2017 Old H50 Page

Over the past decade, health organizations have adapted to an entirely new healthcare system and technological era. However, as with many other industries, healthcare is grappling with technology, social responsibility, and the business becoming more consumer facing. Healthcare agencies have also changed to meet these needs.

Agency communicators can’t just be experts on regulation or trends anymore. They need to support clients in tech, policy, or corporate work, too. Many firms are moving away from siloed practices and health groups and are sharing resources and talent.

“Every agency seems to be approaching health in different ways,” says Paul George, global health business development lead at Omnicom Public Relations Group. “It’s a much more integrated team because health clients are looking to us to service not just traditional communications, but also advocacy, policy, as well as social and digital. Siphoning those into separate practices and teams no longer works.”

The move away from silos is reflected by how holding companies are restructuring their health offerings. WPP created its health and wellness group in February, in which four constituent agencies share resources: Ogilvy CommonHealth Worldwide, ghg, and Sudler & Hennessey — three of the top 10 healthcare agencies by revenue — along with media-planning giant CMI. Havas merged its health and consumer practices to create Havas Health & You in March. Other holding companies, including Publicis and Omnicom, have made similar changes.

 

“Classically, healthcare lagged behind some other industries, notably fast-moving consumer goods, as it relates to marketing, but all the signs are there. Healthcare businesses are evolving fast”
Mike Hudnall, WPP Health & Wellness

 

Senior analyst at Pivotal Research Group Brian Wieser, who focuses on the advertising, media, and internet sectors, has noticed the trend of agencies bringing different skills all under one roof again.

“Agencies are rebundling in different ways,” he says. “There’s interest in marketers having a wide range of services that are broader than what a creative agency or media agency or PR agency has. We went through this great unbundling 20 years ago, and there is an interest in rebundling among many marketers.”

The change, he adds, is driven by clients asking for it from their agencies and clients seeing the opportunity it presents for better integrated service and choosing to work with those firms.

Clients’ changing needs

Healthcare companies have refocused on a patient-centric business model, meaning communication has also shifted toward the individual. The result is a convergence of healthcare and consumer skills.

“That’s where the business is going,” says Mike Hudnall, CEO of WPP Health & Wellness. “Classically, healthcare lagged behind some other industries, notably fast-moving consumer goods, as it relates to marketing, but all the signs are there. Healthcare businesses are evolving fast.”

Patients’ increasing control over their healthcare has pushed the subject front of mind for the average person. Adam Cossman, chief digital officer at W2O Group, says the agency recently pitched a pharma company that didn’t want to see healthcare case studies. The company trusted W2O had healthcare experience and was looking for expertise in areas such as consumer, tech, and data.

“It’s a pendulum shift of people in healthcare being interested in non-healthcare experience,” Cossman adds. “They want to know you understand the regulatory environment, that information needs to be medically accurate and regulator compliant. But they also want experience outside because they know healthcare has been a late adopter.”

George says since Omnicom PR Group shifted Cone Communications under Porter Novelli, the Cone team has helped on several healthcare clients looking to build out CSR initiatives to counteract damaged reputations.

“We blended the teams and pulled knowledge from both sides to deliver on clients’ needs,” George explained. “About 70% or 80% of purpose-driven programs are in the health space. Health companies have to show the values and purpose they stand for. Look at how the pharma industry has been under the magnifying glass in talking about their drugs. People are looking at what they’re doing to contribute back to society.”

Parts of the healthcare and pharma industries have taken a reputational beating — CSR and purpose-driven campaigns are an effort to rebuild reputation. “Purpose is becoming more important,” Hudnall says. “As consumers become more involved and take a greater role in making decisions about their healthcare, they care more about the companies they build relationships with — whether that’s purchasing medicine or pursuing better health and wellness.”

Purpose and reputation also merges into corporate comms and companies are more active in managing their corporate reputation. “With the current political environment, corporations are being looked at to step in to address societal, human, and humanitarian needs,” George says.

The shift was seen clearly when Merck CEO Ken Frazier (pictured below) stepped down from Donald Trump’s manufacturing advisory council over the president’s response to white supremacist rallies in Charlottesville.

 Where’s the talent?

