Drug Safety: Failure to Communicate - Pharmaceutical Executive


Drug Safety: Failure to Communicate
The new drug safety system won't be fixed until companies learn new approaches for teaching patients about their drugs

Pharmaceutical Executive

PR's Cognitive Approach

Would you eat spinach from California? Would you feed your dog pet food from China? Even now, the repercussions of the notifications that those products have a serious risk associated with them persist. The problem isn't only that the media communicated the objective messages of the risk, but that there was a "social amplification" of those risk messages played out in Congress and in reports of regulatory bodies, then communicated repeatedly in the media.

This same type of social amplification has significantly complicated risk communications. Vioxx is a classic case study. After Vioxx was withdrawn, lack of support of the drug safety surveillance system and Congressional inquiries continued to communicate and to amplify the perception of problems associated not only with Vioxx, but with the entire healthcare system.

The public's understanding of Vioxx's risks was greatly influenced by the resultant publicity. Attitudes about the drug, Merck, and FDA were continuously created and updated by processing the press accounts through means both active (e.g., by reading) and passive (e.g., by listening to TV in the background). Because media coverage—not necessarily objective information—drives the amplification of risk, public relations will play a heightened role in the new Culture of Drug Safety.

Risk-First DTC
Companies need to tap PR experts who can draw on more personal communications with patients. This is particularly important when major risks are disclosed and when consumers "reform" their perceptions of a product to integrate the new information. Cognitive psychologists say the information patients have received most recently is more available in memory and is most likely to influence decisions. Therefore, it follows that companies that wish to compete will have to understand what consumers believe and why they believe it—and learn how to balance newly formed beliefs with effective messaging. The new "risk-first DTC" ads for Celebrex are one example of this approach. (See "Risk-First DTC".) Evaluations, whether conducted online, through periodic surveys, or formal RiskMAP reviews of patients' and physicians' beliefs about drug safety, will be increasingly important to influence and maintain a "fair perception" in the minds of prescribers and users.

A New Supply Chain of Information

The advertising and PR industry is always looking for new ways to reach and influence physicians, patients, and the public. Now the pharmaceutical industry, out of necessity, is also looking for new avenues. Expect pharma companies to look to consumer goods (not necessarily consumer agencies) for ideas.

The omnipresence of the Web and the ease of market entrance means medication- or health-related Web sites will continue to grow. Consumers and physicians will gain more control over the content of these sites as they contribute and influence what is communicated online. What some are calling Web 2.0—essentially, community-based participation on the Internet—will evolve rapidly and will significantly change the power relationship in terms of the information supply chain.

Within the pharma industry, the transmission of information has traditionally been "top-down"—that is, from marketers to customers. Expect an increase in "bottom-up" communications. This happens when customers initiate the communication and pharma companies are the passive audience. One example is the recent arrangement between the American Medical Association and Sermo, an online physician-only community. Doctors are free to post any information on the site, but they mostly use it to ask other docs about their treatment experiences.

How can pharma participate in such a bottom-up form of communication, where the audience (in the case of Sermo, physicians) initiates and controls the dialogue? Sermo is still working out the details, however, it appears that pharma will need to adapt to a new role as a information resource for doctors with little ability to control messages and communications. This appears to fit better into the medical-communications and medical-science-liaison "buckets" than classical marketing communications. (Full disclosure: I consult with Sermo and some other companies with innovative communication models.)


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