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REPORT ON PATIENT-CENTERED MARKETING: Expect new rules and guidelines as regulators recognize impact of strategy • 4
INNOVATION REVIEWS: Is it ethnographic research, or just getting a cultural perspective? • 8

Healthcare
The future
MY TURN: Leave decisions regarding choice of therapies to doctors and their patients • 14

likely more
• June 30, 2009 • • www.pharmacongress.info

receptive to
10 digital marketing ideas pharma
Marketing

private sector
companies will never try (but should)  IMS exec says long-
standing ideological

I
 Pharma blogger challenges industry to put a clamp on all the talk, and jump in
Publications Mail Agreement No. 40016917

barriers coming down

G
This blog post seemed to capture a sense of the FIGURE THIS ARTICLE IS THE ONE that’ll the time. So, in an effort to move the
By Ian J.S. Moore
frustration many marketers are experiencing as get the most comments ever. It’s going debate along to something different, I of THE CHRONICLE OF HEALTHCARE MARKETING
pharma slowly adapts to new methods of inter- to be the one that probably outrages decided to come up with a list of 10 other
acting with their customers—doctors and you the most or makes you think that I’ve digital marketing initiatives that pharma OVERNMENT EFFORTS TO CON-

patients. The post is reprinted here with permis- completely lost it (which perhaps I have). companies could try that make basic social strain and control annual
sion, and we suspect you’re going to have a lot to Here’s why I’m writing this. I’ve got- media programs look like child’s play. increases in healthcare costs—
say about Richman’s view. Send us an email at ten really tired of all the discussion about I’m fairly sure that no company is and the debate on how to accomplish a
social media in pharma and healthcare. ready to take these on, but they should sustainable system—will transform
health@chronicle.org
I’ve grown bored with all the debates on start getting ready. Some of these just Canadian healthcare in the years ahead
By Jonathan Richman why these industries should use social might be the next big marketing channel and will likely result in making the sys-
Special to THE CHRONICLE OF media, and this is despite the fact that I or idea that’ll vault some company ahead tem more receptive to the private sec-
HEALTHCARE MARKETING find myself writing and talking about it all Turn to 10 ideas, page 9 tor, says an official with IMS Health.
“The long-standing ideological
barriers between the two sectors are
Dollars for diabetes coming down,” John Pye, editor of
Members of the Juvenile Diabetes Research Foundation Canada (JDRF) opened the TSX on June 12 to salute the 21st Health Edition and principal author of
the report PharmaFocus 2013 told a
annual Toronto Ride for Diabetes Research campaign. The 2009 ride takes place on Sept. 25 at Nathan Phillips Square, where
recent update meeting for the compa-
1,500 corporate teams will help the JDRF reach their goal of raising $2.5-million in Toronto. (CNW Group/TSX Group)
ny’s clients in Toronto.
“This creates tremendous oppor-
© MMIX, All rights reserved. Chronicle I/R Ltd.

tunities for the pharmaceutical industry


to develop closer relationships with
governments and management.”
The current worldwide economic
tumble is going to leave an indelible
mark on our governments and how
they manage healthcare, he said.
“Canada is in the top tier in terms
Turn to Private sector, page 10

Take your brand to new heights with North America’s Health & Lifestyle Agency. Call Kevin Brady at 416-960-3830.

Toronto Montreal Vancouver New York San Francisco www.andersonddb.com


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The Chronicle of Healthcare Marketing June 30, 2009 · 3

Can you blame them? HOFFMANN-LA not-quite bestselling book by former


ROCHE doesn’t want to be a drug Pfizer detailer Jamie Reidy, entitled
Out there
company anymore. The Swiss drug-
What’s happening in drug marketing “Hard Sell: The Evolution of a Viagra
maker, which earlier this year fully Salesman”? Actually, we’d forgotten it,
NOCs of Note: acquired its biotech subsidiary Genentech, says it will leave the US too, until we learned A-list actors Jake Gyllenhaal and Anne Hathaway
June 2009 drugmakers’ lobby, PhRMA, and will affiliate with the Biotech have been signed to star in the film version, set to begin lensing any
Industry Organization. The Star-Ledger newspaper of New Jersey day now, as they say in *Variety.* Both appeared in the Oscar-winning
Significant TPP approvals reports Roche boss Severin Schwan turned down a personal appeal horse opera “Brokeback Mountain.” Reidy’s original title was deemed
of Rxs for human use from AstraZeneca kingpin David Brennan, this year’s PhRMA chair, a bit too stiff for cineplex marquees, so the movie will be called “Love
to remain in the drugmakers’ group. Concurrently, Roche’s UK unit and Other Drugs.” That’s okay with the author, whose real ambition,
Anti-Diabetic Agent / Insulin won’t be renewing its membership in the Association of the British like all reps everywhere, is to direct.
Resistance Reducing Agent 05-20 Pharmaceutical Industry, reports London`s Financial Times. The com-
New data adds further evidence to the theory that drug reps are a dis-
Pioglitazone (supplied as pany had been suspended from ABPI last year following charges of
appearing life-form. SK&A, a California-based consultancy, finds
pioglitazone hydrochloride) improper marketing practices on obesity Rx orlistat (Xenical.) 
(Actos, Takeda access to physician offices is rapidly becoming scarce. Between June
Roche announced it would withdraw systemic acne Tx isotretinoin
Pharmaceuticals North 2008 and the end of last year, the percentage of US doctors who insist
(Accutane) from the US market, citing generic competition. And, per-
America Inc.) Comments: on reps having a pre-arranged appointment rose to 38.5 per cent, from
haps there might have been another factor. “In addition,” the compa-
Manufacturer name change; 31.4 per cent. During the same six-month period the percentage of
ny added, in a statement, “Roche has been faced with high costs from
TAB(15mg, 30mg, 45mg)ORL “no see” practices increased to 23.6 per cent, from 22.3 per cent.
personal-injury lawsuits that the company continues to defend vigor-
SK&A’s Physician Access survey was based on telephone interviews
H+, K+-ATPase Inhibitor 06-03 ously.” Roche faces 5,000 outstanding claims pertaining to the Rx,
Lansoprazole (Apo- with 227,000 medical practices. The consultants say their survey
which went off-patent stateside seven years ago.
Lansoprazole, Apotex Inc.) response rate was 94 per cent. There is some regional disparity in the
Comments: CDR(15mg, First, no Accutane. Now, NO TCHOTCHKES. This is shaping up as the findings. Doctors in the southern states are more receptive to drop-
30mg)ORL worst meeting ever for dermatologists attending the summer American ins, and those in the west are less welcoming.
Academy of Dermatology chinwag in Boston. The confab’s venue is
Non-Peptidic Protease One question concerning DTC ADVERTISING that has never been
the Hynes Convention Center in Boston—where new laws pertaining
Inhibitor 06-03 definitively answered is: Does it work? New research from the
Tipranavir (Aptivus, to Rx marketing are set to come in on July 1. Henceforth,
University of North Carolina, which examined the effect on promo-
Boehringer Ingelheim (Canada) Massachusetts will say “nyet” to common promotional items such as
tion of IBS Tx tegaserod (Zelnorm, Novartis), provides the incom-
Limited) Comments: Update logo-bearing pens and coffee mugs, and the state will also protect its
plete answer of We`re not sure.` The US unit of Novartis invested US
to the Product Monograph - physicians from hospitality offered by drugmakers at congresses and
$127 million promoting Zelnorm to MDs, and US$122 million in
addition of 48/96 week data; symposia. Drug reps will still be able to provide meals in a doctor’s
DTC. A spike in doctor-visits followed, with an additional 1 million
CAP(250mg)ORL office.
new patients turning up with IBS symptoms, within three months of
Beta-Adrenergic Receptor DRUG REPS are so last-century, but drugmakers can’t seem to get the campaign. Four-hundred thousand new IBS diagnoses were
Blocking Agent 06-03 enough MSLs. PharmaForce International says the number of made. However, the effect of the promotion was short-lived,
Atenolol (Atenolol, Pro Doc Medical Science Liaisons employed by 12 stateside Big Pharma and levels quickly returned to normal. Researcher Dr. Spencer
Ltée) Comments: New manu-
companies grew to nearly 2,000 last year, a 48 per cent increase Dorn says he concludes most of the new diagnoses were
facturer and product name;
TAB(25mg)ORL
in just five years. Between 2006 and 2008, however, the US drug- attributable to the heavy promotion to professionals. In the
biz was sending pink-slips to 16,000 bag-carriers, shrinking the end, none of it mattered all that much:
Antiretroviral Agent 05-20 industry field force by 15 per cent.  Just when drug reps seem Zelnorm was withdrawn from the US mar-
Emtricitabine (Emtriva, Gilead to be entering the endangered species list, here comes ket in March 2007, following reports of
Sciences Canada Inc.) Hollywood to makes things worse. Remember the side-effects.
Turn to NOCs page 12
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Patient-c
centered marketing
4 · June 30, 2009 The Chronicle of Healthcare
Marketing