One of the biggest integration challenges is finding people with the right experience to work on blended agency teams, according to Jim Weiss, CEO of W2O Group. “It’s hard to find talent in diversified areas that is steeped in healthcare,” he says. “You might find really good data analytics people who know nothing about healthcare. You might find creatives who are really talented but just haven’t worked in the healthcare vertical.”

His solution is finding those experts in their areas, such as digital or data, and embedding them in healthcare teams where they learn the industry ins-and-outs through their colleagues.

“In non-health areas we’ve been able to innovate and do interesting things outside regulatory restrictions,” Weiss explains. “As regulators get more clear and assured around social, digital, and online, we can apply some of the things we’ve learned.”

Because regulations are so strict, particularly for pharma companies needing to disclose side effects on drugs, it has been difficult to embrace technology in communications. But healthcare companies have established ways to utilize digital, social, and analytics-driven campaigns. The other side of evolving technology involves trends such as artificial intelligence or personalized medicine becoming more mainstream, which means healthcare agencies need to add yet another set of expertise to their teams: tech PR.

 

“It’s a pendulum shift of people in healthcare being interested in non-healthcare experience. They want to know you understand the regulatory environment, that information needs to be medically accurate and regulator compliant.”
Adam Cossman, W2O Group

 

Porter Novelli created a combined health and tech team about a year ago, George points out, and that team has had a lot of engagement from healthcare clients.

“The convergence of tech and healthcare is going to manifest faster and accelerate faster,” says George. “We’ve been trying to blend teams so we understand each other.”

The clients driving these new structures are demanding a simpler support system. Pharma company Kowa Pharmaceuticals moved from using three separate agencies — for marketing, digital, and healthcare PR — to one integrated firm.

The major benefit of having one health agency that does it all is less competition and infighting, says Chuck Hrushka, executive director of marketing at Kowa. “In meetings, everyone [from the agencies] got along well, but there was still more competition than I would like to acknowledge for budget dollars,” Hrushka explains. “My team and I made a decision to go under one roof. It has been absolutely great, not only because of the budget issue, but the integration has also been super.

“Everybody is around the same table working out of the same budget, so there’s more focus on the success of the campaign,” he continues. “People are seeing ways that this [agency] team can work together and, for a brand team, it is absolutely a relief.”

Where healthcare PR is headed

Agencies such as W2O Group will continue to add new expertise through acquisitions, while large holding companies including WPP and Omnicom pull from sister agencies for different expertise to support healthcare clients’ evolving needs in consumer, corporate, and tech. Agency responses to the needs of the healthcare industry aren’t limited to holding companies: boutique, midsize, and independent firms are all dealing with the same shift, and even management consultancies are getting in on the action.

Deloitte’s reputation and crisis management work and Accenture Interactive’s focus on digital marketing are just two consultancies stepping further into the marketing communications sphere.

“We can’t fight that,” Hudnall says. “We have to acknowledge it, embrace it, and open ourselves up to make sure we are evolving to be the best we can.”

The PR agency world overall is seeing management consultancies encroach on their business, but the threat isn’t quite enough to worry some yet. Wieser explains that, despite consultancies moving into PR and marketing, the numbers-based impact is still low.

“The consultancies are having a small effect on the overall sector, maybe half a percentage point of impact,” Wieser explains. “The global agency industry is $120 billion annually and these [PR] holding companies are about $60 billion of revenue. If you look at revenue from agency-like services from Accenture, IBM, Deloitte, and so on, maybe you get to $5 or $6 billion.”

 

Health companies have to show the values and purpose they stand for. Look at how the pharma industry has been under the magnifying glass in talking about their drugs. People are looking at what they’re doing to contribute back to society
Paul George, Omnicom Public Relations Group

 

One agency’s response is to bring management consulting into its own business. Reid Connolly, CEO of Evoke Health, created Traverse HealthStrategy under the Evoke Group umbrella in 2016, along with multicultural marketing and digital health offers. Traverse focuses on digital integration from marketing to a health organization’s internal structure and works with executives both inside and outside the marketing and communications sphere.

