closerlook Thinking

Are you seeing the whole picture?

webmaster@closerlook.com (closerlook) — Wed, 07 Mar 2012 17:24:59 GMT

The job of a pharmaceutical product manager used to be straightforward. The agency of record essentially managed the brand identity, and the marketing associate, usually on an 18-month rotation from the sales force, oversaw the budget and made sure nothing went wrong. Often just keeping the sales aid current with regulatory updates could keep a manager busy until it was time to return to the field. Typical life in a regulated industry.

That was then.

Today there are many new market pressures and expectations from consumers, patient groups, providers, payers, regulators, competitors and even shareholders. A number of industry trends have emerged, forcing pharmaceutical product leadership to revisit their approach to marketing strategy.

More turbulence, more complexity
Four significant social and economic trends have emerged, introducing a level of market turbulence and complexity that is challenging the way brand teams form and execute strategy. Managed well, a new approach can result in greater marketing effectiveness and lead to enhanced value for key customer groups. But if fumbled, these trends will undermine even the most ambitious plans and lead to market share erosion. These four trends are as follows:

The explosion of disparate promotional channels and digital transactions is overwhelming even experienced marketing managers as they struggle with how to integrate these new channels into their strategic plan and manage their multiple vendors. New modes of social media engagement are already disrupting the traditional sales cycle and its reliance on one-way, outbound media.
This burgeoning of new marketing programs creates a "big data" challenge. If embraced, this plethora of information will provide better physician insight but will ultimately undermine traditional research planning methodologies, demonstrating the need for new and faster ways to sort, analyze, segment and target customers.
The decline in physician access and the increasing influence of payers are changing the balance of power. This is forcing brand teams to rethink the standard promotional approach.
The move to specialized products targeting smaller patient populations with more focused physician segments means marketing teams have less margin for error in planning and execution.

These four trends have one thing in common: each represents an environment of complexity or turbulence that requires a much deeper understanding of the customer. However, the traditional pharma brand planning process that worked well in the past is proving inadequate in a world of unprecedented change and speed. The point-in-time snapshot of segmentation or messaging or social media captured by formal market research has a shorter half-life than before and misses the dynamic influences of social media and consumer word of mouth.

This is catching many marketing executives and their agencies by surprise. According to Forrester Research, even direct marketing service providers who have deep expertise in developing and managing customer databases and campaigns are playing catch-up with the need for cross-channel customer intelligence that is relevant for enhancing customer experience and for transforming the business to meet these market challenges.¹

How well do you know your physicians?
Traditional market research provides a strong overarching brand strategy, but it’s not as helpful for understanding needs at the individual customer level. Traditional customer relationship management (CRM) promises customer intelligence but mostly provides reports on transactions, usually focused on the performance of the sales force, and that's not particularly actionable for making marketing decisions at the individual physician level.

What's required is a way to get to a different set of questions. Customer questions, business questions, are-we-offering-a-unique-value-proposition questions. Questions that just might lead to a different way of segmenting your audience or delivering value once you know the answers. Answers that might challenge the way you're doing marketing today and engage your audience in a way that feels authentic to both sides.

For example, how well do you know the answers to these questions?

How effective are your various tactics at the physician level, and do you have a plan for variable spending based on channel preferences?
Are you aware of the difference between channel preference and channel effectiveness at the physician level?
How do you know if your segmentation schema overestimates the value of past prescribers and underestimates the potential of non-targets?
How would physicians rank you in terms of customer experience across your various sales and service touchpoints?
Based on how a physician responds across more than two marketing tactics, can you predict his or her likelihood to prescribe your product?
Who are the most peer-influential physicians, and how do they use social media?
Do you know which physicians respond better to clinical information vs. clinical trial opportunities vs. access to speaker training?
If you were asked by senior management to decrease or increase your promotional budget by 50 percent, do you know how you would cut and minimize impact, or where you would focus your increased budget to make the biggest difference?

Continuous customer monitoring
To get the most accurate answers at the individual level, we need access to customer attitudes, behavior and value on an ongoing basis. Just like a continuous-monitoring glucose meter is more effective in managing insulin levels than a twice-daily finger stick, so is the ability to monitor and manage multiple customer touchpoints better than quarterly focus groups.