I
N AN ENVIRONMENT its newer agents, the marketing emphasis is
where diabetics can now on recruiting physicians, nurses, pharma-
cists and other healthcare pros to help
use their iPods to get enrol this newest patient in a program pro-
information about their claiming the health benefits of adherence.

disease, where US phar-


When it comes to devising a cam-
paign, Cran believes a mix of media is the
mas are now owners and oper- preferable strategy. “Patients do still like
ators of web sites and social getting things sent to their home,” he says
of direct mail. “When they see the enve-
media outlets devoted to dis- lope with the program name, they open
ease states, and Schedule D them.”
products (vaccines, biologics) “But we’re also finding that older
folks are just as web savvy as others. The
in Canada are routinely circum- benefit of the web is that it is much more
venting the PAAB approval cost-effective.”
process, new rules and regula- FOCUS MUST BE ON THE PATIENTS

tions governing patient-cen- More competition from rivals and heavier


pressure from payers looking to restrict
tered marketing (a.k.a. CRM or access to medications are two principal rea-
customer relationship mar- sons for pharmas shifting their marketing

keting to some) are inevitable. Adh


Ad h er
ere
Adherence e nc
nce
n ce
focus from the healthcare professional to
patients, says Don Swainson, managing
The US FDA has already scolded US
rremains
emai
em
e ma
mai ain
aiin s partner at Cameron Stewart Integrated
Strategy, Mississauga, Ont.
m ain
ai n ffocu
ocus
ocu us
pharmas for their search advertisements on
Google and Yahoo, and, prompted by main foc
focus “The patients are core, and should be

of
of m mos
moost
os
o st
most
complaints from the public, Health Canada core to the thinking when companies are
is expected to issue a new advisory reiterat- designing programs and services instead of
ing its own regulations for direct-to-con-
sumer advertising early this summer.. pat
pa t i ent
patient-ent-
en t- concentrating so much on the representa-
tive-doctor dialogue.
“They’re not happy with the current cent
ce
cen nte
nt
n teered
ter
centered “And physicians themselves are saying

mar
ma r k et
marketingetin
etiin
ing
i ng
state of affairs,” Ray Chepesiuk, PAAB ‘We’re not seeing enough value from hav-
commissioner, reports. “It’s not the fact ing all their representatives bombard our

pro
pr o g rra
programs ams
ram
that the [Schedule D] ads are out there, it’s offices.’”
that they don’t have fair balance-risk infor- Will the shift from pro to patient
mation.” move market share? The answer is “yes”
The problem, according to the and “no” so far, according to Swainson. If
Commish, is that some pharma advertisers patient-centric marketing is defined as
take a second kick at the can by submitting attempts to find the most efficient channel
their DTCA efforts for Schedule D products to sales, the answer is affirmative. If efforts
to Advertising Standards Canada for the new media have multiplied so rapidly in them into the are defined as DTC advertising, the answer
approval, if they are turned down by the recent years, iPhone applications are now future.” is negative.
PAAB. available for diabetics to access informa- Adherence to “It’s still about your interaction with
“With DTC ads [advertisers] can go to tion on the symptoms, diagnosis, and care prescribed medica- the physician, but really centering your
ASC or they can come here,” he notes. of the disease, as easily as one looks for a tions is the main rea- promotional efforts on how to help the
C h e p e s iu k

“We told them to put fair balance in, so restaurant’s location and phone number. son for pharmas’ en- patient.”
they chose to go to ASC and ASC didn’t “You can even link your glucose mon- thusiasm for patient- Crucial to marketing success, he adds,
require fair balance. itor to the iPhone and track your glucose centric programs, ag- is the initial step of making it easier for the
“It’s a black eye on the industry. reading,” he reports. rees James Cran, physician to introduce a new medication to
They’re correcting ads—and there are “It’s changing so quickly and the founder and head the patient. Providing sophisticated ser-
more ads coming—and they don’t know dynamics are good. It’s an exciting new honcho at Antibody, vices oriented to the patient will help to
what the hell they’re doing over there.” frontier. The question is controlling it, so it Toronto, because add new patient starts as well as maintain
Chepesiuk believes Health Canada is doesn’t get out of hand.” most new medicat- adherence to scripts.
the original source of the problem, having Patient-centric marketing is getting ions take a long time M c E l w a in
One service option, he says, is
giving ASC permission to review and more promo dollars because pharmas are before they can gain Advanced Speech Recognition (ASR), soft-
approve DTCA campaigns a few years ago, disappointed with the results of their a listing on provincial ware programming, that uses pre-recorded
but failing to enforce their own Health direct-to-consumer advertising, according formularies and pri- professional voices in automated telephone
Canada regulations. to Mark McElwain, vee-pee, the Wellness vate carrier plans. calls to patients.
“It gives self-regulation a black eye,” Group at Allard-Johnson Communicat- “In the old days “When individuals are enrolled in the
he says. “And anybody knows that when ions, Toronto. if we got three program they have to agree to receive these
politicians start asking questions about “My general feeling has been that the patients and lost two, calls, which have a message that has been
self-regulation and the more often Health tide is running away from mass advertising we didn’t really care approved by the company and has gone
Canada has to intervene, they’re going to to consumers,” he says, referring to a because all the mar- through PAAB,” Swainson explains.
report of a substantial drop in DTCA phar- kets like hypertension, In one program, 82 per cent of
Cr an
write regulations like Bill C-51 and they’re
going to write more regulations.” ma advertising in the US last year. high cholesterol, and patients in a group which had been tele-
Kevin Brady, captain at Anderson “Mass spending on consumers may be erectile dysfunction phoned at two-month intervals about their
DDB Health and Lifestyle, Toronto, says less effective than trying to speak to were very new disor- treatment regimen with a statin were still
patients, people who have been prescribed ders and growing taking the medication after six months,
the medicine. They are open to different beyond belief.” compared to only 18 per cent of those who
This SPECIAL REPORT was compiled rules and regulations than consumers, and No surprise, had not been contacted via the ASR sys-
by Ian J.S. Moore, a frequent contribu- companies can say more to them, making then, that when a tem, Swainson said.
tor to THE CHRONICLE OF HEALTHCARE sure they take the meds correctly, which pharma gets a new
MARKETING increases the odds they will keep on taking patient using one of Turn to Adherence/compliance, page 6
Sw ai ns on
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g
e
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6 · June 30, 2009 The Chronicle of Healthcare Marketing