“Those are the people often involved in making decisions about funding and where budgets are going, and if you’re excluded from those conversations, you miss out,” Connolly says.
Smaller and midsize agencies have different strategies to keep up with the market. GCI Health CEO Wendy Lund says her agency has maintained its structure, but focused on adding new talent to address emerging healthcare areas, particularly in health tech.

“The size of our agency is perfect for being nimble and understanding [the client’s] processes and procedures,” Lund explains. But as healthcare companies look for one-stop shop solutions to their communications needs, even the agency behemoths believe specialized firms still have a place.
“Entrepreneurs and independent agencies are a strong force of change in our business,” Hudnall says. “Disruption is usually something that’s happening outside the mainstream. We need to bring some of that entrepreneurial spirit into our own business and embrace that.”

 

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Case study: Kowa Pharmaceuticals

Pharma is a particularly thorny area of healthcare PR. With regulations on proper disclosure of risks and medical information needed in every communication about a drug, pharma tends to stick to the typical 60-second TV spot or full-page ad.

Kowa Pharmaceuticals has a peculiar challenge with its statin — or cholesterol lowering — drug Livalo: It is the only brand name product in a generic market. In an effort to compete, the company needed to build recognition of the brand name drug so consumers and physicians would choose it over generic competitors. “We’re reaching out to the consumer, the patient, in many different ways and forms of media due to the fact that much of the time a patient asks for a drug by name,” says Chuck Hrushka, executive director of marketing at Kowa.

Hrushka credits only using one health agency for the success of the campaign. The resulting activation, supported by W2O Group companies, stretched across traditional healthcare marketing and new, digital strategies. Traditional direct-to-consumer TV spots were complemented with an online Pac-Man-like game, the pharma mainstay of celebrity spokespeople such as Regis Philbin, wellness bloggers, and market research combined with social analytics.

“We have to do due diligence with physicians,” Hrushka says. “But we also want to educate the consumer and make them aware of our brand.”

 

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As recently as six years ago, the idea of harnessing a patient’s own immune system to fight cancer sounded as much science fiction as it did high science.

But for Bristol-Myers Squibb, developer of immunotherapy Opdivo, the stakes and science were clear. The drugmaker had a potential blockbuster on its hands, but most people didn’t fully understand the promise behind it.

Enter Ready. Raise. Rise. Following a wealth of national media coverage, the success of the company’s ongoing three-year initiative to get the public up to speed on immuno-oncology  begs the question of whether pharma marketers are missing out on an opportunity to generate awareness via earned media.

BMS debuted Ready. Raise. Rise in 2015, just months after Opdivo’s late-2014 approval for previously treated advanced melanoma. Its overarching message is that it takes a community to fight cancer — and that’s a line the campaign’s A-list spokespeople have reinforced throughout.

Dallas Cowboys quarterback Dak Prescott, the NFL’s 2016 offensive rookie of the year, noted in interviews for the campaign that his mom’s battle with cancer played an integral part in his decision to come onboard as a spokesperson.

“I know how important the love and support of our friends and family were to her,” he said.

Modern Family’s Eric Stonestreet, who has worked on the campaign since its inception, echoed that point. Tia Mowry, best known for her sitcom Sister, Sister, joined the team this year. Prescott and Stonestreet participated in 21 national interviews promoting the campaign, appearing on shows such as Good Morning America and SportsCenter.

 

So what prompted BMS to seek high-profile celebrity spokespeople to help start a nationwide conversation about immuno-oncology? And will there be more of these efforts going forward? To hear experts tell it, earned media can be as much about building awareness as it is creating credibility — but the company’s success may be hard to replicate.

Creating context

Enlisting celebrities thought to be relatable helps bring a complicated topic such as immuno-oncology “down to a level people can understand,” says Bryan Blatstein, lead of the medical specialist group at Chandler Chicco. “A Q&A with Prescott is worth its weight in gold. Earned media allows a celebrity or spokesperson to put the disease state or treatment into context in a way you can’t quite do with paid integration or branded coverage.”

A broad awareness initiative with earned media can improve the impact of a branded campaign down the line, Blatstein adds. By first turning to education about immuno-oncology, marketers slowly build up the knowledge base and prime target audiences for a brand-specific message.

