How pharma can gain partnership with health care constituencies to develop patient centred care.

1. Pharma, Care and Social Media
How to gain partnership in care –
say “trust”?
Rob Halkes
Pharma Marketing Summit,
Zürich October 13, 2010
value innovation in medical and life sciences

2. Disclosure
> 20 years Health care business development consultant
to all parties in health care, a large part of them being the
pharmaceutical industry in the Netherlands and Europe;
Use a bit of social media
1 Participant in
#hcsmeu –
movement.
www.hcsmeu.com
http://www.slideshare.net/ARJHalk/social-media-and-pharma

3. I. The Dutch Case
II. Social Media?
Development towards improved care?
Experience Co-Creation: integrating health care
patient centred!
2
III. How: Key Customer Focus:
How Pharma creates long term partnership with
health care constituencies:
- differentiated approach to Rx Decision makers
- integrating pharma care in health care 3.0

4. General Trends
Pharma market Average
Western Europe
Actual Market Conditions
the Netherlands
Declining access to prescribers;
Image pharmaceutical industry;
More and more strict regulation of
3
Pharma promotion
Cost of health care is high on The
political agenda: price erosion Netherlands
Pressure on prescribing generics
International
No large blockbusters
Sales forces rationalization
Centralization
Pharma at the “Tipping Point”
Search for new business models

5. 4
Roland Berger: Penny wise, Pound Foolish? May 2010

6. The Dutch Health care market Privatising health care market
2006: Liberalisation Health Care Insurance Customer
Market, Health Care Health care
Insurance provision
• Power and direction of market
market market
development to HC Insurance Co’s:
• Buying power: Pharma tenders, Health Care Health Care
Insurance Co. providers
• Selection of health care providers,
Health Care
• Towards integrated care; Contracting market
5
Liberalisation of prof. medical activities in clinic:
Non-negotiable and negotiable (A & B segment) med. activities,
System of DRG (diagnose related group of act.);
Focus and concentration of care at local GP-level
Integrated care for chronic conditions at health care groups –
towards integrated cost of care (Outcome pricing?);
Allowance for private investments and profit;
Still national Budget/ Standard package of Care Insurance ↓;

7. Primary care: GP practice consolidation
= GP
6 = pharmacist
= nurse practitioner.
1970 2008 = other HC profess.
(51%)
Group+ Health
Solo (20%) Duo (29%) Group
Pharmacist Centre

8. Health Care groups focus on development of chronic care
(Diabetes, COPD, CVRM, etc)
– so as to negotiate with
the heath care insurance co’s.
N= +/-100
HC- HC- HC-
group group group
7
Structures on
Waar-
three levels A- 1e lijns
HOED neem
HOED centrum
groep
GP GP GP
GP GP GP GP GP GP

9. What is this with Social Media?
8
Crossweb.nl
chainconnection.com

10. And What could you do with them?
Publish
MMO Share
9 Social
Discuss
Games
Virtual Social
Worlds Networks
Micro
Livecast
blog
Life
stream
bartvandecasteel.wordpress.com

11. Create
Transactional Desired
Occasional Outcomes
Impersonal Continuous
Short-term Intimate
Loyal
Web 1.0 Web 2.0 Web 3.0
10
- Exposure - Interactive - Focus
- One way - Sourcing - Collaborative
- Information - Dialogue - Commitment
- Public - Public/Private - Together
- Private
Communicate Engage / Relate Collaborate
partner
Listen Engage

12. What party does not use Social Media?
All parties in caring for health and health care use social
media:
Health care providers,
Health care providing organisations: hospitals,
11 pharmacists, GP, local HC centres, etc. etc.
Health Professional organisations,
The government and Ministries of Health,
Health Authorities;
Health Care insurance agencies;
The supplying industry;
Health care publishing agencies;
Patients and patients organisations, and
Yes, Pharmaceutical industry as well…
And each party benefits from them too!

13. But: Pharma is under scrutiny!
Web1.0 and Web2.0 is subsumed under public
Information, so under scrutiny from promotion and
advertising rules;
Accountability;
12
Fulfilling Regulatory Requirements;
Posting Corrective Information;
Links;
Adverse Event Reporting;
Sandra van Nuland, Zamire Damen
April 2010

14. How to tackle the obligations?
Beyond current and existing
systems for pharmacovigilance:
Monitor all social media and internet
mentions of the company and brands,
(Boehringer Ingelheim);
13
Publish guidelines to be followed
internally and to advise external ppl. (Roche);
Design, pilot and test!
Attend to the ROI of things..
Even better to “Return on Health”
ROH!
FDA/ EMEA is watching!

