An overview of the opportunities that physicians' social networks may offer pharmaceutical companies as an emergent new engagement channel in China. Includes analyses of current physicians' social networks in China, physicians' social networks as a global phenomenon, key learnings and Chinese scenarios. Presented at conferences in Shanghai in 2009 and Singapore in 2010. This version presented at EyeforPharma's Sales & Marketing in China for Pharma conference, 3 - 4 December 2009, Shanghai.

1. Physicians’ Social Networks in China An Emergent New Engagement Channel for Pharma? Len Starnes Head of Digital Marketing & Sales General Medicine Len Starnes Head of Digital Marketing & Sales General Medicine Bayer Schering Pharma Sales & Marketing in China for Pharma 3 – 4 December 2009 Shanghai

3. China’s social internet Physicians’ social networks in China

4. In China the internet and social are synonymous ‘ 92% of Chinese Netizens use social media compared with 76% in the US’* *The Great Social Wall of China: Netpop Research, Shanghai, 2009, www.netpopresearch.com

5. *Manhattan Research, Taking the Pulse Asia v9.0, 2009 % physicians owning Chinese physicians becoming tech-savvy

6. How many Chinese physicians online? Manhattan Research 60% Zhan Gao Haoyisheng 90% 84% Based on data from CIC Shanghai & PRC Ministry of Health 2008 卫生部政府信息公开专题 97% Bayer Healthcare China: 5 major cities

7. *Manhattan Research, Taking the Pulse Asia v9.0, 2009 Chinese physicians participate in all types of social media 78% Read posts from colleagues on bulletin boards, in chat rooms and on blogs*

8. *Manhattan Research, Taking the Pulse Asia v9.0, 2009 % physicians agreeing The internet is essential to my professional practice* Distinct similarities worldwide

9. *Manhattan Research, Taking the Pulse Asia v9.0, 2009 % physicians agreeing Internet is a crucial tool for Chinese physicians

10. *Manhattan Research, Taking the Pulse Asia v9.0, 2009 % physician respondents Demand for physicians’ social networks high across Asia

11. Good Doctor’s Forum 好医生论坛 With thanks to Mudskipper Business Consulting Shanghai > 418,000 members

12. China Asthma Alliance 中国 哮喘联盟 With thanks to Mudskipper Business Consulting Shanghai > 7,200 members

13. www.dxy.cn 1.7m members - 50% physicians - 30% biomed researchers - 20% medical students With thanks to Kevin Lin, JSure Healthmedia

14. With thanks to: Mudskipper Business Consulting Shanghai; CIC Shanghai Embryonic characteristics Majority run on public networks (BBS) No authentication, heterogeneous membership Focus on medical information, not community Owners: medical associations, commercial, private No integration with daily practice No compelling community functionality

15. Physicians’ social networks in China The Big Bang

16. Transforming the way medical information is exchanged Based on Pfizer/Sermo press release 15 October 2007 http://www.sermo.com/news/media/press/pfizer The Pfizer-Sermo partnership Pharmaceutical industry Initiating open and honest discussion Medical profession

17. Setting the pace Daniel Palestrant founder &CEO Partnerships with financial sector & pharma US$ 40m VC Continuously evolving services Free lunches for MIT students

18. Global dimensions Physicians’ social networks in China

19. USA Dominant Sermo Physician Connect Student Doctor Network Healtheva Relaxdoc SocialMD Sosido Clinical Village iMedExchange Tiromed Ozmosis Medical Plexus Within3 Rad Rounds MedTrust MedicSpeak Peerclip Syndicom Spineconnect QuantiaMD MDsConnect Number of networks Diversity of networks Business models Attracting VC Pharma participation

20. 110,000 members each

21. Europe Heterogeneous doc2doc (Global) Doctors.net.uk (UK) OnMedica (UK) Coliquio (D, CH, AT) DocCheck Faces (Int’l) DocCheck Faces(D) DocCheck Faces (F) DocCheck Faces (ES) DocCheck Faces (IT) Dooox (D) Esanum (D) Esanum (ES) Esanum (IT) Esanum (CH) Esanum (AT) Esanum (F) Sermo (2009/10?) UK and Germany lead Fewer players Catching up with USA