“It lays a nice foundation for a brand campaign to attract more attention,” he explains. “It was a smart approach due to immuno-oncology’s complicated nature.” But what is the right mix? Blatstein says it varies by campaign. However, he notes “70% earned and 30% branded would be a sweet spot.”

The reason marketers should lean more heavily on earned media is that such efforts tend to go beyond simple awareness plays, explains Frank Iorio, managing director of Frontline Oncology. “Earned media is becoming increasingly valuable,” he says. “When people start to share content and interact with that content, that’s when you’re moving forward.”

 

We recognized that people want to engage online, learn about the subject, and show their support for loved ones in different ways

Caitlin Craparo, Bristol-Myers Squibb

 

To further the campaign’s reach, BMS expanded its digital presence this year, says Caitlin Craparo, associate director of public affairs for U.S. immuno-oncology at the company. “We recognized that people want to engage online, learn about the subject, and show their support for loved ones in different ways.”

As part of that effort, BMS introduced gamification elements, giving participants points for registering on the site, learning about it, and raising and sharing a virtual flag. Participating patient groups that receive the most points are featured on the homepage of Ready. Raise. Rise. The organization also donated $1 for every point earned from June 28 to July 31 and distributed those funds to participating groups.

BMS’ attempt to generate awareness for a way of treating cancer, generally rather than about a specific type of cancer, worked in its favor as it attempted to reach a wide range of audiences. Too often, media campaigns focus on a very specific type of cancer, notes Alyssa Bleiberg, a media specialist at BioSector 2. “It’s hard to relate to people when you’re talking about different kinds of cancers. The organization wanted to go big, and Ready. Raise. Rise. is an unbranded campaign with huge celebrities. It definitely had all the right ingredients for a big earned media presence.”

Bleiberg points out that media outlets tend to be more receptive to unbranded efforts. “When you have an unbranded message, it comes off as a little more genuine,” she continues.

At the same time, BMS isn’t the only company developing an immunotherapy — and one could argue the company is no longer the leader. In August 2016, a setback in Opdivo clinical trials in first-line lung cancer paved the way for competitor Merck to come to market first with Keytruda. The concern is that a big initiative to raise awareness for immunotherapies in general could send patients into the arms of a competitor.

However, Iorio doesn’t believe it’s that simple. “General awareness helps everyone,” he notes. “There is plenty of room for multiple players in this type of science.”

 

Managing the message

The clear advantage of earned media is that it creates a sense of authenticity for a company and brand. And yet that advantage can also be its greatest drawback. The media landscape is littered with examples of spokespeople going off message or veering into a topic that might turn off potential audiences.

Bleiberg’s advice for avoiding a disaster? “Relationships are key. It’s the way you conduct the media interview,” she says.

 

Pharma is a complicated space. There are so many things we have to say about a drug, with safety information that some media outlets don’t want to include
Alyssa Bleiberg, Biosector2

 

Even still, she notes there are certain risks that are unavoidable. “You can work hard with a reporter or producer ahead of time, but ultimately that outlet has control,” Bleiberg explains. “We’ve all seen cases where you have a great interview and the story comes out and they turned it into something negative.”

The key to minimizing that is by doing your homework, Bleiberg adds. She says pharma may be headed toward media with paid — rather than earned — integration, especially in and around therapeutic categories with smaller patient populations.

“Pharma is a complicated space,” she explains. “There are so many things we have to say about a drug, with safety information that some media outlets don’t want to include. There will always be earned media, but especially in those niche audiences, we have to be open to a bit more paid [media].”

 

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Jim Weinrebe
EVP, Health, MSLGroup

Initiatives to align prescription opioid use with appropriate patient medical needs are yielding progress, but substantive impact on saving lives won’t happen for years. Some of this progress is also creating backlash by delegitimizing patients with chronic pain for whom prescription opioids may be the best or only helpful treatment option, and choking off their access to these medicines.

This grim reality is partly fueled by patients and family members who inadvertently lapsed into dependence on prescription opioids, before falling prey to cheaper, more accessible heroin. The crisis has multiple origins, but manufacturers are increasingly deemed solely culpable, regardless of behavior. How can they responsibly participate in this therapeutic area?

Consider reshaping commercialization from a public health perspective. Integrate marketing with functions in public health and public affairs.

