Who Owns Your Social Media?

"Twitter just announced a complex, confusing, and developer-alienating system that restricts their once-open, always cherished but now apparently taken for granted API," complained Michael Spitz, SVP and Managing Director at Zemoga. "The new rules change the playing field for third party developers, establish caps on number of users, and shift guidelines to requirements across four categories of businesses that Danny Sullivan of Search Engine Land humorously characterized in Star Trek terms." Spitz characterized this as #TWITTERFAIL and he thinks the new rules "ruin the spirit of social media" and are "bad for healthcare" (see here).

Spitz's "rant" raises a couple of interesting issues that I will discuss with him this afternoon in a live Pharma Marketing Talk podcast (listen here or use the playback widget below).

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First, the premise that changes to Twitter's API can be "bad" for healthcare is based upon the notion that Twitter has been or could be "good" for healthcare. I'm not sure what Spitz includes in his "healthcare" category. Since he works for an agency with pharmaceutical company clients, I am sure he includes the drug industry as part of what he means by healthcare. I'd like to focus at least part of today's discussion on how Twitter can be good (or bad) for the pharma industry's goals of selling more drugs.

I have written several articles about how pharma can use Twitter to help support patients (see "Supporting Patients via Twitter and Beyond" and "Use of Twitter for Patient Support") and criticized pharma for using Twitter (and blogs) to promote their products (ie, "market"; see "Novo Nordisk's Branded (Levemir) Tweet is Sleazy Twitter Spam!" and "AstraZeneca's Timely CRESTOR Branded Blog Post: Did It Violate Its Own Policy?"). My view is that Twitter has been good for pharma mainly in the public relations realm, which may or may not translate into increased drug sales.

Most tweets from pharmaceutical companies are about what they are doing in this therapeutic area or that therapeutic area (e.g., support for COPD, atrial fibrillation, diabetes innovation, etc.). Pharma tweets a lot about clinical study results (mostly the positive results) and news from medical conferences where they are exhibiting ("come to our booth"). They also tweet about investor presentations and other news about their company that Wall Street finds of interest.

None of those tweets do healthcare any good -- e.g., improve outcomes of drug treatment. They dn, however, provide benefit to pharma companies by getting them more attention by the media, which dutifully followup with articles based on these pharma "Tweet Releases."

Another issue related to the lament about the more and more restrictive Twitter API is the question "Who Owns your Social media?", which was brought to my attention by Phil Baumann of "Health is Social." Baumann is also a member of the Advisory Board at Mayo Clinic Center for Social Media, so he has a healthcare perspective beyond pharma.

I invited Baumann to be a guest on this afternoon's podcast, but he was not available. He did, however, send me some thoughts, one of which is:

"Too much emphasis has been placed on social media in general - at the expense of focusing on the only thing Healthcare or Pharma can own on the web: their own domains. Social Media should not be seen as the center of a web presence - ever. It's a tempting thought, but the reality is the other way around. Healthcare and Pharma organizations should learn [from] these API changes that they don't own anything on these social media sites. Many experts have laughed off blogging and traditional websites, but I still maintain that if you can't build your own solid presence on your own domain, you won't do well on social media in the long-run."

You should also read "The Over-promising of Healthcare Social Media" written by Baumann.

Here are a few other thoughts from Baumann on the Twitter API issue:

• The first thing that Healthcare and Pharma need to realize is that social software is pliant and tenuous. With social software, the tiniest tweaks can produce huge ramifications throughout a digital ecosystem.
• If the industries are going to be involved in social media, they need people on staff who can keep up with the technical changes that happen - in fact, they need to anticipate them and have plans to turn to when those changes take place. 
• The average person probably only cares about Twitter clients - I suspect that Twitter will eventually whittle clients down to a very few. It already owns TweetDeck, but hasn't developed this asset much. 
• The larger Healthcare/Pharma Enterprise impacts of the API changes are likely to be more in the area of data-mining, monitoring, metrics, etc. For example, Twitter might rate-limit calls for certain kinds of data - let's say a Pharma company or its vendor monitors for mentions of a drug and or keywords related to possible Adverse Events. Depending on the API changes over time, there may be limits to the amount of data that can be captured in a timely manner. 
• None of what Twitter is doing with its API is at all unexpected - at least it shouldn't be. Ultimately, this is Twitter's product - albeit one that increasingly is becoming a virtual public utility.