22. 15,000 members Open and closed areas Integrated with BMJ Group medical content Global 130 countries

23. Focuses on D, CH, AT 16,000 members Partnership with leading German medical journal Ärzte Zeitung Expanding to other EU countries 2010

24. Asia Pacific Emerging opportunities High growth rates Significant membership numbers Good Doctor’s Forum (CN) China Asthma Alliance (CN) dxy.com (CN) China obgyn.net (CN) Orthochina (CN) Public networks (BBS) (CN) Doctors Hangout (IN) Doctor.VG (IN) Medtitans (IN) Protomedica (IN) HelloDr (IN) Smartdoc (IN) M3.com (JP) MedPeer (JP) Carenet (JP) NM Online (JP) MT Pro (JP) Medigate( KR) Misc medical news sites (KR) Australian Doctor (AU) New Media Medicine (NZ)

25. m3.com, Japan Authenticated physicians 177,000 members

26. Medigate, South Korea Authenticated physicians 67,000 members

27. DoctorsHangout, India Physicians & medical students 14,000 members

28. Focus on medical students 60,000 members 500,000 posts Medical students today… members of physicians’ SNs tomorrow

29. Anatomies Physicians’ social networks in China

30. Authentication All specialities Includes pharma 1 st dimension taxonomy Authentication Single speciality Includes pharma Authentication All specialities Excludes pharma No authentication All specialities Inc & excl pharma

31. Pure play Social network only Sermo Ozmosis Coliquio 2 nd dimension taxonomy Hybrid Social network + online med resource Physician Connect doc2doc Doctors.net.uk

32. Participation by scientific liaison staff (MDs & PhDs) in community discussions Post information and services germane to discussions Post questions to a specialist community Conduct surveys Establish panels based on pre-selected criteria Unmet needs Treatment trends Drug usage monitoring Future Rx volume Unknown side-effects Off-label usage Early identification of critical issues Engagement Research Observation Pharma partnering options

33. Key learnings Physicians’ social networks in China

34. Membership growing everywhere

35. Sustained growth in USA Physicians in 2012: Manhattan Research, Taking the Pulse v9.0, 2009 Already using + very interested + somewhat interested % respondents Physician Online Communities: Social Networking Manhattan Research, Taking the Pulse v8.0, 2008

36. Source: Coliquio

37. Not just younger physicians

38. Sermo members markedly older than average internet Age of Sermo users Percent total Source: Sermo

39. Substantial pharma interest

41. Physicians welcome pharma participation … but only on their terms. No selling or advertising

42. Welcome interacting with pharma Physician Online Communities: Social Networking Manhattan Research, Taking the Pulse v8.0, 2008 I am interested in interacting with pharma, biotech and device companies on physicians’ only SNs 59% Strongly agree + agree 41% Strongly disagree + disagree

43. Finding Pfizer physicians able to talk openly and honestly is a problem Welcome open discussions with Pfizer* Prime interest is driving P2P and Pfizer doctor to non-Pfizer doctor discussions *Reported at Health 2.0 conference, San Francisco, 22 – 23 October 2008

44. Pharma’s challenges mainly internal

45. Marketing Medical & Scientific Marketing Research Cross-disciplinary collaboration essential

46. Regulatory issues can be pragmatically resolved

47. Real-time poll update: http://polls.linkedin.com/poll-results/28204/lakmg

48. Physicians’ social networks in China Chinese scenarios

49. Next 5 years Highly e-savvy physicians Authenticated physicians-only SNs Routine use & integration of physicians’ SNs Multi-channel pharma engagement models Physicians expecting pharma SM engagement Explicit & globally-unified SM regulatory framework

50. Establish authenticated trusted communities Develop hybrid models integrating community & authoritative medical resources Initiate speciality networks facilitating dialogue between physicians & pharma Create communities with services & functionalities supporting clinical practice Opportunities

51. Shifts focus from selling to dialogue Builds better relationships with physicians Reduces reliance on sales forces Combats increasing regulatory restrictions Benefits for pharma

52. Catch the wave