Picking 1 medium to encourage compliance is usually not a wise idea


continued from page 4 sion, ADHD, and plaque psoria- the potential negative effects of much on the caregiver as the going to be able to communicate
Chris McEvenue, partner at sis treated with a biologic agent. not maintaining therapy.” patient. to your patients, so all strategies
CPC Healthcare Communications, “There are many [disease] Measuring outcomes is should include everybody
SHOULD CREATE A RESPONSE
Toronto, notes a distinction be- categories where the outcome is essential to abandoning programs involved in the mix.”
“It needs to be approached with
tween marketing environments. confounded by poor adherence with poor results, because there is Smith agrees with others
a very good understanding of the
One is disease state awareness, an to therapy, and often it’s a matter no ‘one size fits all,’ he adds. that reliance on but one medium
condition and the reasons why
unbranded environment, which is of the patient not being aware of Some programs concentrate as is not good strategy.
you’ve not been successful so far
appealing to patients and is most “Pick-

colliding
in getting the outcomes in patient
beneficial to brand leaders because ing one
activity you wanted.”
opportunities for converting The world of the physician and the world “The world of the physician
medium is
unaware patients to a specific not usually a
and the world of the consumer
of the consumer are
product are greater. wise idea.
are colliding at light speed,” says
The second is the area where Physicians
Rick Smith, prexy of the health-

at light speed
follow-up is necessary to ensure want to be
care division at Torre, Lazure,
compliance or dosage administra- kept up to
McCann, Toronto. “Without
tion—as in cases of hyperten- speed on
ads for both, your client isn’t
M c Even ue
critical, new
information,
and people
are going to
look up
everything
from the
mildest
medical con-
dition, and
W h it e h e a d

they want
information
to describe
what’s going
on to a
physician.
“This
isn’t just
online, it’s B e rc o v i t z
in any com-
munication
form you
want to
make. It
should be
relevant,
and should
create a B o u r re
response.”
Paul
Whitehead,
the main
man at
Information
Display
Systems,
Toronto, is F o l le t t
another
media mixer.
“Any one medium can be
successful,” he says, “but the
more you can integrate them and
offer patients more options, the
better for everybody, patient,
physician and provider.”
His company concentrates
on point-of-care items such as
proprietary brochure display sys-
tems, a poster network and mag-
azines, such as the Canadian
Medical Association’s Canadian
Health Magazine, and more re-
cently narrow-cast television net-
work for doctors’ offices.
“If the patient is proactive
and wants information, there’s no
better place than the doctor’s
office for the mind set and the
credibility, the doctor being there.
Print materials are still effec-
tive contenders in the media mix,
he adds, referring to the firm’s
research showing brochures and
Turn to Patients, page 12
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The Chronicle of Healthcare Marketing June 30, 2009 · 7

Pharma needs to get a handle on social media


The new influencers

 Newspaper editor says implications of movement to social media will impact how businesses are organized
twenty-somethings, he added, as “You should have one of tal media and research, CTV- judging and results from other

P
By Ian J.S. Moore
of THE CHRONICLE OF the Obama election team demon- everything,” he advised. “Try and Rogers Olympic consortium, said competitions, as well as enabling
strated effectively when it intro- correct the information when about social media sites. “You viewers to create their own high-
HEALTHCARE MARKETING

HARMA AND JUST ABOUT duced the candidate’s Briefing someone’s got something wrong won’t automatically be in the Top light reels from various events.
every other business orga- Book, incorporating the views of and try and do it politely and in 10 online overnight.” The network also plans to
nization in the world today potential voters in policy decisions. context wherever the conversa- He outlined network plans to integrate user-generated content
function in an environment Individuals and groups tion is occurring. make extensive use of social media into site content, he added, and
where all media, including news- including business firms would do “The best way to understand in its preparations for and cover- intends to “wigidize” the content
papers, radio, and television, well to pay attention to social the social media is to become a age of the 2010 Olympics. CTV for broad distribution.
should be considered social media conversations and also par- part of it. So, dive in.” will “embrace” YouTube as a dis- “We use Twitter to track
media, and the implications are ticipate in the conversations “If you build it, they won’t tribution channel and encourage what people are saying about
profound in terms of how busi- through blogging, Twitter, RSS key necessarily come, unless you work user participation, allowing view- CTV Olympics,” Marcovici said,
ness is organized and operated, and other searches, he suggested. it,” Alon Marcovici, vee-pee digi- ers to comment on figure skating Turn to Social media, page 8
says a Toronto newspaper editor.
“I don’t think any media is
really the same anymore in any
way, any media that you look at,”
Mathew Ingram, communities
editor for The Globe and Mail
newspaper told a spring meeting
of the Ontario Pharmaceutical
Marketing Association.
“It’s effectively becoming
social, whether it wants to or not.”
According to Ingram, tradi-
tional media are viewed as a one-
way channel—much like a mega-
phone—but social media is a
crowd with every individual try-
ing to do something.
“Once you get past all the
goofy companies with the stupid
names and bizarre business mod-
"SFZPVMPPLJOHGPSJEFBTUP
els, it’s just people trying to con-
nect with other people who are
interested in the same things that
they’re interested in,” he said.
MBVODI HSPX PS FYUFOEUIF
Some sociologists have cate-
gorized this interest as ambient
awareness, or a network of weak
links. Interestingly, research has
MJGFDZDMFPGZPVSCSBOE 
shown these links are better than
strong ones for exposing an indi-
vidual to new ideas.
They’re also thrashing tradi-
tional media when it comes to
readers or site visitors. The New
York Times has a daily readership
of two million, and its web site
attracts another 650,000 so-called
visitors. But Facebook, the social
networking site, has more than
6.5 million visitors each day and
the numbers are growing at 100
per cent year over year. At last
count, Twitter was growing at
1,300 per cent year over year.
…QIBSNBDFVUJDBMFYQFSUJTFJOTJHIUT
STORM FORMS AROUND ISSUE
Blogs also have many readers, 350
…QBUJFOUDFOUSJDJOOPWBUJPO
million on a regular basis, accord-
ing to Ingram, and companies …ºIFBMUIDBSFUIJOLJOH
would do well to avoid being the
subject of a blog “storm” which
can form quickly around an issue.
“You don’t necessarily want
to find either yourself or your 'PS TUSBUFHJD TVQQPSU  JOOPWBUJWF UPPMT TVDI BT QBUJFOUPSJFOUFE EJHJUBM WPJDF
organization in the middle of one
of these storms, but it’s probably
SFJNCVSTFNFOUDBSEQSJOUNFEJBBMPOHXJUIDPNQMFUFQMBOOJOH NBSLFUBDDFTT
going to happen to some of you,” BOEUSBJOJOHTVQQPSUTFFPVSXFCTJUFPSFNBJMVTBUDNBSUJO!DTMJGFTDJFODFDPN
Ingram remarked, referring to
one storm launched by “Motrin
Moms” against a particular
McNeil consumer ad campaign.
XXXDTMJGFTDJFODFDPN
Social media are not the
exclusive domain of teenagers and
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8 · June 30, 2009 The Chronicle of Healthcare Marketing

Pharma needs to understand patient motivations


A review of innovations in pharmaceutical marketing

 A better understanding of this customer group may well lead the pharma marketer to more effective tactics
THE CHRONICLE OF HEALTHCARE and why people act in a certain way. In
MARKETING presents the second instalment in a essence it is gaining an understanding of
feature series intended to critically assess new cultural perspectives. In the healthcare set-
tools, technologies, and tactics available to the ting a group of patients with a particular
pharma marketer from a range of Canadian and “ . . . w h a t p e o p l e sa y disease may develop their own culture and
international suppliers. In this issue, Andrew hence behave differently than those with-
Senior looks at ethnographic research. does not always reflect out it. Finally the research method is
what they do, and we exploratory, and open. It is more useful at
have been basing
identifying issues rather than testing a