15. Starting opinions
re.: Pharma & Soc. Med.:
- Twitter & non T
- Pharma & non Ph
14

16. Lessons learned in Pharma2.0:
There are structural and fundamental changes in communication
in going
from “advertising” to “engaging”: “Do not promote”…
Form product oriented to patient centred:
15
Listen more than talk;
Be transparent and honest;
Be authentic;
Be personal;
Information ≠ informing
(Quote by Hilda Bastian, IQWiG, Germany)
Pfizer’s principles in online information
Rene Neubach, October 2010

17. Pharma 1.0 Pharma 2.0 Pharma 3.0
- Exposure - Interactive - Focus
- One way - Sourcing - Collaborate
- Information - Dialogue - Commit
- Public - Public Private - Patient’s
Privacy
Communicate Relate Collaborate
One way Two way Experience
16 information Communication Co-Creation
- - -
“Access” To interact Collaboration
- - Partnership to
Detailing E-detailing health care
Conferencing Email campaigns development
Educating Building -
communities Improving
Health Care
Outcomes

18. “Experience Co-Creation in Care”
Imagine structuring and solving problems in process
of delivery and implementing the therapy
Other
Friends Patients Coach
Etc.
Family
Patient
17
GP
Nurse Etc.
Ph Logistics
Industry HCI

19. How does EC3 support HCproviders
in their medical profession
It supports them with support to their patients without a
great deal of investment or energy;
It helps them reach goals in health (e.g. compliance) more
18
easily;
It distinguishes their business from other health care
providers;
They are enabled in cooperation with other stakeholders
without competition between them;
Their professional needs of caring for health care will be
satisfied.

20. How does EC3 help patients
They find a trusted and reliable, easily
accessible health care context that satisfies
their needs in their care for health!
Their care provision is integrated, structured
19 and organised for all related health care
provider and stakeholders;
They have all sorts of information and
support facilities that their providers also are
accustomed to;
They feel a sense of trust and peace of mind,
because there’s always a human helping
hand and listening ear – one click away.

21. Pharma: Add to your promotion:
“Key Customer Focus”
1. From promotion to Health Care Support and Health care
development:
Value proposition by Integrated Offering;
2. From Approaching Individual Prescribers to
20
Health Care Groups:
Segmentation of Potential, Accessibility and Feasibility;
3. From promotion only, to collaboration and on to Partnership
Operational levels of cooperation;
4. From a standard approach to all, towards Differentiation of
Accounts;

22. Development of integrated
value proposition
Product Medicine, Drug profile Product
Rx
Core: Pharmaceutical and Information on
Pharma economically characteristics features,
functionality and effects
21 Focus on adequate use Augmented brand
1st Layer
For the right patient Support and service by
in the right condition marketing tools
through different channels
A. Professional Support of Value proposition
HC professionals A. Patient oriented health care
2nd for the patient activities by Health Care
Layer Professionals
B. Cooperation and synergy
between co-acting B. Increasing HC effects by
health care providers improvement of care and health
processes

23. Possibilities and perspectives for EC3
Communication and information to patients
Self knowledge tests on condition and implications
Patient coaching on initial experience of diagnosis
Support to first drug issue
Peer support and coaching
22 Patient partnerships
Integrated connection for care processes
Close cooperation with pharmacists, health care providers
and other stakeholders in care
Compliance support
Behavioural change and life style support
Food and nutrition information
Information on multi drug interaction issues
From first support to problems in use
Remote diagnosis
Patient profiling

24. Development of value proposition
Key to an effective value proposition of Pharma, is:
• A USP that opens doors to gain access;
• Added value to health care professionals and health care payers;
• Added value in terms of improvement of patient care;
• A means to develop and sustain a long term relationship.
Guidelines to the development of the value proposition:
• Define major steps of treatment to the disease to define the total
cycle of care to the patient
23 (from awareness and diagnosis to treatment and recovery);
• Develop Care for the disease as integrated HC-approach:
• Patient support programmes;
So much to gain by elaborating on:
providing information ≠ informing
• Various elements to structure the health care process by health
care providers;
• Various elements that improve care but do not extend providers’
action or time;
• Allow for various levels of offering depending on sales potential;
• Make an inventory of the needs of HC-groups with care for the
disease treatment;
• Develop business case for HC group

25. How to know the networks of influence around Rx
24
• Data collection (relevant data and keeping them up to date)
• Registration (integrating and aligning information,
report and relation management systems)
• Segmentation (segmenting account groups)
• Targeting(selecting and focusing on access and sustain
relationship)
Not just on potential of individuals, but of groups,
their accessibility and the feasibility for success
to differentiate

