The Cyber Six: ePharma's Hot Growth Spots

Promising opportunities for e-business created an optimistic mood at the 2001 ePharma Summit.
Jan 01, 2002

Although other trade shows and industry events suffered cancellations and poor attendance after the September terrorist attacks, November's ePharma Summit in Philadelphia was largely unaffected. The crowd of pharma company e-business executives, academics, and exhibitors included some new and welcome faces-venture capitalists and online media representatives from web portal giants such as AOL and Yahoo! scouting the conference for potential investment and partnership candidates.

That interest served to reassure pharma companies that they're headed toward growth, with a focus on five hot e-business areas that may herald the the industry's direction, communications, and even product development. Additionally, a sixth area emerging from the education field may energize e-learning for several pharma audiences and significantly improve general understanding of the science behind breakthrough research and treatments. They are as follows:

1. eClinical Trials The critical shortage of eligible, qualified clinical trial patients has become a leading cause of delayed regulatory filing of new drug candidates, which, in turn, creates huge losses for pharma companies and their research partners. And, although the National Institutes of Health, patient advocacy groups, and established portals such as

CenterWatch, Patient Quest, and Acurian have boosted the number of patients responding to trial announcements, they haven't solved another major problem plaguing pharma R&D-recruiting qualified patients while maintaining the confidentiality of the sponsoring company and the inquiring patient or physician.

According to a recent report by Kevin Berg, CFA and Noah Yosha, healthcare services analysts for FAC Equities, technological savvy and proprietary software are not the keys to success for web-enabled clinical trials. They say that contract research organizations (CRO) and other companies competing for pharma's business and partnerships will require them "to understand and piece together the various technologies and be able to link the clinical trial participants," such as sponsors, internal staffs, patients, doctors, FDA, and CROs. Berg and Yosha contend that the "winners [in that competition] will separate themselves by building and operating a model based on the process and not on the technology.

2. Electronic Data Capture (EDC) According to Charles Jaffe, MD, PhD, director of medical informatics for AstraZeneca, "the need for speed" in clinical trials can be achieved only when clinicians, researchers, executives, and regulators end their "antiquated" relationships with paper records and implement electronic systems. His vision for the ideal research environment fuses the benefits of EDC with electronic medical records.

"Tomorrow's technology offers more than faster trials and secured data," he wrote in an editorial published by the American Academy of Allergy, Asthma & Immunology. "The clinical record of the not-so-distant future can be tied to the data requirements of clinical research. The patient record and the trial documentation will be seamlessly integrated. Patient care, best practices, and drug development will be married by a common bond of improved outcomes, cost containment, and rapid deployment of technology. Subject recruiting will be unnecessary, investigator meetings will be held online, and clinician satisfaction will again climb."

Per G. H. Lofberg, CEO and president of Merck Capital Ventures, identified EDC as an area of interest for his company, which has already invested in the web-enabled clinical trial recruiter Acurian. In a keynote address, he stated that EDC at investigator sites is "off to the races," as the number of research organizations adopting the technology grows around the world.

Michael Barrett, a Forrester Research senior analyst, supports Lofberg's assessment, acknowledging that EDC technologies are evolving to meet the needs of those on the front lines of research who have been dissatisfied with other methods of data capture for more than a decade. In his presentation, he said that the reasons for clinical research coordinators' and associates' dissatisfaction ranged from the on-site data entry burden (68 percent and 49 percent, respectively), to system user-unfriendliness (40 percent and 32 percent) and high cost (24 percent and 34 percent). He also cited research, based on a survey of 400 clinical trial professionals, that demonstrated researchers' preference for web-enabled systems over paper. (See "Imperfect Web Better Than Paper,"page 76.) His final message to pharma executives was that researchers expect trial sponsors to push the transition to EDC and that the companies who lead that push will not only gain competitive advantage, they may also generate tremendous cost savings in the process.

ScienceMedia uses compelling, science-based visual content to educate physician and patient audiences about therapeutic mechanisms of action as well as basic human biology.
3. eDetailing Although patients have taken greater control of therapeutic selections, physicians still have the final word. They are pharma's most important customers, but they have become more and more difficult to reach with product and corporate messages.

During a crowded presentation by Physicians' Interactive, IMS Health, and Allscripts, it became clear that e-detailing is a major blip on the radar screen for investors, pharma companies, and physician groups. The presenters worked to persuade the audience that e-detailing complements pharma companies' sales forces and offers reps another vehicle for reaching busy or "no-see" doctors who prefer a "virtual detail" at their leisure. PI's general manager Aaron Gerber, MD, suggested that those virtual details can also be used as effective market research tools that monitor physicians' attitudes about research findings and the products involved. Gerber says pharma companies that may have thought of detail calls as having one purpose only-sales-are now considering the opportunities they afford for gathering physician feedback.

In a workshop hosted by Cap Gemini Ernst & Young (CGEY), participants considered "Death of a Sales Rep," a controversial tag line for a trend proposed by Alisdair Mackintosh, a CGEY vice-president and global leader of the company's marketing and sales/CRM practices, life sciences, and chemicals. He suggested that, although widespread adoption of e-detailing may not put pharma sales reps out of work, it will definitely require reps to shift from their roles as "drug sellers" to "treatment advisors." In the future, Mackintosh advised, pharma companies will have to use new benchmarks for sales force success that include e-detailing's impact on their relationships with physicians.