T
By Andrew Senior
Special to THE CHRONICLE
hypothesis. However, the nature of
OF HEALTHCARE MARKETING
d ec i s i o ns ethnography allows it to both learn and test
HE DYNAMIC FOR DECISION-MAKING
on as the research proceeds. (See .A Synthesis

what
in prescription drugs is changing with of Ethnographic Research, by Michael
power and influence shifting away Genzuk, PhD, of University of Southern
from physicians and toward other stake- they California, Center for Multilingual,

say.”
holders. Nurse practitioners, pharmacists, Multicultural Research.)
and naturopaths are being granted the rights GEARSHIFTING INC is one of the
to prescribe drugs. The various bodies first organizations to bring ethnographic
responsible for reimbursement are taking on understanding of their needs and motiva- patient compliance program has failed to research to the pharmaceutical industry.
stronger roles and patients are becoming tions. In the past we have gathered data and improve compliance. Patients said they The company, started by Mehbs Remtulla,
more knowledgeable and empowered. information though patient focus groups, “forget to take their meds”, so we sent them former CEO, EURO RSCG LIFE, helps
The pharmaceutical marketer is faced surveys, patient advocacy groups, and reminders, emails, or had telemarketers call clients develop innovative solutions to
with a new challenge. Not only does through physician feedback. Unfortunately, them. What has been missing are true everyday challenges. The starting point is
he/she need to differentiate and grow their these forms of research rarely yield great insights into patient behavior. A patient gaining insights through ethnographic
brand, they must do it in a marketplace of insights into patient needs and the motiva- with overactive bladder does not “forget” research and includes assembling a group
changing customers. tions behind their actions. The reason might their meds. They simply do not take them if of lateral thinkers (client, key stakeholders,
Historically, the prescriber was king, be that what people say does not always they are going to be at home where they can and even a few from outside the industry),
and the patient an afterthought. Now mar- reflect what they do, and we have been bas- quickly get to a washroom. On the other to turn those insights into innovative initia-
keters need to consider the patient more ing decisions on what they say. hand, if they know they are going to be out tives. To date, their work has involved
seriously, and to do that requires a good Perhaps this is why almost every in public, the fear of embarrassment moti- patients, physicians and even payers, in
vates them to take their medication. Canada, US, and Europe.
An innovative way to obtain patient For a European client developing a
insight is through ethnographic research. drug for diabetes the insights identified led
Historically it has been used to study edu- to a solution that may completely change
All you need, cation systems, consumer behavior, and
other areas where human behavior is
the way diabetes is treated. The concept
promises to offer more integrated and
important. Surprisingly it is just now mov- cohesive care than the current treatment
ing into pharmaceutical marketing. model provides, with improved patient
Ethnographic research (or ethnography) outcomes expected. Payers are on-board
relies heavily on observation, participation, with the promise of listing the drug if the
need it and interaction with the subject. Insights are model works. The ultimate outcome, based
developed by spending an extended period of on one insight gathered from ethnograph-
time—sometimes a day or two—with the ic research, could improve access to target
subject in their environment: home, social physicians, generate a readily available pool
life, the clinic setting, work, etc. The ethnog- of patients for clinical research, create a
rapher records observations and descrip- true industry-customer partnership, reduce
tions, and also finds out the motivations the time to formulary listing and provide a
behind the subject’s actions to better under- competitive listing advantage.
stand why they act in a certain way. Most understand that the role of
patients is changing and most would agree
OBSERVE BEHAVIOR IN NATURAL SETTING they have limited insights into the needs and
There are three principles to ethnographic motivations of patients. A better understand-
research which give it an advantage over tra- ing of this customer group may well lead
ditional market research in understanding pharma marketers to stronger positioning,
the nature of human behavior. First, behav- innovative strategies, and/or more effective
ior is observed in a natural setting. Any arti- tactics. If your brand requires patient-specif-
ficial setting such as interviews cannot pre- ic strategies or tactics, ethnographic research
cisely replicate what is done in this setting. could help you invest your promotional dol-
Second, the ethnographer learns how lars efficiently and effectively.

Social media: Fewer barriers improves commentary


—continued from page 7 “and we are struggling as many of you
may be in terms of how we react. How do we react with a human voice?”
The network is feeling its way in this digital universe, he admitted, and has several
other considerations to ponder. How should blogs and social conversations be monitored
and to what level? What if nobody builds content?
“We really are cognizant of not putting in too many barriers for people to comment,
because there are place they can go where there are no barriers,” he said.
“While no man is an island, every man is his own medium. Every one of you can be
out there and be as destructive or as productive as you want with your own brand.”
Social media offer pharma great opportunities to humanize the industry, according to
Natalie Bourré, prexy of Marketing 4 Health, Inc. of Richmond Hill, Ont.
“If we don’t get involved, we’re really missing out on an opportunity to learn about
our markets, to engage with our consumers,” she said. “And also to put discussions into
p.r.n. Publishing Inc. context, because patients are providing their own personal experiences and their own
prndata@healthconnect.ca personal contexts.”

   02.  s PRNONLINECA


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The Chronicle of Healthcare Marketing June 30, 2009 · 9

10 big ideas on digital marketing pharma will never try, but should
continued from page 1 to your site without going too patients? Oh, what’s that you my opinion) is Patients Like agers” to help fix your online
of everyone else. And I almost far. Not sure what Friend say, you don’t let people track Me (http://tiny.cc/0wqCp). reputation. Let’s be honest, no
forgot, it’s what your customers Connect is? There’s a video their prescription history and They feature an array of tools brand manager has time to
are demanding. from Google explaining it symptom improvement on that let you track your monitor what’s going on
(http://tiny.cc/h9wlD). your site? Hmmm. Nevermind progress, medications taken, online with their brand. They
Before I begin, know that I
5. Allow patients to share their this one. and side effects. What’s even can’t keep track of everything
understand the regulatory realities
history with Google Health (or 6. Add features to your site more important is that you can that’s happening and every-
of pharma and healthcare market-
Microsoft HealthVault). Yes, that allow patients to track compare yourself to others to thing people are saying (or can
ing. I lived them for 12 years. So,
more Google. I’m sure you their condition and compare see if you are doing better or they?)(http://tiny.cc/Ubzih).
I’m not suggesting anyone run
know about Google Health with others. If number five worse and see which treat- Nevermind the monitoring,
out and do exactly what I spell
(http://tiny.cc/8Sp1A), but did didn’t appeal because you ments seem to be working best how about actually responding
out here. I know it’s not that sim-
you know that you can become don’t have any tracking func- for the community. You’ve got to some of the comments?
ple. However, I offer these to
a partner and allow patients to tionality on your site, here’s to give people a reason to What about correcting the bla-
help stretch your thinking and to
export their prescription histo- your chance. The best in class come to your site and you do tantly inaccurate information?
challenge you to figure out a way
ry directly from your site into healthcare sites feature tools to this by adding value beyond It’s certainly your right to do
to do something that preserves their Google Health record? help people manage their dis- your product messages. this, but corporate policies
the spirit of the ideas here, but Why not make it easy for your ease. The best of the best (in 7. Hire five “community man-
doesn’t get you fired. If you need Turn to 10 big ideas, page 11
help, just give us a call. So, here
they are, in no particular order.
1. Create a game for the Wii
Fit that helps your patients
manage their disease and begin
a proper exercise and fitness
regimen. I just wrote about
this (http://tiny.cc/YjZhZ)
More details on why this is a
good idea in my post.
2. Get rid of your brand web-
site. No one is really visiting
your site anyway. It’s likely not
driving anyone to get a pre-
scription and it’s almost cer-
tainly not getting anyone to
stay on your treatment.
Instead, take all the money
you were going to spend on
your site and create great con-
tent that you syndicate out to
credible third-party sites. The
information can include
branded and unbranded infor-
mation, but it would now be
located where patients (and
doctors) are likely to find it
and pay attention. It’ll be on
the health sites they trust at a
time when they’re researching
their condition.
3. Add ratings and reviews to
your brand site. Don’t want
to get rid of your website?
Okay, how about adding rat-
ings and reviews to your site.
Every other industry has real-
ized that this is critical to
building trust with visitors
because it shows authenticity.
It turns out that simply having
reviews can increase traffic,
conversion rate, and average
order value (see more detail at
http://tiny.cc/NFn7x). In
addition, negative reviews
aren’t an issue so long as there
aren’t only negative reviews.
Your products are already
being reviewed on sites like
iGuard, so why not bring this
onto your site and build some
credibility with your patients?
4. Install Google Friend Con-
nect. Wonder who your real
friends are? Install this tool
and see. Visitors can join your
site, which in turn adds your
site to their Google profile as
one of their “friend” sites.
They can comment on the site
and quickly and easily share
your site with friends. A simple
way to add a little social media
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10 · June 30, 2009 The Chronicle of Healthcare Marketing