At any given moment, most brands have numerous sales and marketing efforts deployed to reach their target set of physicians. Each one of these touchpoints can contribute a nugget that adds up to a rich lode of customer data. Capturing transactional, behavioral and attitudinal data about healthcare professionals from multiple personal and non-personal sales and marketing programs can provide the raw material to address much of the market complexity we now face.

These methods are rooted in physician CRM. The result is more efficient and effective marketing.

Three steps to developing a strong insight-based customer strategy
Capturing data, creating actionable insight and delivering on that knowledge are three important steps that product managers can take to develop and execute a strong customer strategy. This is not an insignificant undertaking and requires a strong visionary leadership team to maintain the necessary rigor.

Get the data
The first step in a physician CRM program is collecting all physician interaction data from internal sources and all the various agencies involved, and making sure that they’re identifiable and attributable at the physician level. Although these data may be scattered around various offices and ad agencies, they need to be identified and consolidated into a single dataset.

This process can involve delicate negotiations, but it must be done. Eventually it will be automated with technology, but even just pulling and merging monthly files is an important first step and will reveal just how disconnected physician profiles and datasets have become.
Unravel the ball of data
The second step in building strong physician insight into your strategy is to analyze this consolidated dataset for answers to your key business and customer questions. Unraveling the data stream to determine what works at the physician level, where to overinvest (or underinvest) and what combination of content, tools and channels will be most relevant to attention-constrained physicians will help create a strong strategy and build the intelligence to achieve competitive advantage.

Engagement metrics are important proxies for what physicians deem important, but the ultimate business measure is how those engagement metrics lead to market share growth. Prescription trend data need to be an input to allow marketers to measure the return on sales and marketing investments at the individual physician level.

The transactional, behavioral and attitudinal data that will come from multiple campaigns are not only voluminous, as in "big data," but can also be very granular, sometimes called "nano data." Sifting through terabytes of data hoping to stumble across "insight" is expensive and needless. Better to start with the right business and customer questions and build an analysis framework for developing a strong customer strategy.
Make change happen
The final step in creating business impact is to take the insight from the data analysis and develop a unique customer-centric strategy and implementation plan. By learning how to provide the content most relevant to the brand’s most valuable targets how and when they want it, you create the much-vaunted two-way conversation with healthcare professionals to which every brand should aspire. CRM will evolve from a top-down process to one that allows physicians to also participate in managing their relationships with the brand.

This ongoing virtual conversation provides the brand team with a growing body of intelligence to make better marketing and resource decisions, and using predictive analytics, to begin to confidently anticipate the needs of its customers. Physician CRM provides an opportunity for a pharmaceutical product team to make change happen on its own terms.

Given the increasing complexity and turbulence of our industry, we need a framework and a set of tools that enable us to provide business leadership and customer insight. Physician CRM begins with the right business and customer questions, finds the necessary answers through the capture and analysis of physician data across multiple channels, and then implements a new marketing and content plan validated by the continuous feedback loop of physician engagement.

Are you ready to do this?
According to Brian Smith, professor and author of Making Marketing Happen, the process for developing marketing strategy in an environment of both complexity and turbulence requires a balance of sophisticated research and vision. Research works to unwind the complexity of a multifaceted environment and provide the timely customer insight needed to make smart marketing investment decisions. Vision comes from leaders with the nerve to honestly acknowledge and engage the market turbulence head-on.

Our experience at closerlook, inc. is that without the internal cultural support within the pharmaceutical company for both of these components—the permission for the product marketing team to take risks and the willingness to follow what the data reveal—the marketing strategy will be weak and the execution disappointing.

Physician CRM involves a serious investment of resources and commitment, but given the inexorable market trends we are experiencing, it is our best path forward for transforming our businesses to effectively and efficiently deliver the best value we can for our customers.

Reference:

1. The Forrester Wave™: US Database Marketing Service Providers, Q1 2011.

A version of this article, titled "Putting the 'Relationship' in CRM," appeared as the cover story of the February 2012 issue of PM360 magazine.

Make every move count.

webmaster@closerlook.com (closerlook) — Thu, 13 Oct 2011 10:33:58 GMT

A lot of ink has been spilt on the decline of the blockbuster and the search for a new specialty-product commercial model. But less attention has been paid to how that changes physician marketing strategy.

