 Getty images: Russell Tate
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Big Pharma's approach to social media is a work in progress, with the will to engage hampered by the impact of regulation
and reputation. The medium wants companies to talk, but regulators and their legal interpreters press heavy on the mute button,
while patients and the public wonder whether anything credible can come from listening in. I recently took a trip on a packed
Acela train from Newark, NJ to Washington DC with some bright young things from a digital agency working for the industry.
They spent the journey lamenting the days when they could set up patient front groups and slip off-label claims onto "sponsored"
sites. Anything involving real engagement with real people was illegal and, at any rate, undesirable. Specifically, I was
told that a single New York Times reporter, Duff Wilson, is assigned to cover tobacco and pharmaceuticals. Their conclusion: "That's all you need to know about
how Big Pharma is viewed on social media."

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The lesson I draw from this is that pharma companies looking to influence policy and practice through social media must avoid
putting the emphasis on precedents from their well-funded advertising and corporate communications campaigns. Instead, they
should look to examples of engagement around alliance development and patient outreach programs, four of which we profile
in sidebars to this story.
 Global Health Progress
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Those table-mates on the Acela seem to reflect a lot of the thinking from Big Pharma on digital communication. A review of
links to brand-sponsored patient communities reveals that many of them no longer work. Those that do often resemble the digital
equivalent of a declining prairie-state town, with people and props frozen in time. The blame seems deflected away from the
companies themselves: a recent survey by the consultancy Cutting Edge found that industry is dissatisfied with its digital
agencies. Not one of the 34 respondents thought that their experience with outsourced digital marketing had been very good;
a third thought it was poor.
But there must be some decent people in the field. There are a few good examples of product-led sites, with some clever examples
of patient involvement. Tiny UCB, for example, has created some innovative design tools around a yet-to-be-launched medicine
for Crohn's disease. The glaring omission here is anything about the big questions in health—the ones that will decide whether
you and I have a job in the industry in 10 years' time. No one in Big Pharma is using social media to shape the decisions
that policymakers make on health, despite growing evidence that the Twittersphere is molding opinion and thus calling the
shots.
To be taken seriously on policy, companies need to use the social media networks to position themselves as helpful participants
in the debate. Through their online engagement they need to identify and advance shared goals with allies, even if those allies
don't necessarily agree with the company's approach.