In today’s #hcsmeu (Healthcare Social Media in Europe) discussion via Twitter, I posed the question “Patient support via Twitter: is there a need for Pharma to do it? or should it be left to HCPs?” Actually, this was how Andrew Spong, a leader of the discussion, nicely rephrased it. 

I was actually looking for some more specific insights about how Twitter could be used for patient support such as those in my “What’s Your Opinion About Branded Patient Support via Twitter?” survey. But I was glad the topic got shifted somewhat into a debate of the role of pharma versus healthcare provider in patient support.  

Marc Monseau, the Twitter and social media face of Johnson and Johnson, suggested the following uses of Twitter by pharmaceutical companies (see me in my Hawaiian shirt and Marc Monseau in this video from Digital Pharma 2009:

1. Customer Service
2. Provide Expert Advice and Information
3. Traditional News and Information Provider
4. Suggestion Box
5. “Engage with you in some other fashion”

What did he mean by “Customer Service?” I could ask him, but it’s better we deconstruct that concept here and decide what WE mean by it.

First, who is pharma’s “customer?” That’s a bit like the blind men describing an elephant. To a PR, corporate communications person like Monseau, the customer might be the media – reporters and such. To the medical affairs people it would be key opinion leaders and other healthcare professionals. To the managed markets people it would be P&T committees and other managed care professionals.

But what about the consumer and specifically the patient? Who inside pharmaceutical companies think of the patient as their customer? Officially, no one. The product manager and other marketing people certainly want to reach out to consumers and spend a lot of money doing that. To them, however, the consumer is a TARGET, not a customer to be supported. Once a consumer becomes a patient, the brand team virtually ignores him or her.

Yes, everyone within a pharmaceutical company has the patient “top of mind” in every thing they do. Maybe. But I question if TOP executives put patients first. I’ve documented many times here on this blog where it appears that top pharma executives think Wall Street analysts and investors are their customers that they have to support. When was the last time you, as a patient, was invited to listen in to a CEO presentation?

OK, so pharma companies have a problem viewing patients as customers because they have no one inside their organizations whose job it is to specificly think of patients as their customers.

A platitude that’s often repeated at industry conferences focusing on the Internet is that you need the “buy in of top management” to be able to implement a successful social media program. Bull! As I just said, top management’s main concern is Wall Street. They want ROI because that drives profits, which drive stock prices. They are not interested in tactics; ie, how you get ROI, they just want ROI.

Another obstacle in SM evangelists’ quest to get pharma more “engaged” with consumers/patients via social media is the sacrosanct physician-patient “relationship.” Pharma is loathe to “interfere” with that relationship. But is there really a relationship? I don’t see myself having a relationship with any of my physicians. They do not contact me by email or via Twitter or even by phone! I have a better relationship with CVS, which calls me every so often to remind me to refill my prescriptions. But my physician does not call me to remind me to come in for a test to make sure those prescriptions are not destroying my liver!

What the drug industry really should stay out of is the conversation between me and my physician once I am in the office. But if CVS can call me to remind me to refill my Lipitor prescription, why can’t Pfizer DM me via Twitter and remind me as well? In fact, there are many other “support” activities pharmaceutical companies can offer patients via Twitter, including:

  • Drug/device safety alerts (eg, drug recalls, medical device malfunctions, emerging safety issues)
  • Prescription management, including pharmacy refill reminders
  • Daily health tips from authoritative sources
  • Publishing disease-specific tips
  • Clinical trial awareness & recruitment
  • Enhancing health-related support groups (e.g. buddy-systems for depression)
  • Providing around-the-clock disease management
  • Patient-sharing of health-related experiences
  • Issuing dietary/lifestyle tips

(Thanks to Phil Baumann who compiled a list of “140 Health Care Uses for Twitter“, which included many of these activities.)

Some people will say that there are not enough patients using Twitter to justify this. However, everyone who uses Twitter is or will be a patient. What the naysayers mean is that there is no mass audience, no ROI! Parden me, but ROI should not be the goal of customer support!

In order for any customer support channel — whether it be Twitter, email, or phone — to work, it must be promoted and require opt-in. Pharmaceutical companies already solicit visitors to Web sites to sign up for email messages, which are most often merely marketing messages. They could also solicit patients to sign up for Twitter support if they had a mind to do it.

So, when you ask how pharma can engage consumers via social media, first define what you mean by “engage” and who you mean by “pharma.” Does engage mean “market to” or “have a conversation with” (if so, a conversation about what?). It’s not likely you’d get many consumers to opt-in to engage in marketing conversations with pharma. But if you offered something of more value to patients, then you might succeed in gaining a lot of followers via Twitter.

Also, don’t forget the “who.” Among all the pharma Twitter accounts, I only can recognize a human being behind 2 or 3 of them. All of these people are dedicated and competent, but all are part of corporate communications, which is the least trusted source of information as far as consumers and patients are concerned. Where’s the consumer ombudsmen within pharma that can build the necessary trust before engaging consumers? That’s the question you need to ask and answer to determine if social media can be successfully used by pharma.