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Diagnosis: Potential
By: Staff
Issue: 2009apr
The new PhRMA code may be a tough pill to swallow, but pharmaceutical sales don't have to suffer—if you know where to look.
Promotional products have served as important tools within the medical community for several decades and have been used by pharmaceutical companies to advertise their new drugs, to ensure that physicians are aware of available medications and to help educate patients on prescriptions.
Now that this practice has come into question and new guidelines have been issued, our industry must evolve and change. Now is time for a new approach.
As it will become increasingly more difficult to offer standard logoed items such as mugs and pens to physicians, we must work with pharmaceutical companies to become better counselors, consultants and educators. Physicians maintain a serious, ongoing need for better tools to educate their patients and educate themselves. This is our opportunity to demonstrate how promotional products can help the pharmaceutical community do a better job of understanding physicians’ wants and needs.
To do this we need to develop stronger ties with physicians and other medical professionals. As professional marketers, how many of us have established successful relationships with physicians to understand what they want and need?
How do we, as a community of marketing professionals, help pharmaceutical companies audit and survey physicians regarding their needs in order to provide solutions that will help them focus more on quality of care and patient education?
Are there opportunities to work with pharmaceutical companies on physician surveys, polls and other forums for feedback that will enable promotional consultants to create solutions for physicians and their practices?
In addition to working with physicians, what other avenues should we be looking at to maximize opportunities within the medical community?
One of the most frequent questions we all try to answer is what works and what doesn’t. For these questions, unfortunately, there are no simple answers. So we asked.
Education Is Key
In interviews with several physicians from a variety of specialties including pediatric primary care, dentistry, ophthalmology, cardiology and dermatology, the pervasive theme was a greater need for support. Physicians are dealing with increased pressures stemming from tighter budgets, higher insurance costs, smaller offices, reduced medical staffs and packed patient schedules. We need to always think: What can we do for physicians that will help support them and their practices? In what small ways can we help relieve the pressures they are experiencing?
Physicians said, “It starts with information.”
New information, supported by clear, high-quality data, is imperative to build trust between physicians and pharmaceutical representatives. Physicians need credible and compelling information about new products and services if this information is to influence decision-direction for their patients. In order for promotional consultants to provide pharmaceutical representatives with the tools needed to offer that credible information, we must first understand that education is key.
Advertising at its core is about education--sharing accurate and compelling information to help individuals make the best, most informed decisions. In our conversations with physicians, most stated they were frustrated by pharmaceutical companies applying hard sales techniques for pushing their newest drugs. They stated that since their time is limited, they would welcome any platforms where they could be taught more about the variety of options available and receive the most accurate information about each option, provided the information is communicated in an efficient and effective manner.
To justify meeting with pharmaceutical representatives, physicians want them to add value to their day. Providing useful, relevant information and education is the best way to not only grab their attention, but also to stand out and earn their respect. In this environment, promotional consultants and pharmaceutical representatives need to be even smarter marketers and continuously demonstrate an expertise as it applies to physicians’ specialties.
Because promotional products are held to a higher standard than print or television advertisements, we should assume that as we continue to work with pharmaceutical companies it will be essential that our promotions capture information such as drug composition, therapeutic indications, contra-indications, effects, side effects and warnings.
The new code essentially focuses on eliminating reminder advertising—advertising intended to further name recognition of a medicine or drug. As a result, it will be increasingly difficult for promotional consultants who today use promotional products such as mugs, ballpoint pens and notepads to continue leveraging these products with physicians. Promotional consultants, therefore, have two paths they can take as they continue to sell into the pharmaceutical community.
Path 1: Diversify
Since many promotional products have limited space to imprint a message, we should look to other types of promotional products and mediums for sharing this information.
Path 2: Business As Usual
Since the code is voluntary, potential opportunities to use promotional products such as ballpoint pens and notepads as tools for education can still be explored. While the new modifications are likely to make it more difficult to use these tools with physicians, the option is still available.
Both options provide an avenue for the near and long term, but the more we adhere to the first path and apply products not limited by their physical real estate, the greater opportunity we have as an industry moving forward.
Diversifying
Since these new guidelines make it difficult to advertise on products that are limited by their size, physicians and PPAI anticipate pharmaceutical companies will incorporate more brochures, patient handouts, office posters and print or DVD presentations designed to clearly explain diseases, treatment options and management details.