Private sector: Pharma can develop closer relationships with players


continued from page 1 grams, and health programs buy “add ons” as Alberta is doing better co-ordinate services to struction with the private sector
of how much of our collective accounted for 35.6 per cent, but in long-term care are other possi- improve business practices. playing an important role.
wealth we dedicate to health- this percentage will be affected bilities. “Shared service organiza- Home care, a proven cost-
care—eighth among 30 OECD by the expected drop in tax rev- “The other option is to allow tions are expanded and activity- efficient policy, is also expected
countries.” enues under the current econom- the private sector to provide based funding is being consid- to become prevalent, helped
Pye noted that healthcare ic conditions. more and ensure more services to ered and experimented with to along by new technologies like
spending is expected to amount “For healthcare, belt tighten- consumers who are willing to pay provide more equitable funding telemonitoring.
to 10.7 per cent of the country’s ing and creating new revenue for it.” for the distribution of money,” The aging physician popula-
GDP for 2008, with 30 per cent streams are the only options,” he said. tion and an influx of female
SHORTER HOURS FOR DOCS
of the total coming from private Pye said. Community care is another physicians (who now form a
Things are tight now and will
sources like insurance plans and Among the revenue options, area of healthcare that will under- majority of med students) are
become even tighter in the hospi-
household out-of-pocket he said, governments will have to go significant changes during the other factors that will affect the
tal sector, Pye predicted.
expenses. define core services in the public next five years, and “the pharma- national healthcare system in the
Governments are already working
After interest payments, system and introduce selective ceutical industry will have a years ahead, he noted.
to restructure their hospitals and
provincial and territorial govern- fees for service. A dedicated tremendous role to play,’ Pye New physicians are expected
manage costs, principally by limit-
ments spent $332-billion in 2007- health tax or healthcare savings predicted, noting that more long- to work shorter hours and have
ing budget increases. Regional
2008 on all their various pro- plan, or allowing consumers to term care facilities are under con- smaller case loads. Receptive to
health units are being revamped to
new technologies, they will use
innovative approaches in their
practices, which he predicted
would likely be within the team-
based care model.
Pye anticipates that pharma
policy will be redefined within
the next few years, as govern-
ments attempt to control rising
expenditures in this area, forecast
by the Canadian Institute for
Health Information (CIHI) to
have been slightly fewer that $30-
billion for medications last year.
Prescription drug sales accounted
for $25-billion of this total.
FEDS MOST CONCERNED WITH
SAFETY OF MEDS
Pye reported that sales of pre-
scription drugs have doubled
since 2001 and the annual
increase in spending has been
higher in this segment than the
increase in overall healthcare
spending each year since 1999.
“According to CIHI, 2008-
2009 is expected to be the first year
that the annual increase in provin-
cial/territorial drug spending was
in line with that of healthcare over-
all, 5.8 per cent for drugs and 5.9
per cent healthcare,” he said.
“It’s the same situation for
2009-2010 based on the current
budgets.”
The federal government is
determined to adhere to its core
responsibility—principally prod-
uct safety—and this is the reason
why nothing has been done con-
cerning the much-discussed pro-
gram called the National
Pharmaceuticals Strategy.
“This is why the feds have
invested in the drug safety and
effectiveness network to the tune
of some $31-million over four
years,” Pye said, “but there is no
movement from Ottawa to split
the cost of a $5-billion cata-
strophic drug plan as proposed
by the provinces.”
It is the provinces, he
noted, who are taking the policy
lead, particularly Ontario on
pricing and Alberta on its
Expensive Drugs for Rare
Diseases program. And all
provinces are moving to enact
legislation for income-based
drug plan coverage.
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The Chronicle of Healthcare Marketing June 30, 2009 · 11

10 big ideas on digital marketing pharma will never try, but should
continued from page 9 sound a bit Machiavellian on (http://tiny.cc/LWr54). Now, this as a pharma company? get even more useful content
make this impossible. How the surface, it’s for everyone’s that’s handy. Simple. Remember that most or tools from you.
about hiring someone (or a benefit. Consider that your 10. Implement OpenID on people don’t really trust you SO, WHO’S going to be first to
few someones) who are program probably has thou- your website wherever you that much. Giving visitors a implement any one of these? If
empowered to go online, sands of people in it that will require registration. way to engage with you that you know of a pharma or health-
search out this misinformation never change their behavior, (http://tiny.cc/5BV9C). doesn’t immediately require care company that’s doing any of
and correct it? They also can try the product, or be persis- Don’t know what OpenID is? them to give you personal these, I’d love to hear about it.
engage in discussions and help tent with it. They just won’t You will. It continues to grow information (yes, an email Also, if there’s anything I missed,
improve people’s overall per- respond to your program. as people have grown tired of address counts as personal) feel free to send a comment..
ception of you. You can give Don’t feel bad, they probably having a different user name probably will increase the
them a set (approved) script of wouldn’t respond to anything. and password on hundreds of chances that they actually do Jonathan Richman is director of busi-
things they can and can’t say to The problem with allowing different sites. Instead, they engage with you. As you build ness development for Bridge Worldwide,
guide where they get involved these people to enter and stay can now have a single, vali- trust over time and they real- an interactive and relationship market-
if you’re really worried about in your program is that in dated user name and pass- ize that what you are provid- ing agency based in Cincinnati (1-513-
the legal implications. order to allow this you have to word that gets them onto any ing is valuable, then they’ll 297-1060). He is the author of the
8. Create a portal allowing take money and resources site that supports OpenID. start to volunteer more per- healthcare industry blog, Dose of Digital
physicians to get every piece from those who actually Why should you care about sonal information in order to (http://www.doseofdigital.com).
of clinical information related would benefit from some-
to your product and its indica- thing. If you only allow access
tion in one place. Now, to those you know you can
wouldn’t that be useful? More help, then you can concentrate
and more doctors are using more resources on them,
the Internet to research condi- which will allow you to create
tions and medical challenges more robust support systems
(no duh?!?), but it’s still pretty and programs. You don’t have
hard to find everything you to completely forget the oth-
need and it involves a lot of ers if it makes you feel better,
fishing around. Sites like but you have to send them a
PubMed don’t offer a great very “lite” version of your
search interface (just compare program so you can focus
it to Google) making it hard to where you’re going to make an
find what you need. How impact. Don’t think it’s possi-
about instead automating ble to figure out which people
some searches and adding a you can and need to help? BMS is in the neighborhood
feed on your physician brand Merck does. They created
site that allows them to see the “‘The Adherence Estimator,’ Over 300 BMS employees across Canada took part in the 2nd annual Bristol-Myers
absolute latest clinical data an elegantly researched tool Squibb Canada Community Action Day by volunteering with various organizations. In Montreal,
about your disease state? for predicting which patients the organizations included Moisson Montreal, a food bank; Heritage Laurentien, an environmental
Technically speaking, this is a will display poor compli- protection organization; and the West Island Cancer Wellness Center. In the photo, from left to
pretty simple exercise, but will ance—by focusing on just right: BMS Canada employees Vicky Esposito, Jean Bellavance, Lucille Frappier (retiree), JoAnn
your regulatory team allow it? three core issues: commitment
Tarzi, Litsa Kouroumalis and her son, Michael-John Sakellaropoulos, Marie-France Miljours,
9. Kick people out of your CRM to treatment, concerns over
program. While that might therapy, and cost Philippe Toupin, and Margaret Jackson. (CNW Group/Bristol-Myers Squibb Canada)
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12 · June 30, 2009 The Chronicle of Healthcare Marketing