In the traditional PCP blockbuster model, promotional saturation was effective. The medical claim could be simple and the sales message clever. It didn't matter if marketing tactics existed in their own silos with little or no coordination. Whether it was a leading statin or ED product, there was strong consumer demand and the marketing strategy could be share of voice.

In today's specialty market, these old assumptions are just plain wrong. Not only is the target audience smaller, the buying criteria are more sophisticated. Writing a $15,000 oncology regimen is different from writing a monthly $150 PPI script.

To address this paradigm shift from a marketing perspective, the first necessary change is to move from a product focus to a user focus, with key messages evolving from product features to user needs. Done right, this will mean a profound transformation from a single detail verbatim and media plan to a more complex set of messages and coordinated channels that are tuned to the needs of individual specialists. Done well, the brand will create an ecosystem of communication that surrounds the physician with targeted, responsive and relevant information. This is true physician CRM.

In the blockbuster age, it was acceptable to allow agencies and list vendors to own and manage physician databases on behalf of pharma. It was easy to order up a mail drop or e-mail campaign. But in today's increasingly competitive environment, having one's own physician database combining all channel activities is a key strategic brand asset.

Even as senior executives consider long-term product portfolio decisions, brand teams can create tremendous corporate value by investing in building their own physician insight databases. As a practical matter, this doesn't require a major IT investment. An experienced agency partner can support physician CRM and all the technical requirements. What is important is that the brand team becomes very clear about who owns the data and how they will be used exclusively to benefit the brand.

A pragmatic way to start investing in physician CRM begins with three steps.

Begin collecting data on physician interactions from a brand's various agencies, ensuring that the data are identifiable and attributable at the specific physician level, and then to pull these data into a single physician database to provide a full and comprehensive view of all physician touchpoints. This process ultimately will be automated, but in the beginning it can be done with simple data transfers.
Analyze this new data set and segment physicians by message and tactic response to reveal their individual engagement levels. This will show us where we are "overinvesting" and "underinvesting."
Use this intelligence to make better marketing decisions about how to deploy resources in a more effective and respectful way.

In a world of resource constraints and changing market dynamics, physician CRM gives us the tools to design a physician marketing strategy based on user needs and preferences and then to create the most compelling and relevant promotional messages for the greatest business impact.

A version of this article, titled “Potential of physician CRM,” appeared in the September 2011 issue of Medical Marketing & Media magazine.

Is there substance behind your style?

webmaster@closerlook.com (closerlook) — Wed, 27 Apr 2011 10:23:31 GMT

The visual sales aid has a new competitor. Talk to any pharmaceutical sales rep today (one who still has a job), and you'll find someone who either has or is expecting to receive a shiny new iPad. No, it's not the latest in sales incentives; it's the newest way of presenting the lowly sales aid—the “digital detail.” But is it really something new and creative, or is it simply old wine in new wineskins?

Actually, presenting visually interesting content on these electronic devices is the least of our challenges. Creative agencies will fix that. The real issue is that the mobile device alone doesn't address the fundamental pharmaceutical sales and marketing problem—physician relevance.

The business challenge is well documented. The door to the physician is closing, and marketers are turning to new so-called closed-loop marketing technology and the tablet for their promise to reinvigorate the sales experience.

Closed-loop marketing means that data from every customer touchpoint are captured, analyzed and packaged into insight to create more valuable and personalized physician experiences. If the tablet is not part of an authentic closed-loop strategy, however, it simply replaces a glossy presentation with a shiny presentation. It's like replacing a traditional hammer with an auto-hammer: it's cool, it's electric, but in the end it still does the same thing.

Instead, mobile tablets should be one component in a larger strategy to listen, learn and build more personal relationships with physicians. The iPad is a medium for content, yes, but just as important, it's a tool to capture physician insight in the field and feed it back to marketing. But if that insight loop isn't closed, if we're not listening and learning and changing in response to what we learn, then the expensive iPad deployment is just, well, a cool, electric way of doing what the sales aid did. With the same results.