Under a public health umbrella, manufacturers would remove product-branded direct-to-patient and direct-to-consumer comms from the promotional mix. They would work more with public health authorities and advocacy groups to support non-branded public education about harm avoidance in households.

As data yields deeper insight into the epidemiology of prescription opioid dependence, manufacturers can better educate physicians about products. It’s neither ethical nor fiscally viable for manufacturers to run from patients for whom prescription opioids may be the only viable treatment option. It’s time to revisit education about pain.

 

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Wendy Lund
CEO, GCI Health

The future of opioids marketing should be redefined as we try to find common ground where physicians fully address the safe and appropriate use of these medicines – as well as when they should consider an alternative therapy – and are comfortable prescribing them, while patients are able to trust in their physician’s decision to prescribe an opioid and learn how to use them without unreasonable fear of addiction.

The goal is to drive informed dialogue between prescriber and patients and their families about their specific pain needs, pain management, and all the appropriate treatments that exist to empower the prescriber to make the right determination. Too many physicians are reticent to prescribe opioids out of fear of potential consequences – abuse, misuse, diversion, liability – and need to regain the assurance to prescribe these drugs when appropriate.

We need a radical departure from past efforts that have grown the opioids market – whether by design or not – by making these medications the go-to for all types of pain, even when an opioid is not appropriate.

Future marketing must be ultra-responsible and focus on the safe and appropriate use of pain medications. Modern technologies of today, such as abuse deterrent formulations and Prodrug new molecular entities are available now to help discourage misuse and abuse.

Physician and patient education available today can help ensure appropriate prescribing with small numbers of pills, especially for acute pain treatment. Appropriate storage and disposal of unused medications are actions that can occur today to reduce diversion into the misuser orb. In short, the opioid marketing of tomorrow is available today – if all players are willing to change.

Efforts should be a partnership between industry, government, public health, and others to focus on key issues and create a paradigm shift in the way these medications are accessed. Balancing responsible prescribing with meeting the pain management needs of patients is a challenge, but given the life or death nature of addiction and chronic pain, we all have a stake in communicating in a new and different way.

 

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John LaLota
CEO, Neura Therapeutik

In the midst of the U.S. opioid crisis, many stakeholders have a primary objective of simply reducing the number of prescriptions. However, millions of Americans suffer from chronic pain, and for many of these appropriate patients, opioid analgesics are the mainstays of therapy. Many of these patients have been denied access to opioid treatment and have suffered greatly as a result.

Several barriers exist to the responsible use, including the need for mandated physician education, inadequate access in certain demographics, and a lack of proper ongoing assessments by practitioners. Achieving a critical balance between adequate pain control and access, and minimizing the risk of abuse, misuse, and diversion, is crucial to foster better outcomes.

Opioid manufacturers have a responsibility to provide a forum that promotes networking between pain specialists, primary care, and addiction medicine physicians, which can be fostered at major national pain conferences, such as Pain Week, and can be continued throughout the year at various Pain Weekends. Partnering, through PR initiatives, with national pain organizations, patient advocacy groups, and law enforcement agencies to support public policy, with a patient-centric focus, is essential to achieve optimal treatment outcomes.

For their part, physicians must be knowledgeable on how to structure opioid therapy based on perceived risks and must adopt various proactive and reactive strategies, via a REMs structured educational mandate.

A recent survey, conducted by Pain Insights, characterized the recent dynamics in the treatment of chronic pain, identifying patients segments with varying perspectives on opioids.

The researchers found that ongoing patient assessment (via mobile devices, apps, etc.) utilizing risk-mitigation tools, such as the ORT and SOAPP, as well as a cohort of outcome-based identifiers, can lead to more effective communication of patient-centered opioid therapies and can provide feedback on issues that are most meaningful in achieving the aforementioned balance.

 

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Bob Twillman
Executive director, Academy of Integrative Pain Management

First and foremost, pharmaceutical manufacturers need to market opioids in the proper context. Opioid monotherapy is almost never the right answer for people with chronic pain, and patients will do much better with an integrative multimodal approach to treatment.

Opioids will be most effective when they are combined with non-opioid medications and non-pharmacological interventions. Using this kind of treatment approach should maximize effectiveness while minimizing harms to patients. Manufacturers need to continue innovating with respect to abuse deterrence as well, making their products as safe as possible, even if most of the abuse that is deterred happens among non-patients.