How Johnson & Johnson Uses Twitter for Patient Support: A-plus for Effort, D-minus for Sharing

Every day, I get a synopsis of tweets and newsfeeds from selected pharma companies that I am following (see "News Direct from the Pharma Industry"). Lately, I've been noticing a number of tweets from Johnson and Johnson (@JNJComm) that are direct responses to complaints from consumers about its products. In some cases, complainants have had an extended conversation with JNJ.

However, you won't find these conversations if you look at the @JNJComm Twitter timeline here but you can find them in the PMN Forum archives here. More on this later. Right now I'd like to focus on one of these conversations.

@hiltmon (Hilton Lipschitz) complained about an Acuvue contact lens problem in a tweet posted to @JNJComm. @hiltmon said: "@JNJComm, could you please fwd this to Acuvue team: See the hole in the lens (top right), happened twice now. Thanks. pic.twitter.com/50ML8IrT" The link leads to this photo:

Whether or not this could be classified as a legitimate "adverse event," is a matter for debate, but JNJ responded as if it were: "thanks for alerting use. Please call us at 800-843-2020. It's important that we fully understand what occurred. Thanks! ^DE" Here's a screen shot of the full exchange:

I am not sure what "^DE" means. It appears that JNJComm uses it only at the end of responses to these sorts of complaints. I assume it allows some kind of tracking or followup. [Actually, it indicates the author - in this case Devon Eyer; see UPDATE at the end of this post.] In any case, the end result was one happy (I assume) customer.

I cannot find a legitimate Acuvue Twitter account, although the brand does have a Facebook page. After a quick scan through the Acuvue FB page, I can find no consumer complaints or conversations like the above. It's all good brand "conversations" over there on the Acuvue FB page :-)

The above Twitter conversation might be considered a "brand conversation," which is what brand marketers would like to see (although they would like positive rather than negative conversations about their products). So, JNJ corporate communications people are having these brand support conversations via Twitter, but the brand people -- who presumably manage the FB page -- do not. That's telling in respect to the question I asked in a previous post: "Who's Your Social Media Daddy?"

This conversation is somewhat hidden from most of the nearly 20,000 @JNJComm followers. As I mentioned above, it does not appear in @JNJComm's Twitter timeline because each tweet begins with "@". That makes it a personal conversation in Twitter. Unless you access @JNJComm's Twitter RSS feed as I do, you won't see these tweets. That's unfortunate, IMHO, because it means that the power of social media (e.g., sharing content with followers) is sidestepped. In this case, other consumers may not learn about important safety and other information about Acuvue lenses. Public health would be better served if everyone could learn from the conversation (e.g., the batch number of the faulty lenses).

Of course, it also means that these conversations may not be picked up by the media -- presumably the main audience for @JNJComm and other pharma corporate Twitter accounts -- or by regulators who may like more information about faulty medical products.

UPDATE: ^DE indicates that the @JNJComm posts were written by Devon Eyer, Director, Corporate Communications, Social Media at Johnson & Johnson (see her LinkedIn profile here).

I have included Devon in my list of contenders for the 3rd Annual Pharmaguy Social Media Award. You can learn more about this award here and/or vote for your favorite here.

Who's Your Social Media Daddy? A Panel Discussion

That is one of the questions/topics to be discussed by a panel of experts I will be moderating at the next PharmaForce conference in Princeton, NJ, on October 30, 2012. Actually, the real question to be considered is "Who Owns Your Social Media Initiatives?"

Pharma Marketing News is a Media Partner for this event and is helping promote it through advertising. The panel I volunteered to moderate is titled "Effectively Building Your Social Business" (see here). I am not getting paid to do this, but I hope to learn a lot from the experience, especially from meeting and working with the expert panelists.

Not all the panelists have been chosen as yet. I and the conference organizers are interested in finding pharma panelists who can give their POVs regarding the following discussion bullet points:

• Tap into social media data to reveal customer behavior
• Understand the power of influence and influence mapping
• How to best balance the risk and rewards of social
• Who owns your social media initiatives
• Determine the desired outcomes of your social media strategy
• Align social media activities to your multichannel marketing strategy

I'll be contacting a few qualified people from my contacts, including my list of Pharma Twitter Pioneers (here) and candidates for the 3rd Annual Pharmaguy Social Media Pioneer Award (here). If you are interested in being a panel member or know someone you'd like to recommend, please let me know by filling out the following form.