Patients getting more information on managing disease states, treatments


continued from page 6 eting 4 Health Inc., Richmond Hill, Ont., “The intelligence I’m getting from the Toronto, believes industry and agencies
posters are more popular than ever among confirms that older age groups are Internet US is that pharma is moving somewhat should temper their enthusiasm for newer
patients. users. more slowly with this [web site and social digital and electronic gadgets and the
Among the media options, the social Bourre is preparing a white paper on media] process than the public at large,” media they generate.
media offer pharmas some outstanding the use of social media in the industry says Debbie Locke, director of marketing During his last visit for a check-up he
opportunities, but many challenges, too, and notes that research by others has at IMS Health, Mississauga, Ont. “I think noticed his doctor still had a printed vol-
according to Kim Bercovitz, medical soci- shown that 51 per cent of those older that’s because they have to be so mindful ume of the CPS in his office
ologist and prexy of The Research Doctor than 60 are regularly online, and as many of what they can and cannot say on these “There’s a lot of noise around new
Inc. in Thornhill, Ont. as one in five have visited a social net- sites. applications such as the iPhone, but 2009 is
working site. “I had heard of the J&J site, not the year where iPhone applications are
INTERNET PROMPTS QUESTIONS
And for Canadian of all ages, looking (www.Childrenwithdiabetes.com) and going to replace direct mail,” he says.
“Patients don’t know one web site from
for medical and health information is the I’ve heard of the one AstraZeneca is “iPhone applications [downloads] have just
another and they also don’t know which
fourth most popular Internet information doing, (a branded YouTube channel for reached the one billion mark, but my take
web site is credible and which isn’t. And
activity: almost 70 per cent say they do Symbicort), but I think they’re approach- on the current situation is that the market-
they’re using the Internet to self-diagnose
occasionally, compared to 38 per cent who ing it as people sharing their experiences, ing mix now has a capital M, because it’s a
and to confirm or question the doctor’s
list job searches. and they’re keeping control over the con- true mix.”
conclusion about the illness.”
IMS figures for 2008 indicate the pro- tent. And the stress of creating a successful
She noted that a Pew Internet
motional spend of Canadian pharmas These sites, she notes, and any others marketing mélange is evident.
Project last year revealed that 59 per cent
dropped by 13 per cent last year, with that may be developed by US pharmas can “It’s not just ‘We’re going to do a DM
of newly diagnosed patients reported the
declines of 7.38 per cent in detailing costs be easily accessed by Canadians. drop, we’re going to get new detail aids in,
Internet prompted them to ask physicians
and 28.9 per cent in journal advertising. and we’re going to do a Slim Jim,’” Follett
new questions or to seek second opin-
There are no figures on how much CAN’T APPEAL TO EVERYBODY told THE CHRONICLE OF HEALTHCARE
ions.
Canadian or US pharmas allocated to web Neil Follett, founder and managing direc- MARKETING. “And you’re not going to do
Natalie Bourre, president of Mark-
sites or social media. tor of Brightworks Interactive Marketing, iPhone apps to appeal to everybody.”

Oral Anticoagulant 06-03


NOCs of Note: Acenocoumarol (Sintrom, Paladin Labs Inc.) Comments:

June 2009
Manufacturer name change; TAB(1mg, 4mg)ORL
Antibiotic 05-07
Significant TPP approvals of Rxs for human use Ceftriaxone (supplied as ceftriaxone sodium) (Stragen
—continued from page 3 Ceftriaxone, Stragen Inc.) Comments: PWSO(250mg/vial,
500mg/vial, 1g/vial, 2g/vial)IM, IV; PWSO(10g/vial)IV
Comments: Manufacturer name change; CAP(200mg)ORL Androgen 05-08
Testosterone undecanoate (pms-Testosterone, Selective Norepinephrine Reuptake Inhibitor for
Antipsychotic Agent 05-07
Pharmascience Inc.) Comments: Product name change; Attention- Deficit/Hyperactivity Disorder (ADHD) 05-25
Haloperidol (supplied as Haloperidol Decanoate)
CAP(40mg)ORL Atomoxetine (supplied as atomoxetine hydrochloride)
(Haloperidol Decanoate Injection, Hospira Healthcare
Corporation) Comments: Manufacturer name change; (Strattera, Eli Lilly Canada Inc.) Comments: Revision to
Opioid analgesic 05-22
LIQ(50mg/ml, 100mg/ml)IM Fentanyl (Ran-Fentanyl Mat, Ranbaxy Pharmaceuticals the Dosage and Administration section and other revisions
Canada Inc.) Comments: New formulation; to the Product Monograph; CAP(10mg, 18mg, 25mg, 40mg,
Antiviral Agent 05-20 60mg, 80mg, 100mg)ORL
PATCH[25mcg/hour (4.2mg/patch), 50mcg/hour (8.4mg/patch),
Adefovir Dipivoxil (Hepsera, Gilead Sciences Canada Inc.)
75mcg/hour (12.6mg/patch), 100mcg/hour (16.8mg/patch)]TRD Endothelin Receptor Antagonist 06-05
Comments: Manufacturer name change; TAB(10mg)ORL
Opioid Analgesic 06-03 Bosentan (supplied as bosentan monohydrate) (Tracleer,
Topical Corticosteroid with Antibacterial - Antifungal Actelion Pharmaceuticals LTD.) Comments: To extend
Fentanyl (Sandoz Fentanyl MTX Patch, Sandoz Canada
Agent 06-03 the currently approved indication to include the treatment
Inc.) Comments: PATCH(12mcg/h, 25mcg/h, 37mcg/h,
Flumethasone Pivalate / Clioquinol (Locacorten Vioform of pulmonary arterial hypertension in patients with WHO
50mcg/h, 75mcg/h, 100mcg/h)TRD
Eardrops, Paladin Labs Inc.) Comments: Manufacturer
functional class II; TAB(62.5mg, 125mg)ORL
name change; DPS(0.02%/1%)OT Antipsychotic Agent 06-04
Quetiapine (supplied as quetiapine fumarate) (Sandoz Antiretroviral Agent 05-20
Antimetabolite / Antirheumatic Agent 06-03
Quetiapine, Sandoz Canada Inc.) Comments: New indica- Emtricitabine / tenofovir disoproxil fumarate (Truvada,
Methotrexate (Methotrexate Injection BP, Accord
tion; TAB(25mg, 100mg, 200mg, 300mg)ORL Gilead Sciences Canada Inc.) Comments: Manufacturer
Healthcare Inc.) Comments: SOL(25mg/ml)IAR, IM, INT,
name change; TAB(200mg / 300mg)ORL
IV Calcimimetic Agent 06-05
Cinacalcet (supplied as cinacalcet hydrochloride) (Sensipar, Antiretroviral Agent 05-20
Prostaglandin 06-05
Amgen Canada Inc.) Comments: New Indications: For Tenofovir disoproxil fumarate (Viread, Gilead Sciences
Alprostadil (Muse, Paladin Labs Inc.) Comments:
the reduction of hypercalcemia in patients with parathyroid Canada Inc.) Comments: Manufacturer name change;
Manufacturer name change; SUP(125mcg, 250mcg, 500mcg,
carcinoma and for the reduction of clinically significant TAB(300mg)ORL
1000mcg)URH
hypercalcemia, as defined by relevant treatment guidelines.
Calcium Channel Blocking Agent 05-07 In patients with primary HPT for whom parathyroidecto- Human Growth Hormone 04-20
Nimodipine (Nimotop, Bayer Inc.) Comments: New my is not clinically appropriate or is contraindicated; Somatropin (Omnitrope, Sandoz Canada Inc.) Comments:
dosage form: 30 mg/tab; TAB(30mg)ORL TAB(30mg, 60mg, 90mg)ORL PWSO(5.8mg/vial)SC; SOL(5mg/cartridge, 10mg/cartridge)SC

Opioid Analgesic 05-07 Psychotropic Agent 05-27 Immunomodulator 06-08


Oxycodone hydrochloride (Oxycodone, Pro Doc Ltée) Quetiapine (supplied as quetiapine fumarate) (Seroquel XR, Interferon beta-1a (Rebif, EMD Serono Canada
Comments: New manufacturer and product name; AstraZeneca Canada Inc.) Comments: New indication: Incorporated) Comments: Updated Product Monograph;
TAB(5mg, 10mg, 20mg)ORL Major depressive disorder; TER(50mg, 150mg, 200mg, SOL(8.8mcg/0.2ml, 22mcg/0.5ml, 44mcg/0.5ml)SC
300mg, 400mg)ORL
Antibiotic 06-05 Cardioprotective Agent 05-28
Erythromycin (supplied as erythromycin ethylsuccinate) / Antiepileptic Agent 05-06 Dexrazoxane (Zinecard, Pfizer Canada Inc.) Comments:
sulfisoxazole (supplied as sulfisoxazole acetyl) (Pediazole, Gabapentin (Sig-Gabapentin, Sigmacon Lifesciences Inc.) New dosing regimen: The ZINECARD dose should be
Amdipharm Limited) Comments: Manufacturer name Comments: New manufacturer and product name; reduced by 50% in patients with creatinine clearance values
change; PSU(200mg/5ml / 600mg/5ml)ORL CAP(100mg, 300mg, 400mg)ORL < 40 ml/min. In patients with moderate to severe renal
dysfunction, the recommended dosage ratio of
ZINECARD: doxorubicin is 5:1; PWSO(250mg/vial,
500mg/vial)IV
Luteinizing Hormone / Releasing Hormone (LHRH)
Analog 05-22
Goserelin (supplied as goserelin acetate) (Zoladex, Zoladex
LA, AstraZeneca Canada Inc.) Comments: Update to the
Clinical Trials section and revisions to the Product
Monograph; IMP(3.6mg, 10.8mg)SC
Antineoplastic Agent for Bladder Instillation 06-01
Bacillus Calmette-Guerin (BCG) Strain TICE (OncoTICE,
Schering-Plough Canada Inc.) Comments: Manufacturer
name change; PWSO(800000000unit/vial)ITV
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The Chronicle of Healthcare Marketing June 30, 2009 · 13

