Pharmaceutical companies are capitalising on the advent of the internet and the development of new media forms to promote their products. Electronic detailing, interactive websites, email prompts and viral marketing campaigns using social networking sites such as YouTube, MySpace and Facebook are among the tools being used. Such campaigns are targeting both health professionals and the general public. The internet is helping to globalise and to change the nature of pharmaceutical marketing, and thus raises some new challenges for regulators.
The internet and related technologies have revolutionised many aspects of society. For the pharmaceutical industry, as for other sectors, this has brought new marketing opportunities. The internet can greatly expand a company's reach. For example, a popular video on You Tube may potentially be seen by thousands of people. Perhaps more importantly, internet-based technologies are enabling new styles of communication between the industry and its targets, including more interactive and customer-responsive campaigns. Consultancies have been established and books written1to help the pharmaceutical industry develop internet-based marketing.
In the context of drug promotion, detailing has traditionally involved face-to-face contact between a visiting sales representative and a health professional. However, drug companies, especially in North America and Europe, are increasingly turning to electronic detailing or e-detailing for help in marketing their products. E-detailing includes diverse strategies, such as videoconferencing, the provision of electronic education modules, and the use of email and related technologies as prompts and to promote two-way communications. It has been used for disease-awareness campaigns, and for ‘customer relationship management’.
Presentations to a pharmaceutical marketing conference in Europe suggest that e-detailing is not popular with all doctors.2However, it is cheaper than traditional sales representatives and can result in a significant return on investment through increased sales. Some companies are providing financial incentives for doctors to participate in e-detailing, such as honoraria, product samples, practice tools, and patient education resources.3In Poland, for example, Sanofi-Aventis lent physicians internet-connected hand-held devices which were loaded with clinical support information, drug indexes, abstracts of clinical studies, information from key opinion leaders, and advertising and educational materials. In exchange, the doctors participated in a clinical trial of a Sanofi-Aventis drug and entered anonymous patient data into the device. The company aimed to build relationships with the doctors, to use the device as an advertising medium, and to gather feedback. The company also reported that these doctors then prescribed more of its diabetes products.3
An important aspect of e-detailing is that it enables ‘predictive marketing’. This means that companies can be more effective and timely in eliciting feedback from prescribers in order to tailor marketing strategies to their individual preferences and needs.4
Understanding the lingo
Consumer opinion leaders
Corporate blogs and websites
The global reach of the internet means that Australians now have easy access to overseas blogs and websites promoting prescription medicines and other products, and even selling them. Safety concerns have been raised about the purchase of prescription, non-prescription and complementary medicines over the internet.56
Companies are also using blogs and websites to develop customer relationships. As GlaxoSmithKline says on its corporate blog in the USA for a weight loss product (http://alliconnect.com), ‘it's a place for you to have a conversation with us about weight loss issues’. Such ‘conversations’ may enable companies to gather patient stories and feedback for use in positioning their products. The discussions are not only mined for information (http://pharmamkting.blogspot.com), but also ensure the repetition of marketing messages. Sometimes companies use multiple websites to promote their products and issues to different market segments. For example, GlaxoSmithKline also promotes weight loss issues at www.questioneverything.com
Websites are also used for patient support programs and education although it is not always clear from the website name who is behind it. In the USA, Pfizer runs such a program (www.get-quit.com) for varenicline users, providing regular emails and other prompts such as a personalised web page to support their product use. In Australia, the company's advertising and marketing campaign is backed by a consumer website (www.outsmartcigarettes.com.au) that includes prompts for questions to ask doctors. Meanwhile, a Wyeth Consumer Health Care website (www.caltrate.com.au) sounds the alarm on osteoporosis and encourages people to see a doctor if they answer yes to any questions on a ‘one minute risk test’, including the question ‘have either of your parents broken a hip after a minor bump or fall?’.
Company websites can link to other sites that may not meet regulatory requirements. GlaxoSmithKline's Australian website raising consumer awareness of genital herpes and treatment issues (www.thefacts.com.au) links to the Australian Herpes Management Forum but advises that external links such as this ‘may not comply with the Australian regulatory environment’. The Forum, whose board comprises prominent physicians, aims ‘to improve the awareness, understanding, management and control of herpes virus infections in Australia’, and is sponsored primarily by pharmaceutical and diagnostic companies.
Pharmaceutical companies are not alone in using the internet to market products and to conduct awareness-raising campaigns that may affect patients’ interactions with doctors. The complementary medicines company Blackmores, for example, has a sophisticated website (www.blackmores.com.au), while Nescaf- has launched a website (www.nescafe.com.au/hcp password: Coffee) supported by advertising in the medical press which promotes coffee as an agent that may help lower the risk of developing type 2 diabetes.
The Medicines Australia Code of Conduct attempts to regulate the promotion of prescription medicines on the internet. However, it is difficult to police the anonymous marketing of drugs on blogs and forums, or to regulate consumers’ access to information from countries where pharmaceutical marketing may be less regulated than in Australia.
The ongoing development of internet-related technologies is likely to provide pharmaceutical manufacturers with further opportunities to influence consumer expectations of health care and prescribing practices. It is also providing new opportunities for those concerned with the quality use of medicines and evidence-based education.10Much can be gained from constructive engagement with the world wide web, and 21st century doctors also need to understand its use as a marketing tool.
Note: Websites and links can change quickly. Those cited in this article were accessible at the time the article was accepted for publication.
- Dogramatzis D. Pharmaceutical marketing: a practical guide. Englewood (CO): Interpharm Press; 2002.
- Heutschi R, Legner C, Schiesser A, Barak V, sterle H. Potential benefits and challenges of e-detailing in Europe. J Med Market 2003;3:263-73.
- Bates AK. Conference Insights: Online marketing and eDetailing: in-depth report from an eye for pharma conference. J Med Market 2006;6:298-300. [More detailed version available at www.keywordpharma.com]
- Lerer L. E-business in the pharmaceutical industry. J Med Market 2002;3:69-73.
- Bessell TL, Anderson JN, Silagy CA, Sansom LN, Hiller JE. Surfing, self-medicating and safety: buying non-prescription and complementary medicines via the internet. Qual Saf Health Care 2003;12:88-92.
- Armstrong K, Schwartz JS, Asch DA. Direct sale of sildenafil (Viagra) to consumers over the Internet. N Engl J Med 1999;341:1389-92.
- Food and Drug Administration. Patient safety news: New safety warnings about Chantix [video]. www.youtube.com/watch?v=ep3U0SVfpW4 [cited 2008 Nov 18]
- Pfizer becomes latest to partner with fast-growing online doctors' forum Sermo. The Age (Melbourne). 2007 Oct 15. http://healthyskepticism.org/library/2007.php Go to HSL12469 [cited 2008 Nov 18]
- Johnson A. Pfizer-doctors web pact may get looks. The Wall Street Journal. 2007 Oct 15. http://healthyskepticism.org/library/2007.php Go to HSL12470 [cited 2008 Nov 18]
- Boulos MN, Maramba I, Wheeler S. Wikis, blogs and podcasts: a new generation of Web-based tools for virtual collaborative clinical practice and education. BMC Med Educ 2006;6:41. www.biomedcentral.com/1472-6920/6/41 [cited 2008 Nov 18]