As far as methods are concerned, I have two thoughts. It seems to be universally agreed that the marketing model used in the 1990s and early 2000s was extraordinarily effective at encouraging prescribing. If that is the case, then why not resurrect that model, which is essentially an academic detailing model, only with a focus on marketing effective pain management instead of just more opioids?

Additionally, there is a great need for effective marketing to patients, to help them understand the proper role of opioids in the larger scheme of a comprehensive integrative pain management plan. Patients are very important members of the care team, and they need to understand their role as such, and to understand that they will need to make an investment in their own care if they want to get the best possible results. Educational efforts aimed at patients, and, perhaps, at the general public as well, need to be prioritized.

 

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Delia DeRiggi-Whitton
Nassau County Legislator, D-Glen Cove

Many people don’t know that the exploding heroin epidemic is due in large part to prescription painkillers being the road to addiction. Some move to heroin because it’s easier and cheaper to find and gives a “higher high.” Others overdose on painkillers without ever using heroin.

From the training sessions I’ve sponsored over the past few years on Narcan, which counteracts an opioid overdose, I’ve met parents whose children got hooked on painkillers from sports injuries. Years later, they’re still fighting a daily battle to stay clean.

To begin to make a real difference in opioid-related overdoses, marketing that speaks to the paths to addiction needs to be blunt and multi-targeted. Since addiction to opioid pills and heroin often starts innocently with prescriptions, patients and parents of minors must understand that opioids are very addictive. But doctors and pharmaceutical companies must also become part of the solution by counseling patients and developing less addictive substitutes, respectively.

The legislation my colleagues and I recently filed requiring signage in pharmacies warning patients about opioid addiction is a good first step. So is the national database that monitors opioid prescriptions per person. But they are both only small parts of a bigger puzzle. Everyone needs to understand how easy it is to become addicted to opioids and how painfully difficult it is to break the habit.

Every possible form of marketing should be used to warn patients, parents, educators, the medical industry, and pharmaceutical companies about how opioids are a major reason why the heroin epidemic is so out of control. The responsibility should mainly lie with pharmaceutical companies and their messaging should trickle down to doctors and hospitals, educators, and consumers.

 

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Marsha Stanton
Independent consultant, medical affairs and program development/education

Those of us who have been involved in the pain management specialty, through both direct patient care and the pharma industry, have seen significant changes in how medications and devices are advertised, marketed, designed and indicated over the past 20-plus years.

We have encouraged new terms, such as breakthrough pain, pseudoaddiction, etc., and have learned to specify our efforts and financial support towards more definitive objectives. We are constantly under review for the most insignificant of wording in disseminating information to the community, which includes both clinicians and consumers.

The current media frenzy over opioids, has frequently tied our hands from accomplishing a clear and timely consumer education initiative or in providing clinicians the most critical information for use in their patient populations. Sensitivity in finding the right project, the right audience and the right structure is at the root of what we try to accomplish. The use of consumer organizations to encourage education, has proved almost impossible due to an overzealous negativity towards the pharma industry as a source of funding.

Additionally, professional organizations have become increasingly less apt to secure financial support from our industry due to the critical regard for our ultimate purpose. Medical education has undergone substantial changes, with a shift to independence rather than specific product information.

Alliances, collaboratives and/or partnerships and CME have been the cornerstone of the “new” model for transference of information. Organizations such as CLAAD (Center for Lawful Access and Abuse Deterrents), the National Family Partnership “Lock Your Meds program”, SaferLock equipment such as Locking Caps, The Abuse Deterrent Coalition, ASPMN (The American Society for Pain Management Nursing), AAPM (The American Academy of Pain Medicine), the AIPM (Academy of Integrative Pain Management), as well as others have provided an opportunity to support all audiences with impartial data.

The criticism directed at the use of KOLs for education or experiential learning has caused an uneasy relationship and unfortunately some have chosen to eliminate all association with the pharma industry. There is still a substantial need for the voice of both clinician and consumer, however, their messages may be less responsive and more refined. Caution is the overriding principle in all things pain-related.

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