Leave therapy decisions to patients and their MDs Up here


—continued from page 14 between the development of a What’s happening in the world of drug marketing
drug and the approval of its use
in Canada is left out of the equation. ISOTECHNIKA PHARMA, the Edmonton approval. Nuvo, once known as
LONG APPROVAL TIMES DEPRIVE EVERYONE Rx developer, named Jonathan Ross Dimethead Research, will receive an up-
The longer it takes for a new medication to be approved for use the more patients who Goodman as board chair. He is the front, non-refundable payment of US$10
might be helped by the drug must go without, even when people with identical condi- founder and prexy of Paladin Labs, the million, and may get a US$15 million
tions in other countries are being prescribed the drug and benefiting from it. Health Montreal specialty drugmaker. Iso and milestone payment on Pennsaid’s
Canada, recognizing this, is working on meeting a goal of approving or barring a drug Pal recently inked a joint venture to approval by US regulators, which will
within 300 days of its submission, or 180 days if the drug is considered a high priority. bring to market antipsoriatic Tx candi- increase to US$20 million if certain
Advocating for patient safety, a number of critics—including the CCPA—believe that date voclosporin. Goodman replaces labeling criteria are agreed to by the G-
faster approval will increase the number of patients who have serious reactions to new Donald Schurman, who ankled. Clemens men. Says Nuvo supremo Dan Chicoine:
drugs, resulting in injury or death. Kaiser, Iso’s chief marketing officer, also “[Mallinckrodt] is aggressively adding
But by stressing the number of fatal adverse drug reactions, the criticism misses the resigned.  Paladin picked a peck of resources to maximize the value of the
products currently marketed in Canada Pennsaid/Pennsaid Plus franchise and
wider issue. What too many critics of the pharmaceutical industry neglect to address is
by Wyeth, including warhorse OTC anal- pursue its strategy of becoming a global
that patients taking experimental or newly released drugs are usually suffering from dis-
gesics ASA (Anacin) and benzocaine presence in the treatment of pain.”
eases that greatly hamper their quality of life and can be fatal. All medications carry some
(Anbesol.) Financial terms were not dis-
risk, however small. They are prescribed because they also confer great benefits. Whether MERCK will ankle from its three-year-old
closed. Sales for the acquired brands
the risks for a particular patient outweigh the benefits is a difficult judgment that is dif- R&D and licensing agreements for pain
came to $4 million last year.
ferent in every case. It is precisely because this decision is so personal that it should be Tx candidates with Vancouver`s privately
left to patients and their doctors. Ontario added a once-monthly formula- held Neuromed, the companies announ-
In order to make the right decision, though, doctors must be equipped with up-to- tion of risedronate (Actonel) to the ced. Says Neuromed kingpin Christopher
date and accurate information about the side effects associated with any drug, and they province`s formulary, reports P&G Gallen: “The molecules generated in our
must share this information with their patients. In this respect, the CCPA paper is exact- PHARMACEUTICALS CANADA. Says collaboration, while effective in disease
P&G boss Andy McClenaghan: models, did not demonstrate the profile
ly right.
Osteoporosis affects almost two million needed to enter the next phase of testing,
One way to mitigate the risk is to follow the US example of imposing penalties—
Canadians. Treating osteoporosis`and including human clinical trials.``
through litigation—on manufacturers who don’t disclose the risks of their products. This
the related fractures costs our healthcare
dynamic is largely absent in Canada. The CANADIAN MEDICAL
system billions of dollars every year, not
The solution is not to ask the government to play a heavy-handed role and decide on ASSOCIATION tapped Paul-Emile
to mention the impact it can have on
behalf of patients and doctors what treatments should be available to Canadians. Nobody Cloutier as CEO and Secretary-
patients and their families.”
has as much on the line when choosing a treatment plan as patients themselves. The best General, effective next month.
way to ensure good outcomes combined with access to drugs is to make available as many NUVO RESEARCH, the He joined the CMA joined the
options as possible, coupled with current and comprehensive information about the risks, Mississauga, Ont. maker of CMA in 2002 and worked in
known and unknown, of each treatment. topical Txs, out-licensed its the advocacy, communications
NSAIDs, marketed as and public affairs offices.
It is time to change Health Canada’s focus from delaying access to drugs to boosting
Pennsaid and Pennsaid Barbara Drew, who has
access to information to help Canadians, with their doctors, make the best choices possi-
Plus, to Mallinckrodt. The been the association`s act-
ble about their medical care.
product is approved in ing secretary general and
Rebecca Walberg is director of health policy at the Frontier Center for Public Policy, Canada, but has endured CEO since October 2008,
based in Calgary long delays in gaining FDA announced her retirement.
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14 · June 30, 2009 The Chronicle of Healthcare Marketing

