The Age of Influence

In November 2009, FDA held a public hearing to field questions, comments, and concerns from key stakeholders regarding guidance on FDA-regulated medical products including prescription drugs for both humans and animals, prescription biologics, and medical devices. The pharma industry, health care professionals (HCPs), consumers, patient groups, internet vendors, advertising agencies, and others participated to address the use of the internet and social media. With moveable goalposts established¹ and the landscape constantly evolving and innovating, the rulebook was always meant to be a work in progress.

Years later, the prevalent theme running through most of 2020 and 2021 was the acceleration of digital and virtual through the pressure and physical isolation brought on by the COVID-19 pandemic. In March 2020, people began almost entirely interacting virtually, spending a vast amount of time on all of their devices. Despite being a highly regulated industry that invests a staggering amount of money on research and development, total pharma advertising spending topped $6.58 billion in 2020, according to Kantar measured media. And while TV advertising spend is still king, digital ad spending grew 43%, mostly at the expense of out-of-home and print.

When COVID first took root in public perception in March 2020, Google was receiving 1 billion health-related searches per day, or 70,000 searches per minute,² an incredible search engine marketing (SEM) opportunity, which is no secret. SEM makes up the lion’s share of pharma’s digital spend because of its inherent ability to provide timely relevance to the curious and empowered patients/consumers, as well as HCPs and other stakeholders. That said, social media is an extension of this thirst for answers and discussion, a fertile digital landscape featuring all of the players and stakeholders: digital opinion leaders (DOLs), micro and mega influencers, patients, and perhaps the most important of all, the HCPs.

Informing strategy

In 2014, a survey of more than 4,000 physicians conducted by the social media site QuantiaMD found that more than 90% of physicians use some form of social media. This number has most certainly risen in terms of professional usage with most physicians consuming media on their phones; it’s much more convenient, as you can search or interact on a break or during downtime anywhere. If you visit Twitter today and search out a specific disease state, you’ll find HCPs with a variety of specialties having scientific exchanges with other HCPs as well as conversations with patients/customers and other users.

HCPs also use Facebook and Twitter to observe and accumulate valuable patient insights. They want to see what their patients care about, and how to prepare for the questions and manage interactions to deliver better outcomes. Going up the ladder, insights from HCPs’ social conversations inform a pharma company’s marketing strategy; more specifically, how exactly to provide value both in terms of content and when to reach out to them. Sales teams need any advantage to capture HCPs’ attention in hopes of getting them to adopt a given product, become a vocal proponent, or at the very least, win another interaction with the HCP. With the bulk of pharma salesforce interactions shifting to digital, relevant and timely communications to these HCPs cannot be overstated.

So where will the conversation be in 2022? Where should pharma companies be looking to help inform their sales and marketing strategy? Pharmaceutical Executive reached out to Vanessa Melendez, social strategist at CDM Princeton, for some insight. “In 2021, HCPs shifted from simple behaviors like sharing which type of notable conference experiences was their favorite to holding debriefing sessions by Tweeting followers and inviting them to join conversations on social platforms like Clubhouse,” she says. “And these conversations were not scripted KOL/DOL conversations; they were unprompted. I expect to see something similar in 2022, but the big question will be Clubhouse vs. Twitter Spaces, further growth in podcasts, or something else entirely. What’s clear is that we’re likely looking at no-frills, authentic conversations.” Some of the newer tools, audio-driven Clubhouse and Twitter Spaces, are still in an experimental phase for many people. The mediums facilitate real-time audio rooms that enable both passive listening and active engagement from the audience. They provide a much-needed break from video, while offering the satisfaction of podcast/radio, a Twitter-like character, and the feeling of congress all in one. But the goal is one and the same for pharma stakeholders: authentic conversation.

Influencer marketing and authenticity

This past year, there has been buzz around the word authenticity and how it relates to the success of a brand. In our September issue, Pharm Exec wrote about Biohaven’s Nurtec® ODT. Biohaven took a multifaceted approach—it used an unknown, but relatable and trustworthy college-aged everywoman named Ellie as its patient advocate, but also enlisted mega-influencers like Khloe Kardashian and Whoopi Goldberg to offer peer-to-peer advice and representation. With 204 million Instagram followers, Kardashian’s reach and influence is apparent, but even in her case, there’s a stamp of authenticity—her issues with migraine were well-documented on Keeping Up With the Kardashians. She tried Nurtec® ODT, had a robust response, and became an evangelist for the medication. Vlad Coric, CEO of Biohaven, told Pharm Exec, “It’s the patient story. We’re dedicated to following the patient’s story and telling it in a genuine way. That’s what we’re about.” And the results speak for themselves—according to Biohaven’s latest update, Nurtec® ODT has a 57% share of the oral calcitonin gene-related peptide (CGRP) market in the US versus top competitor Ubrelvy’s 43% share. While there are certainly rules (and pitfalls) to using influencers on social media, it can be an incredibly effective tool. And it all really comes back to relevance. If it isn’t authentic or “genuine” as Coric stated, it’s safe to say it’s not relevant to the vast majority of consumers.

Telling your story—15 seconds or 30 minutes?

Even in such a heavily regulated environment, there are still ways to tell a story—via unbranded campaigns and communications. Much like influencer marketing, the goal is to garner attention and educate people on a particular disease state or therapeutic process, remove stigma if present, and get them to take action—investigate further, reach out to a hotline in the case of suicide/depression, go to a doctor, ask for a certain drug, etc. During the past year, we’ve seen some wonderful examples of approaches, both long and short form. No more than two minutes has been the rule of thumb for video for a long time, but various lengths are hitting home, from 15 seconds all the way up to 45 minutes. Even the platforms have been adjusting their lengths to try to find the sweet spot. CDM Princeton’s Melendez states, “As a content creator, you’re looking to appeal to a particular audience with certain expectations. Who do you want to see it? Look at where your target audience spends time. With patients and caregivers, talk about the disease state and make it be more relatable depending on where you want to use that content. ‘Now This’ has had incredible success on TikTok taking longer form pieces and crafting entertaining points in the one- to three-minute range.” Tailoring the length and style of your content for different platforms is a great strategy to employ, especially if you’ve filmed a significant amount on a particular topic. People use TikTok for short, informal entertainment and information, not overproduced video.

On the other end of the spectrum, clocking in at 30 to 45 minutes, were long-form, polished videos created by Johnson & Johnson called “The Road to a Vaccine” and “Eureka Moments.” These productions, posted on YouTube and LinkedIn, impressively pulled together several experts and stakeholders to tell a much-needed story about health to a concerned population. People genuinely addressing people to illuminate important health topics, processes, and key moments proved to be very effective and was praised for its impact.

Moving forward into 2022, the collective hope is that we emerge from the COVID pandemic to find a much improved “normal,” and it will be interesting to see if digital trends will be embraced, further evolve, or find their way back to a supporting role.

Fran Pollaro is a Senior Editor for Pharm Exec. He can be reached at
fpollaro@mjhlifesciences.com.

References

1. https://www.fda.gov/about-fda/center-drug-evaluation-and-research-cder/industry-using-social-media
2. https://www.telegraph.co.uk/technology/2019/03/10/google-sifting-one-billion-health-questions-day/