26. To determine 1. Analyse and Profile
Decision makers’ differentiating
Selection and
segmentation of
Potential characteristics on Accessibility Accessibility
Variables
and Accessibility
2. Determine main dimensions
for distinguishable
approach
Determine feasibility of success
Distinguish categories
Test Define and decide
on Routines and
25 Content of approach
3.What steps in Account
development and management
How to implement
Create national and
local Health Care
Institutions - Focus on content
to create
guiding and 4. Upon analysis
Collaboration for
sponsoring create specific value propositions /
Health care
Health Care incentives
development,
Development by gradually moving
your partnerships into optimising
patient care
5. Implementation

27. Account Based Marketing
Everything must be seen fit to the account!
Segment type
Data and characteristics Targeting
Effects and output
Investment: volume
26
Monitoring Account
Commercial action plan
Related professional functions
Process structures
Account management
Information and
Means and channels communication

28. To create cooperation: Steps towards
Integrated care and Partnership
4. Targeting
health care
Contract to integrated care with more parties:
Level of Multi party deal on outcomes outcome directed, long term,
Health Outcomes With more
Integration stakeholders In development and improvement.
Value
Value
3. Commitment Design Contract to design and implement
27 and realisation of
Partner to joint tailor made Based on customer knowledge,
Creation
Creation
Results solutions
Level and in co-makership.
2. Cooperation to
Commitment on Implementation Contract:
Level of realize
mutual effort goals Agreement at DMU level, on effort.
Cooperation
1. Sponsor contract:
Service Offering These are our
Level of services Utilising capacity,
Sponsoring
Transaction Experience and “know how”.

29. “Key Customer Focus”
1. Learn which accounts to focus on, depending on
accessibility, potential and feasibility of success;
2. Teach the field forces how to differentiate in their account
management;
3. Define and create value propositions that adopt the
28 customers’ desires and demands for results of the
relationship with pharma and for health outcomes,
into EC3;
4. Teach marketing and field force to step beyond promotion
and develop cooperation towards partnership with health
constituencies;
5. Decide strategically your company’s position to health care;
6. Develop a business cycle to budget and implement, and to
adopt to changing market conditions.

30. USP in pharma field forces
Integrated Offering Development of
Integrated Health Partnership
and Pharma Care in stages
29
Differentiated Business Model
Account Specification
Based Marketing

31. 30
THANK YOU

32. References
31
Never hire an expert: http://timbaker.info/never-hire-a-social-media-expert/;
Rob Halkes, Social Media and Pharma, Selling Sickness, Amsterdam, & October 2010:
http://slidesha.re/acjF84
Pennywise, pound foolish? Accessible, affordable and high quality pharmaceutical healthcare for the
Dutch patient – Today tomorrow. Position Paper, Roland Berger, 2010.
Quote by Hilda Bastian, IQWiG, Germany: Independent Patient Information, Selling Sickness Conference
A’dam 7 October 2010, http://slidesha.re/avDQrK
Rene Neubach,Pfizer: How to successfully launch online programmes and engage with HCPs, Digipharm
October 2010
Judith von Gordon-Weichelt, Head of Media & PR, Boehringer Ingelheim GmbH, Social Media Monitoring,
Digipharm Conference London, October 2010;
Ernst & Young, Progressions Pharma 3.0, Global Pharmaceutical Industry report, Basel May 2010.
Rob Halkes, Experience Co-Creation in Health Care (EC3), http://wp-pharma.waardeinnovatie.nl/?p=183

33. Van Spaendonck’s BU “Value Innovation in Medical and life Sciences”
is a focused consultancy firm.
Van Spaendonck management consultancy supports and directs parties and professionals to
proper choices and processes to create and develop their USP, a better market position and performance.
In the dynamics of health care systems, pharmaceutical industry, health care insurers, social parties,
and health care professionals will be challenged more and more to their added value.
The business unit “Value innovation for Medical and Life Sciences,”
has the needed expertise and experience to initiate and develop processes and clinics for health care, marketing,
sales and management systems, professional development, and strategic organisational change.
20 years of consultancy expertise to pharmaceutical and medical industry, life sciences and health care.
Actual research and publications in health care and marketing developments.
Rob Halkes
BU Van Spaendonck – Value innovation in Medical and Life Sciences
T +31 418 578000
M+31 653 420722
E r.halkes@VanSpaendonck.nl G.E.H. Tutein Noltheniuslaan 7
W www.medicalandpharmamarketing.com 4181AS Waardenburg
T www.twitter.com/rohal the Netherlands
value innovation in medical and life sciences