T
The Premier’s summer musical of his cabinet in key roles in this entertainment, and placed This rousing number brings down the curtain on
the spotlight on a deserved selection of talented behind-the- Act I.
O FIND ONE’S SELF IN ONTARIO DURING THE EARLY scenes personnel. Bravo, and take a bow, Mr. Premier! Act II begins with an ensemble of E-health Ontario
summer of 2009 is to be transported back to small Mr. McGuinty has cleverly revised the script to make consultants and contractors who form a barbershop quartet,
town Iowa in the year 1912. That was the place and it more meaningful to contemporary audiences, and, in a submitting invoices to the province for duties such as
time depicted by Broadway legend Meredith Willson in his minor adjustment, has transplanted the setting from small- munching on pastries during bull sessions, reading the news-
Tony award winning stage hit, The Music Man. town Iowa, to the Ontario Parliament. To make things paper, and chatting with each other on the telephone. Mayor
In Mr. Willson’s extravaganza, the townsfolk of River more topical, his crisis has nothing to do with a pool hall, McGuinty appears on stage momentarily to inquire about
City are at odds; to paraphrase the familiar lyrics of the but rather, with healthcare. what is taking place. “Oh, we’re busy creating electronic
show-tune, “They got trouble.” The municipal authorities, Indeed, he’s got trouble, right here, right here. His health health records,” the group exclaims. “Excellent! Carry on
led by Mayor George Shinn, are unable to contend with the minister, a Buddy Hackett lookalike whose mother got him then,” says the Mayor, as he confusedly strides off-stage.
threat to civic order represented by the opening of a new his job, can’t seem to deliver services to patients, and this The plot thickens, as some of the townsfolk seem to
pool hall. In their fear, incompetence, and lack of sophisti- minister’s idea of how to solve the crisis is to glue posters to cotton on to the idea that their mayor is being hornswag-
cation, they become prey to a travelling con-artist, Prof. the wall in the Buffalo, NY air terminal, inviting any physi- gled, or perhaps hoodwinked.
Harold Hill, who convinces the hick-town politicians that cians who may be passing through to relocate to Ontario.* “This is crazy. Why do we need to spend all this
the answer to all their problems lies in establishing a boys’ Personally taking on the role of the bumbling Mayor money, if all we need is electronic health records?”, cries a
band. The professor, of course, has an ulterior motive. He Shinn, Mr. McGuinty provides a convincing portrayal of a cast member. “There are dozens of suppliers who will pro-
intends to exploit the River Citians’ uninformed enthusi- sitting duck waiting for the arrival of the conniving Harold vide solutions for next to nothing! Why don`t we just ride
asm, by taking their money and delivering nothing. Hill character, who offers a solution to the healthcare cri- along with a successful existing program, join forces with
The whole world loves The Music Man: whether we’re sis. In this revised version of the musical, it isn’t a boys’ Google and the Cleveland Clinic, or Microsoft and the
discussing the original 1957 stage version, the 1962 screen band, but something even more preposterous: electronic Mayo Clinic, and spend the 25 million bucks on patient
adaptation, or the Broadway and UK revivals, which health records! care? Can’t you see that River City is being conned?”
occurred in 2000, and 2008, respectively. However, no one The political leaders, not understanding a thing about The community’s anxiety eventually penetrates Mayor
is as fond of the enduring musical as is Ontario Premier electronic health records, or much else, either, seize on the McGuinty’s fog of obliviousness, and he calls a town-hall
Dalton McGuinty. The Premier enjoys The Music Man so opportunity to be seen as doing something useful, and meeting in the high school gym, to determine what to do with
much that he has taken an extraordinary step toward fur- agree to set up a public agency to undertake the project, E-health Ontario. Wringing his hands, he asks, “Where’s the
ther popularizing the play throughout his province. which, in a moment of inspired comedy, they decide to call e-health records? Where’s the e-health records?”
As his personal contribution to the lively arts, Premier E-health Ontario. Ethel Merman, fearing that her ruse has been ex-
McGuinty has created, and performs in, his own updated Mr. McGuinty, employing grand theatrical gestures, posed, is about to be led away in handcuffs by the town
2009 version of The Music Man, in a summer stock produc- writes out a cheque on the provincial treasury for $25 mil- constable. Just then the cast convenes to perform the
tion for Ontario audiences. He has also cast several members lion, and hands it to the health minister, who in turn hands rousing closing number:
it with a flourish to Prof. Hill, represented by Twenty-three genomes led the big parade
an Ethel Merman lookalike who is the execu- With a hundred and ten DNA samples close at hand.
tive director of the agency. The characters cel- They were encoded on smart, smart cards
ebrate their achievement by singing the show- that were stacked in feet and yards
stopping “E-health Ontario” song, which is and contained your ev’ry DNA strand.
performed to the tune of “Gary, Indiana,”
from Willson’s original score. The lyrics have Twenty-three genomes on a plastic plate
June 30, 2009 • Published with Chronicle MONDAY and Chronicle MIDWEEK been revised as follows: With a hundred and ten molecular cures right behind
E-health Ontario! There were plenty of chromosomes
PUBLISHER What a wonderful name, Just like subdivision homes
Mitchell Shannon The ‘E’ stand for electronic; that’s our game. There were cytoplasms of ev’ry shape and kind.
E-health Ontario, all your health records on a
EDITORIAL DIRECTOR SALES & MARKETING
card, Encores abound. Theatrical critics across the province
R. Allan Ryan Henry Roberts
ASSISTANT EDITOR
Pork for all us insiders, so, come on, let’s spread can only agree that Dalton McGuinty owns the role of May-
PRODUCTION & CIRCULATION
Lynn Bradshaw Cathy Dusome the lard — or Shinn, and that, by offering this musical spectacle to the
COMPTROLLER E-health Ontario, E-health Ontario, E-health province’s taxpayers, he is the most successful impressario
Rose Arciero Ontario, the province has seen since Garth Drabinsky and Myron
Let me say it once again. Gottlieb—pending the result of Garth and Myron’s
Published seven times annually by the
E-health Ontario, E-health Ontario, E-health Supreme Court appeal, of course.
proprietor, Chronicle Information
Resources Ltd., from offices at 555 Ontario, Premier McGuinty’s version of The Music Man passes
Now let’s go out, and hire all our frien’s.
Burnhamthorpe Rd., Suite 306, Tor-
_________________________________ the ultimate test of any stage performance, which is that
onto, Ont. M9C 2Y3 Canada. Tele-
* (This part is absolutely true; no one except the health audiences are guaranteed to leave the theatre singing the hit
phone: 416.916.2476; Fax 416.352.6199. E-mail: health@chronicle.org
minister could possibly have made this poster idea up.) tune, “We got trouble.”
Contents © Chronicle Information Resources Ltd., 2009, except
where noted. All rights reserved worldwide. The Publisher prohibits
reproduction in any form, including print, broadcast, and electronic,
without written permission. Printed in Canada.
Subscriptions: $59.95 per year in Canada, $74.95 per year in all other

Leave decisions on therapies to doctors and their patients


countries. Combined rate including Chronicle MONDAY and Chronicle

W
MIDWEEK newsletters: $240 per year in Canada, $360 per year in all other
countries. Single copies: $7.95 per issue (plus 5% GST).
Canada Post Canadian Publications Mail Sales Product Agreement Number By Rebecca Walberg, Special to THE CHRONICLE OF HEALTHCARE MARKETING
40016917. Please forward all correspondence on circulation matters to:
Circulation Manager, The Chronicle of Healthcare Marketing, 555
HILE A STUDY RELEASED IN APRIL BY THE CANADIAN CENTRE FOR POLICY ALTERNATIVES (CCPA)
Burnhamthorpe Rd., Suite 306, Toronto, Ont. M9C 2Y3 Canada. E-mail: correctly identifies a number of administrative problems involved in drug monitoring, arguing that
circulation@chronicle.ca Canada allows new drugs onto the market too soon, its emphasis on the hazards associated with
ISSN 1209-0654 innovative drugs leads it to advocate for an unduly restrictive approach to pharmaceuticals.
CCPA’s conclusions are wrong because it forgot to include two stakeholders in their analysis: patients and
THE CHRONICLE OF HEALTHCARE MARKETING welcomes contributions from their doctors. Both safety and good medical outcomes are maximized if patients and their doctors have as
readers. In particular, we’d like to know what’s going on at your company, or organi- many treatments options as possible, as well as comprehensive information about the risks and benefits of all
zation, and you are especially welcome to keep us informed about new develop-
indicated drugs.
ments, new appointments, and new practices at your shop.
If you’re submitting an article, opinion piece, press release, or letter to the edi- Drug companies, of course, are not disinterested actors in pharmaceutical policy, since their income
tor for consideration, please bear in mind that we select material for publication depends upon consumption of their product. But governments are equally biased, since every province subsi-
from a large volume of submitted material, and that we may not be able to publish dizes out-patient prescriptions for those in need, and pays directly for drugs prescribed and administered in
your submission in a specific issue (or at all) due to space constraints and other con-
hospital.
siderations.
Our policies are: All material submitted to THE CHRONICLE becomes the prop- The stakeholders least biased and best positioned to make informed and appropriate decisions about
erty of Chronicle Information Resources Ltd., and is subject to the company’s usual when to use drugs and which ones to use are patients together with their doctors. Needless to say, it is
editorial procedures; We will not consider for publication any material that has been patients who stand to lose or gain the most when choosing a course of treatment. Patients are not well
simultaneously sent to other publications; Only original material or information will
be considered; Payment at our established freelance rates will be offered upon publi-
served by an adversarial relationship between those who develop and sell drugs and those who regulate
cation for feature articles and for the following departments: them.
What Lies Ahead: Original articles of approximately 500 to 700 words dealing with trends When a new drug is submitted to Health Canada for approval, its manufacturer must satisfy the govern-
that shape the healthcare industry; and ment that the drug is safe and effective. The interval between submission and approval is, on average, almost
My Turn: Opinion pieces of approximately 500 to 700 words, offering original commentary on
issues facing the healthcare industry. two years long in Canada. In the US, UK, and Sweden, it takes slightly over one year to accomplish the same
Please refer inquiries to: Editor, The Chronicle of Healthcare Marketing, thing. When investigators take longer to authorize the use of a drug, the possibility that dangerous side effects
555 Burnhamthorpe Rd., Suite 306, Toronto, Ont. M9C 2Y3 Canada. will be discovered before the drug hits the market increases.
Fax 416.352.6199, E-mail: health@chronicle.org
Too often, however, the downside of lengthy delays Turn to Leave decisions, page 13
*S
HCM_June_2009.qxd:HCM_June_2009_rar8 ms vers.qxd 7/2/09 1:49 PM Page 15

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