of American adults looked online for health information. Now, 75% of American adults go online, 57% of American households have broadband connections, and 61% of adults look online for health information. Further, many adults now have wireless access to the internet. Asked to assess the quality of their online health experiences, 60% of e-patients (42% of all adults) say they or someone they know has been helped by following medical advice or health information found on the internet. This represents a significant increase from a 2006 Pew report that found 31% of e-patients (25% of all adults) said that. Just 3% of e-patients say they or someone they know has been harmed by following medical advice or health information found on the internet, a number that has remained stable since 2006. The biggest topic on the rise include fitness, which jumped from 21% in 2002 to 38% in 2008 – an 88% growth, a more rapid increase than any other health topic covered in the survey. Other topics seeing growth included • A specific disease or medical problem (49% of adults, up from 36%) • A medical treatment or procedure (41% of adults, up from 27%) • Prescription or over-the-counter drugs (33% of adults, up from 19%) • Alternative treatments or medicines (26% of adults, up from 16%) • Depression, anxiety, stress or mental health issues (21% of adults, up from 12%) • Experimental treatments or medicines (15% of adults, up from 10%) Download the full report.

Washington Post's new Health Care Forum

Wed, 10 Jun 2009 15:59:57 -0500

The Washington Post has created a forum dedicated to the health care reform debate that is consuming our nation's capital. Health Care Rx will pose weekly questions to its expert panel, spanning CEOs, academics, practicing physicians, former policymakers and patients. Hosted by Ceci Connolly, the forum hopes to provide "real-world insights into how to improve health care" and invites readers to join in the conversation and add your own suggestions.

FDA Launches a Blog on Transparency

Fri, 05 Jun 2009 18:00:27 -0500

The FDA has definitely taken strides to become more transparent, as President Obama has asked. In addition to the public meeting of the Transparency Task Force on June 24th, they have launched a new blog, FDA Transparency Blog. They plan on posting questions in the weeks leading up to the public meeting, and while comments are moderated, they have posted comments that have been critical of their practices to date.

Pharma on Facebook?

Mon, 18 May 2009 13:19:43 -0500

~~The blog of UK-based publication~~ John Mack's Pharma Marketing Blog ~~News~~ this week led with the headline “65% of psychiatrists say “no” to pharma on Facebook!”. The blog highlights an online survey conducted by Psychiatric Times revealing that the majority of psychiatrists believe that pharmaceutical companies should not be allowed to join social networking sites, such as Facebook, to promote their products. On the face of it this may seem like a forthright rejection of the industry’s involvement in social media, but as Pharma Marketing News rightly points out, the key wording in the question comes right at the end – ‘to promote their products’. It is unlikely that the majority of people who engage in social media would want it to be used for the overt promotion of anything. The only surprise in the statistic is that the 65% is so low. Social media is about meaningful engagement between individuals connecting because of a common purpose or shared interest (whether that is a TV show, a local restaurant, a health condition, or simply friendship). If social media allows individuals such as patients with a certain health condition or physicians with a special interest in treating that condition to interact with some of the partners involved in the management approaches of it (including the pharmaceutical industry) then why not? Pharma Marketing News has taken the initiative to follow up the question with a more in-depth survey of people’s attitudes to how the industry should engage with social media. The results of this should prove to be quite insightful.

Cheerios Gets Warning Letter from the FDA

Tue, 12 May 2009 17:14:17 -0500

Did you hear that General Mills got a warning letter from the FDA? Cheerios has been promoting its health benefits -- specifically its ability to reduce cholesterol -- in packaging, TV and print advertisements for the past two years. Although they have clinical data to back it up, the FDA says they can't make those claims without applying for a new drug approval. From pharma's view, consumer packaged goods marketers have been often looked as innovators with their use of marketing practices, especially the use of the online medium. I've worked in an agency where some of us were pharma-focused and some were CPG-focused. I often got teased by my CPG colleagues that the pharma side wasn't as creative, and it's true that pharma communications must follow strict guidelines from the FDA [that were originally created for print and broadcast and have never been adapted for the online medium]. But now, with the recent FDA warning letter about Cheerios' claims, it looks like CPG is being told, "if you want to play in our sandbox, you have to play by our rules." I must admit I'm a bit surprised by the warning letter. While I recognize that claims by products we consume should be truthful, it seems that this is a bit over-the-top. If this is truly a concern -- that Cheerios is misleading the American public by making these claims -- then why did it take two years for the FDA to issue a warning letter? And with pharma, warning letters are a concern for the companies that receive them because they may prompt class action lawsuits. Although our society is pretty litigious, will anyone go after Cheerios for this? What do you think?