The Active Patient: Faces Of Change - Pharmaceutical Executive


The Active Patient: Faces Of Change

Pharmaceutical Executive

Acting up online

The vibe at's headquarters in San Francisco's Pontrero Hill district is an even commixture of dressed-down mellowness and political urgency. Sunlight blooms through unobstructed windows onto hardwood floors and illuminates the office's white, industrial-style interior. Employees freely congregate around unwalled work centers and flat screens in the main office space. Philz local blend coffee is available in the kitchen, and Kentucky, Cayo-Cotter's dog (rescued roadside on a trip through the Bluegrass State) tirelessly pursues a tennis ball. Cayo-Cotter joined in 2011, after founder Ben Rattray reorganized the company's focus.

Rattray, a Stanford graduate, launched in 2007 with a desire to "use technology on a massive scale to create positive change, not just as a way to share photos or sell coupons," says Cayo-Cotter. In the beginning, was fundamentally a blogging platform, with a fundraising capability and space for debating ideas. Bloggers on the site could start petitions around things they blogged about, and eventually Rattray decided that petitions should be open to anyone on the site.

One of the first non-blogger petitions was started by a South African woman, a lesbian, whose close friends had been victims of "corrective rape," a practice whereby gay women are raped by men in an attempt to correct them of their lesbianism. The South African government wasn't addressing the problem, and in one week the petition had racked up nearly 150,000 signatures from people all over the world. Rattray started getting calls from the Justice Ministry in South Africa. Ministry officials agreed to set up a task force to examine the problem, and to consider hate crime legislation. Corrective rape is still prevalent in South Africa, but Rattray's experience with the campaign convinced him that online petitions could serve the public good.

Others remain skeptical about the actual power of an online petition. Last fall, introduced a new tool aimed at further demonstrating the impact of its petitions, called Verified Decision Makers. Once a petition is created, can reach out to the decision maker and let them know about the campaign. The decision-maker is given a dedicated page and instructions on how to respond to the petition. If the decider responds directly to a petition, those comments show up on the petition page, to be shared and critiqued by other online commentators.

"It's really interesting to see which decision makers respond, and how they respond," says Cayo-Cotter. "So far the most responsive entities have been local government officials, followed by companies, and third is the federal government in the US, which is kind of a telling state of affairs." There has been some federal participation. Rep. Paul Ryan (R-WI) and Sen. Elizabeth Warren (D-MA) are both Verified Decision Makers.

Cayo-Cotter says pharmaceutical company decision makers "would be fantastic to have on the site...there are so many petitions around health issues." Over 10,000 health-related petitions were signed by over 18 million people, at press time. hasn't begun pitching the Verified Decision Makers tool to pharmaceutical executives yet, but "if anyone reading your article wants to sign up, we'll get them verified," says Cayo-Cotter.

Pharma isn't known for its consumer-facing digital prowess, but companies "trying to brand themselves and show their investors and their customers that they're different, and willing to engage with patients in an interesting way...I think there's a real advantage in that," says Cayo-Cotter. Pharma is "already creating responses to policies and proposals around things that are getting raised in petitions. They're just being left out of the conversation. This is an opportunity to directly communicate with the people that care the most about a particular issue."


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