NOTE: I am looking specifically for pharma people. There is no compensation for participation on panels except for the 45 minutes of fame and notoriety involved (I probably will write up a summary of the panel discussion afterward).

Create your free online surveys with SurveyMonkey, the world's leading questionnaire tool.

The Next New Drug: An FDA-Approved Video Game

Imagine my surprise when I read this in today's Wall Street Journal: "Akili Interactive Labs Inc. of Boston, formed by start-up-creating firm PureTech Ventures, and San Francisco company Brain Plasticity Inc. are seeking Food and Drug Administration approval for a video game treatment they hope clinicians will turn to before prescribing medicines for ADHD" (read the story here).

I've been writing a lot about "gamification" and the pharma industry (see "Pharma & Fun, Not Oxymoronic? Here Comes Gamification!" and "Gamification, Then and Now", for example), but never from the perspective of games designed to compete with drugs such as Novartis' Ritalin, a stimulate indicated for the treatment of ADHD.

Akili -- meaning "wisdom" in Swahili -- is the name of the video game that Akili Interactive Labs hopes will be the first ever video game "treatment" approved by the FDA. The game is designed to run on smartphones and iPads. The company also hopes clinicians will recommend the game to patients before prescribing medicines for ADHD.

Fat chance!

First, fat chance that the FDA will actually approve a video game as an effective treatment for a medical condition. Second, fat chance that even if approved, health insurers/patients will pay for a game treatment after being conditioned all these years to think only of drugs as treatments. Third, fat chance that physicians will prescribe the game to their patients. That would require overturning the entire drug-physician industrial complex!

Nevertheless, Akili co-founder Eddie Martucci said "his company's research shows that people want choices other than today's powerful medicines. 'We would aim to have efficacy and tolerability that outstrips any of the drugs.'"

Wow! Are these guys anti-drug industry? NOPE! Senior Partner, Chairman of PureTech Ventures is Dr. Ben Shapiro who was previously Executive Vice President, Worldwide Licensing and External Research for Merck. Another Senior Partner at PureTech is Dr. John LaMattina, who was previously President, Pfizer Global Research and Development and Senior Vice President, at Pfizer Inc.

LaMattina, who also writes the Drug Truths Blog at Forbes, was once enthusiastic about torcetrapib, a drug that Pfizer hoped would replace LIPITOR. "We believe this is the most important new development in cardiovascular medicine in years," said LaMittina. That was before Pfizer halted development of torcetrapib and after it spent more than $800 million on its development (read "torcetrapib: $800 Million Failure but Kindler Safe"). Hopefully, Akili isn't costing nearly as much to develop as a new drug.

With such experienced drug industry veterans as partners, Akili might have a chance of making it to the FDA. Unless, of course, clinical trials reveal dangerous side effects.

It's not likely such side effects will be similar to those that torcetrapib caused; i.e., death. Some video game critics, however, fear that "electronic media might improve visual attention but impair the ability to sustain attention on a hard or boring task," notes the WSJ article. "The latter type is what teachers need from students, according to ... Douglas A. Gentile, a developmental psychologist at Iowa State University." What teachers DON'T need, however, is for students to claim that playing video games during school is part of their medical treatment!

It's interesting to speculate how FDA-approved video games would be marketed, assuming any will actually be approved by the FDA. Akili, for example, might splurge on exhibits at medical meetings and lure physicians into its booth to play the game. And maybe it would hire physicians to be "consultants" and "speakers" to promote the game to their peers. I'm betting that direct-to-consumer (DTC) TV ads would be out of the question -- much too expensive for a product unlikely to reach "blockbuster" levels of sales.

I do, however, envision that DTC social media could be very cost-effective for marketing FDA-approved video game treatments.

Congress Gives FDA 2 Years to Issue Social Media Guidance. All Bark, No Bite.

A little-noticed "Miscellaneous Provision" of the "Food and Drug Administration Safety and Innovation Act" (aka PDUFA, pdf), which was signed into law by president Obama on July 10, 2012, simply states:

SEC. 1121. GUIDANCE DOCUMENT REGARDING PRODUCT PROMOTION USING THE INTERNET.

Not later than 2 years after the date of enactment of this Act, the Secretary of Health and Human Services shall issue guidance that describes Food and Drug Administration policy regarding the promotion, using the Internet (including social media), of medical products that are regulated by such Administration.