Still, in our conversations with physicians, most believe there is a need that promotional products can meet that isn’t being met today. Our queries revealed that physicians are looking for tools they can use at all points of care: at the initial consultation, during tests or lab work, when the patient is sent home and as part of ongoing follow-up.
In today’s busy medical offices, physicians often fail to communicate all that a patient needs or wants to know. Physicians we spoke with admitted to forgetting to share important details with patients, e.g., illness, virus, condition, diagnosis. They also admitted to oftentimes forgetting to share the name of the medication they were prescribing.
For promotional consultants that market branded handouts including practice profiles, medication pamphlets and rebate coupons, a 2004 study by Salu Inc. demonstrated that 80 percent of physicians reported not providing relevant handouts to patients during appointments. And according to a paper authored by IMS Health, the majority of physicians felt their responsibility ended once the prescription was written.
Additionally, Dr. Duane Cady, former president of the AMA Foundation, has said that patients themselves forget most of what they are told within six minutes of leaving the physician’s office.
And what happens when the patient returns home with the prescription?
Data demonstrates that up to 20 percent of the time the prescription is never filled or picked up and more than 30 percent of patients disregard the medication instructions they were provided.
As promotional consultants, there are several ways we can aid physicians in providing this ongoing care and education to their patients.
Business As Usual
When asked about their knowledge of the new PhRMA code being implemented in January 2009, none of the physicians interviewed were familiar with the new recommendations. When we shared information regarding the code, none believed the notion that offering physicians promotional products somehow affected their drug-prescribing decisions.
Further, when asked if they had seen any changes in the amount or kinds of promotional products that were being given to their practice since PhRMA announced its intention to recommend this new code, none of the physicians who recently received promotional products could recall any changes. All physicians stated they are continuing to receive items that are not educational, which would suggest that pharmaceutical representatives are taking a business as usual approach. This further reinforces the fact that PhRMA’s code is voluntary.
Physicians who have received promotional products on a consistent, or somewhat consistent, basis could not recall a time where the product provided was educational in nature or when the pharmaceutical representatives, who typically interact with the office staff, ever asked how they could provide tools that would assist the physician in providing better care and education to patients.
While those asked agreed educational information would be beneficial to their practice, they also felt the role of patient education remained squarely in the lap of each practitioner and that the role of pharmaceutical companies and the promotional products industry is as a supplement to help keep physicians educated on the side effects, benefits and other details in order to provide the best ongoing care possible. Physicians are in a good position to educate their patients, but they need innovative new ways to ensure they are following up with patients, offering reminders and preventative tools. Pharmaceutical companies can also provide tools to educate physicians that will extend their knowledge and ultimately improve care for the patient.
What follows are a few examples and ideas we captured through our conversations with PPAI suppliers, distributors and multi-line representatives as well as physicians.
Educating The Patient
In one conversation, a dentist created a dental prevention game to help patients start a personalized prevention program for issues such as gum disease and cavities. The game was given to all patients during their first office visit and used at every appointment thereafter, serving as a constant reminder to patients and the physician. The dentist said the game has helped him educate while building strong, long-term relationships with his patients. He said that if a promotional products consultant could have created this game in tandem with a pharmaceutical company, it would have been a very beneficial tool for his dental practice and patients.
The dentist also said that he uses promotional products such as posters, billing inserts, postcards, counter cards and flyers to communicate with patients about new dental procedures, treatments and information about upcoming consultations.
Physicians also believe that items considered to be of nominal value by PhRMA can be adapted to serve as education tools for patients.
• For example, a pediatrician said notepads could be imprinted with the top five items a patient should know about a specific medication as a reminder to the physician and patient.
• An ophthalmologist stated a pen pre-loaded with scrolling directions on how to take a specific medication would be helpful to his practice.
• One primary care physician stated she could give patients mugs imprinted with human diagrams to show them how to perform specific self exams.
Educating The Physician
In a conversation we conducted with a dermatologist, the physician referred to a pre-recorded greeting card she received as a unique marketing tool that she had not seen until recently. She said it provided an innovative way for pharmaceutical representatives to reach a physician when in-person meetings weren’t possible.
