Yesterday, I posted one simple idea: pharmaceutical company employment of Twitter to notify patients about drug recalls, counterfeit drugs, or drug safety warnings (see “Twitter and Drug Safety: A Paramount Concern“).

There has been an interesting discussion in the comments to that post, including comments from representatives of Novo Nordisk and Johnson & Johnson. I also had some good reactions from my Twitter pals such as the following:

  • RT @MaverickNY: RT @pharmaguy Pharma shld use twttr 2 warn patients abt drug recalls, counterfeits, warnings, etc. eg, Levemir… /Gr8 idea! (posted by @blogaceutics)
  • @pharmaguy Really interesting perspective on Pharmaceutical Industry and Twitter. (posted by @askfrasco
  • Liked: Twitter and Drug Safety: A Paramount Concern (by @pharmaguy) (posted by @andrespong)
  • RT @MaverickNY @pharmaguy Pharma should use Twitter to warn patients about drug recalls, counterfeits, warnings eg, Levemir… /Great idea! (posted by @whydotpharma)
  • Great perspective from @pharmaguy on “Twitter and Drug Safety: A Paramount Concern” (via Pharma Marketing Blog) (posted by @DUrbaniak)
  • @pharmaguy argues that Twitter should not just be a marketing tool for pharma but a consumer safety mechanism too (poseted by @Media_Allori)
  • A capital idea! RT @pharmaguy: If patient safety is paramount concern, use Twitter to notify patients of probs: (posted by @fredgebhart)
  • RT @pharmaguy Pharma should use Twitter to warn patients about drug recalls, counterfeits, warnings, etc. eg, Levemir… /Great idea! (posted by @MaverickNY)
  • @pharmaguy Right on ! They should allow users to register at product websites for new information (posted by @richmeyer)

What was a half-baked idea yesterday has morphed into the idea that individual drug brands should have Twitter accounts to support patients who use the brand.

Virtually all pharmaco Twitter accounts spew out corporate communications that are not likely to be followed by many patients. Novo Nordisk, which has a Levemir-branded Twitter account (Race with Insulin), is the exception. However, that account so far has focused only on marketing (see “Novo Nordisk’s Branded (Levemir) Tweet is Sleazy Twitter Spam!“) and posting the daily trials, tribulations, and hopefully victories of spokesperson with diabetes and racecar driver Charlie Kimball (see “Charlie Kimball, Novo Nordisk, and Me Make Up“). It offers very little in terms of patient support.

A branded, patient support Twitter account can be used for more than just issuing safety alerts. The following are just a few ways that a branded Twitter account can be used for this purpose (I’ve taken many of these suggestions from @philbaumann‘s post: “140 Health Care Uses for Twitter“):

  • 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
  • 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
  • Adherence and compliance messages
  • etc.

A branded patient support Twitter account can deliver appropriate messages to followers who opt-in to follow via notices on the web site as @richmeyer suggests. Because of the viral nature of Twitter, one follower can lead to many more with very little extra effort or expense on the part of the sponsoring pharma company. If the posts are relevant to patient needs, followers will RT (re-tweet) and recommend that others follow.

Unbound by Time and Location!
@blogaceutical made an observation via another Twitter discussion thread that Twitter allows users to communicate with a lot of people immediately. This makes Twitter useful for sharing time-critical information such as drug safety alerts.

Because you can also receive Tweets via your cell phone, you can receive text-message Tweets wherever you are. On the iPhone, of course, you can use Twitter apps to view Tweets integrated with the Web browser. Twitter, therefore, is the perfect mobile application for patient support.

One of the best features of Twitter, IMHO, is the 140-character limitation. No one has time to read lengthy messages. However, Tweets can include links to the patient support area of the Web site where patients can get as much information as they want, when they want it (assuming the Web site has the expanded information).

What About FDA Regulations?
Whenever we are talking about a pharma-sponsored new media branded application, we have to consider how the FDA would react to it. Unfortunately, FDA has not come up with any guidelines we can use, so we have to read the tea leaves and use precedents to guide us.

Obviously, a branded patient support Twitter account would juxtapose brand name and indication on the Twitter account home page. It must, therefore, have the necessary fair balance information. Race with Insulin is an example and may be a precedent to cite. However, FDA may yet review Novo’s use of Twitter and declare it violates the law.

However, I don’t think any of the above uses of Twitter for branded patient support will run afoul of FDA regulations as long as marketing is kept out of the picture. That is, patient support Tweets do not need to mention product benefits.

@MeredithGould noted “This would require actually training people how to use Twitter properly and well.” Very true. Recall that Lilly got into a lot of trouble (with the FTC) for sending an inappropriate email message to patients. The message was “inappropriate” because it included the email addresses of all recipients in the CC line, which was visible to everyone who received the email.

With Twitter there is no personal information that can be inadvertently shared with all recipients of Tweets (except the personal information Twitter users reveal about themselves). However, personnel who write the Tweets must be trained how to do it without breaking any laws or regulations and in compliance with corporate/brand goals as well.

As always, there are many nuances to consider and barriers to overcome to implement what I am considering. It would be great if these ideas were discussed at conferences so that solutions could be found and shared. I welcome your opinion on this. Please take the following survey on how effective Twitter can be in carrying out patient support activities/communications:

What’s Your Opinion About Branded Patient Support via Twitter?