4. e-CRM CGEY's Mackintosh also urged pharma companies to maximize the richness of physician and patient data through effective implementation and execution of electronic customer relationship management (CRM) systems. "Don't just install the software," he counseled. As he delineated some of the major action imperatives identified by the workshop, he advised workshop participants to move from science-based to business-based models, as consumer goods companies did, with great success. Executing effective e-CRM, he contends, is one way to begin doing that.

Executives from C3i, a partner of e-business consulting giant Siebel, explained that Big Pharma is perhaps the slowest to capitalize on e-CRM because of the many mergers and acquisitions hampering the integration of companies' employees and operations, not to mention their sales force automation systems (SFA). Berlex Laboratories hired C3i to provide a host of e-CRM-related services to its 800 users, including web-based learning, instructor-led training, production support, and data analytics. But not all companies are at that level of integration.

Several presentations and lectures at the ePharma Summit discussed the obstacles faced by companies attempting to make the shift from older SFA systems to more modern e-CRM systems. One obstacle, generated by the impact of HIPAA regulations on prescriber and physician data, continues to thwart the best efforts of pharma companies and their research partners. The perceived bureaucracy created by the legislation has confused both groups and delayed the progress of implementation because of panic over timely compliance.

At the booth for Physician Verification Services, which provides pharma company websites with a security system to verify the authenticity of users' MD credentials, several executives discussed the need to ensure that their professional users are who they say they are. That would quell the fears of many in the industry concerned about violating FDA and DDMAC marketing regulations that limit certain scientific communications to healthcare professionals and prohibit the dissemination of that information to consumers.

According to Mark Bard, healthcare practice director of Fulcrum Analytics (previously Cyber Dialogue), pharma companies should consider consumers their next most valuable customer after doctors for marketing communications.

In a recent industry analysis published online, he wrote:

"There are currently 11 million ePharma consumers online. That number is projected to grow to 20.4 million by the year 2006. As companies learn to integrate online channels as an equal partner to traditional offline initiatives and as the marketing savvy and understanding of the web grows, the ePharma market will become even more attractive to product managers. Pharmaceutical companies, general health portal sites, and healthcare providers each bring specific strengths and weaknesses to the table. If they work together in a rational fashion, they can optimize the impact of internet initiatives as part of an overall brand strategy."

5. ePrescribing Large pharma companies aren't the only ones slow to change their e-ways. Although the numbers are climbing, physicians still rely on paper and pen to scribble down prescriptions. And, although a few major national pharmacy chains have adopted the necessary enabling technology and standards, many patients have yet to realize the safety and convenience of e-prescribing.

According to Glen Tullman, CEO of the growing physician e-learning company Allscripts, the mainstreaming of e-detailing may mean that widespread adoption of e-prescribing is not far behind. In fact, Walgreen's and Eckerd have already implemented infrastructures and technology enabling e-prescribers to send formulary-checked prescriptions to their stores.

"Part of our strategy has been that, although we started off just with prescribing, the most common physician behavior, physicians told us 'that's not all we do,' and 'I don't want to wear a bat belt,'" said Tullman, explaining that doctors don't want to carry the various handheld devices -such as those for dictation and document management, bedside medical reference materials, charge capture, and electronic medical records-that would help them streamline their practices.

He predicts that doctors who avoid using all-in-one handheld devices and who are slow to adopt e-detailing and e-prescribing practices will find that their businesses suffer. He believes patients who are well informed and motivated to make their own healthcare decisions will expect their providers to be at least as technologically savvy and facile as they are.

6. Interactive eLearning New developments in digital animation and illustration will hit pharma marketing like a tidal wave, devastating current methods of pharma e-learning in its wake. Enterprises such as Philadelphia-based Medical Broadcasting Company have known for years that learning must be dynamic, and they have created fascinating and realistic digital images of therapeutic agents' mechanisms of action, anatomic structures, and biological processes involved in drug metabolism, as well as other vital elements of sales force training, physician detailing, and public education programs. (See "Insider Profile: Of Science and Showbiz," PE August, 2001.)

From her booth at the ePharma Summit exhibit hall, Michelle Youngers, president and CEO of ScienceMedia, showed observers stunningly sophisticated digital animation that took viewers on a voyage inside the human body, inside the microscopic worlds of cells, viruses, and bacteria. Originally, Youngers' San Diego´┐Ż´┐Żbased company served medical textbook publishers with web-enabled teaching modules and interactive CD-ROMS that supplemented printed course materials in biology and biochemistry. That experience enabled the company to reach out to the pharma industry and help companies develop interactive animation software to use with their sales forces, healthcare provider customers, and direct-to-consumer marketing campaigns. (See "Fantastic Voyages.")

The Next Big e-Thing Merck Capital Ventures' Lofberg summed up the annual themes of the ePharma Summit with optimism and candor: "Two years ago, it was 'Irrational Exuberance.' Last year it was 'Doom, Gloom, and Despair.' This year, it's 'Three Yards and a Cloud of Dust.'" Next year's theme may be difficult to see through that dust, but industry observers point to expanded use of e-mail marketing as the next big growth area for web-enabled communications.

"If there is any history generated at all next year on the internet, it is going to be in the area of e-mail," wrote Emerging Interest founder and CEO Bill McCloskey in the December 2001 issue of Media magazine. "Particularly, rich media e-mail. Any direct marketers (especially traditional direct marketers) who are not at least looking hard at rich media e-mail and giving themselves a crash course on the subject will be in the corner wearing dunce caps by 2003."

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