She stated that the pharmaceutical representative composed a message focused on a new psoriasis drug and its benefits and then sent talking greeting cards to everyone in her practice. She felt this use of promotional products to market a new drug was an innovative way to share important information, capture attention and help her remember both the pharmaceutical representative and the medication itself.
Because these messages can be pre-recorded and pre-approved by legal or regulatory departments this is one example of how the promotional products industry can leverage new mediums to help pharmaceutical representatives better educate physicians and their patients.
New Tools For Educating Patients And Physicians
Physicians also noted that there was an opportunity for better education when pharmaceutical representatives visited them at their offices if they changed what information was provided. Because physicians receive information on new medications through pharmaceutical representatives who typically use flipcharts to demonstrate drug benefits and show studies to validate their claims, why not also develop and use educational tools that highlight drug interactions and potential side effects when presenting to these individuals? Doctors stated that they do not typically receive such information when meeting with pharmaceutical representatives, but would benefit from the data.
Since promotional products have limited space to educate a physician, their medical staff or patients, physicians believe that a good use of promotional products is to help direct them to specific studies, research and other educational instruments. Why not bundle promotional products with items such as journal articles and scientific reference guides as a tool to keep physicians apprised of important developments? By using appropriate promotional items to reinforce information shared in a specific article, pharmaceutical representatives can educate physicians without having to become an expert on a specific topic.
The full whitepaper may be downloaded free under the Members/Business Management tab at www.ppai.org.
PPAI's PhRMA Workgroup is comprised of professionals from PPAI and its communications firm, VOLLMER Public Relations. Together, PPAI and VOLLMER compiled information, advice and counsel from PPAI members, physicians and other marketing experts.
The Work Behind The Report
Thirty individuals were interviewed for the whitepaper regarding their knowledge and recommendations around the PhRMA Code. Participants included PPAI suppliers, distributors and multi-line reps, members of the marketing, advertising and public relations community, as well as physicians from a variety of specialties.
PPAI members and members of the marketing, advertising and public relations community were asked approximately 15 questions about their observations, recommendations and concerns regarding the revised PhRMA code.
Physicians interviewed answered approximately 25 questions regarding issues related to patient education, use of promotional products within their offices, practices or hospitals, and how pharmaceutical companies and promotional consultants can work with doctors moving forward.
Sample Of Physicians Interviewed
• Dentist, Dallas, Texas
• Dermatologist, Henry Ford Medical Center, Detroit, Michigan
• Gastroenterologist, UCSF Medical Center, San Francisco, California
• Internist, Beth Israel Deaconess, Boston, Massachusetts
• Internist, Dallas, Texas
• Internist, New York, New York
• Neuro-Optometry, Plano, Texas
• Ophthalmologist, Tucson, Arizona
• Pediatric Cardiologist, Children’s Hospital, Boston, Massachusetts
• Pediatrician, Plano, Texas
• Radiologist, Santa Barbara, California
Deciphering The PhRMA Code
On July 10, 2008, the Pharmaceutical Research and Manufacturers of America (PhRMA), a trade association for the pharmaceutical industry, announced a modification to their code on interactions with healthcare professionals.
Under the new terms of this voluntary code, which took effect January 2009, PhRMA proposes that all non-educational products, including practice-related items of minimal value such as pens, notepads, mugs and similar reminder items, should not be offered to healthcare professionals or members of their staff, even if they are accompanied by patient or physician educational materials.
However, PhRMA will continue to support the distribution of items designed primarily for the education of patients or healthcare professionals if they are not of substantial value ($100 or less) and do not have value to the healthcare professional outside of his or her professional responsibilities.
Clarifying The Code
• This code is not a law or bill put forth by any legislative body.
• It is not a crime for pharmaceutical manufacturers and researchers to distribute promotional products to physicians.
• Compliance with this code is voluntary; there are no penalties for non-compliance.
• Company adherence to the code is expected to be fostered by the scrutiny of the press and market competitors.
• This code relies on the industry to police itself.
• The modified code applies to member companies of PhRMA, physicians and healthcare professionals. When reviewing the code, please note the following programs are still allowed: internal programs, marketing to consumers, marketing to hospitals and product distribution to hospitals.
This article is an excerpt from a whitepaper developed by PPAI’s PhRMA Workgroup.
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