Does that mean the FDA will deliver? If not, it wouldn't be the first time that a government agency missed deadlines imposed by Congress.

Usually, Congress specifies that regulatory agencies must issue regulations that spell out how to comply with the laws it passes. Regulations, therefore carry the weight of law. FDA Guidance (guidelines), however, is just FDA's current thinking on a topic. "It does not create or confer any rights for or on any person and does not operate to bind FDA or the public."

So, if FDA misses the deadline set by PDUFA, what can Congress do? Write a letter? Not another letter from Charles Grassley! I'm sure FDA is shaking in its boots.

The only thing interesting about this provision of the PDUFA act is why it was included and who lobbied to have it included? It couldn't have been Pfizer (see "Pfizer Asks for New FDA Regulations, Not Guidance, for Social Media"), but it could have been PhRMA (see "PhRMA Statement on FDA Social Media Guidance Delay").

OMG, LCOI! Open Source Pharma: Creative Commons Coming To Pharma

I had an interesting phone conversation yesterday with Jerry Matczak, Community Manager, Lilly Clinical Open Innovation, Eli Lilly and Company. Yes, "Open" and "Innovation" together in the same phrase from a pharmaceutical company - OMG! LCOI is the acronym for Lilly Clinical Open Innovation, a venture that Lilly hopes "can transform clinical research and development." How will they achieve this? "We look to engage in the open for insight, innovation, talent and wisdom to drive new capabilities to fight disease and meet patient needs." There it is again, "open" and "innovation" in the same sentence.

The devil is in the details and I hope to interview Mr. Matczak soon on my Pharma Marketing Talk show.

It's was a happy coincidence that my conversation with Matczak followed yesterday's show about "Pharma Wikipedians: The Pros and Cons of Pharma Employees Editing Wikipedia Articles" (use the playback widget below to listen to that podcast).

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An even happier "coincidence" was an audio commentary from my friend Brad Pendergraph (@bradatpharma), former Senior Manager, Consumer Digital and Social Engagement at Novartis, in response to a question raised during my show.

Brad posted his commentary to Audioboo, which is "a simple way of recording audio while on the move and adding as much useful data to it as possible, such as photos, tags and location." Audioboo is the audio equivalent of Twitter -- you can record as many 3-minute audio messages from your smartphone as you like. I signed up immediately so that I can post Auioboo comments while on the road at drug industry conferences.

In his audio commentary, Brad touched upon how pharma deals with proprietary information. "Is pharma really going to let some of its information 'go general'?," Brad asked. He mentioned "creative commons" and "taking a look at what material you [pharma] have and figuring out how you can distribute it to people in the social media space in ways that they can understand and work with that are still compliant." Brad was suggesting pharma use creative commons rather than the more restrictive copyright when distributing information. Listen to his comments using this Audioboo playback widget:

listen to ‘A quick response to a question raised during @pharmaguy blog talk on Wikipedia.’ on Audioboo

Meanwhile, back at LCOI, here's their take on "open Innovation" published on the LCOI website (here):

There’s plenty of evidence that drug development is broken. The estimated efficacy rate of drugs for many common illnesses comes in at 50% or below, and a recent Forbes article by Matt Herper suggests the cost of bringing a new drug to patients is twice the already-big-number commonly used – over $4 billion per drug.

Patients need better.

The Lilly Clinical Open Innovation team exists to make it better. We believe that Open Innovation models – focused on clinical drug development – can result in transformational gains in value-to-patients and efficiency.

We also believe that open data, linked, crowdsourced, consumed and curated by experts outside (as well as inside) the walls of pharma will bring innovative insights and wisdom. And that open communities will set and meet objectives to reduce costs and improve outcomes.

We’ll explore challenge driven innovation and gamification to tap into expertise which might otherwise be missed. We embrace open source development to maximize technical contribution and benefit, and will Work Out Loud to assure transparency on our projects. To manage rights in a distributed digital age we leverage Creative Commons licensing. In the open, with no strings attached.
That’s a lot of buzzwords, and even more to actually try to do. Too much for the smallish Lilly COI group for sure – but that’s kind of the point. Open Innovation promises that we can all play bigger than we are, and enables greater innovation than any individual or organization can accomplish on it’s own.

Keep tuned for an announcement of an upcoming show where I will interview Jerry and Brad about "Open Source Pharma."