Physicians are early adopters of mobile technology...This year, smartphone usage is up to 72 percent among physicians and is expected to be at 81 percent by 2012.

There are three things that pharmaceutical marketers need to think about as they spearhead device rollouts to ensure they are closing the loop and providing value to physicians.

1. Marketing needs to take the lead with closed-loop marketing.

First of all, there aren't any “no see” docs out there. There are “no see me” docs. Physicians are accessing medical content every day, but it's happening through channels that might not include a field sales force. Fixing that is a marketing problem. Sales and IT play important roles and manage big budgets, of course, but that doesn't mean they should be setting the strategy. That's what marketing should be doing: finding new ways to achieve physician access and delivering greater message relevance. Marketing teams, lead.

2. To create personalized physician experiences, stop, look and listen.

Second, your pre-school teacher was right. When approaching a dangerous intersection, you should stop, look and listen. Closed-loop marketing and promotion must be approached the same way. Tablets, portals, eDetails and mobile apps are listening posts first and presentation devices second. The quality of data from these interactions is profound and offers marketers a view into their customers' behavior, attitudes and preferences, a view that never existed before. The ability to decode that data stream into actionable, predictable insight and compelling marketing messages will require new capabilities in analytics and imagination, but it will give brands a competitive advantage and sales forces a right to exist. Marketing teams, listen.

3. Closed-loop marketing is a social contract.

Finally, closed-loop promotion is not another marketing channel. It's a way of doing business across every channel. A commitment to providing personalized and relevant value to healthcare professionals when and where they want it. A social contract that trades data for respect. When physicians begin to see content that's focused on their specific needs and presented in a way that respects their time and business needs, even if it doesn't promote the brand, then you've established grounds for a relationship. Marketing teams, commit.

A first step to personalized physician experiences

Whether you are currently implementing or still contemplating a mobile device rollout, there is a way to close the loop. Hire a quarterback. This could be a closed-loop marketing consultant, but it's more likely to be a specialized agency that will help you lock down your customer strategy, define your success metrics, analyze the new data stream and then help you manage the interests and integration needs of multiple internal stakeholders and external agencies.

True closed-loop promotion is a new paradigm for the pharmaceutical industry. For those who truly “close the loop,” it can be transformative. But it will require commitment, investment and leadership. Putting iPads into the hands of sales reps without the right support is like fielding a Ferrari without a pit crew; it's fast off the starting line and looks good for a few laps, but it's not sustainable and will not win any races.

Closing the insight loop will provide the market intelligence to help both sales and marketing achieve customer relevance and personalization, leading to lasting physician relationships.

A version of this article, titled “The closed loop has a leak,” appeared in the March 2011 issue of PM360 magazine.

What are you bringing to the party?

webmaster@closerlook.com (closerlook) — Thu, 04 Nov 2010 13:39:49 GMT

Mobile applications for healthcare offer a channel that can be used by pharmaceutical companies to improve recognition and brand loyalty among physicians and patients. But, to offer successful mobile tools for healthcare, the pharmaceutical industry must keep in mind a basic marketing best practice: focus on the wants and needs of patients and physicians, and not necessarily the wants and needs of the company.

To highlight my point, let's take an example from my personal experience. I was in the market to join a gym and had narrowed my choice to two health clubs. The first was high-end. It had the best equipment and plenty of it: an Olympic-sized pool, steam room and sauna…you get the picture. The second club had less equipment, mostly weights and cardio machines, and they were hardly state of the art. Because of a corporate subsidy, cost was not a significant factor in choosing between the two gyms.

The first gym gave the best initial impression. They had great commercials that inspired me, the most fit-looking staff and up-to-date equipment. As I talked with one of their sales people and started asking questions, however, I soon found out that this gym was all about its rules, its fees and its goals. If you wanted to use a trainer, you had to use one of theirs. If you wanted to use a racquetball court, you had to become a member of their “court club” for an extra fee. Their stated goal was to be the most elite health club in the city. The overall impression I got was, “if you are willing to pay the price, you can be one of us: the elite.”

The second gym's approach was quite different. While it was not as sleek as the first, as I began working with one of the health consultants at the second gym, I realized their approach to their business was based on me. They were there to help me become a healthier person. They offered free personal training for the first month (at which time I could continue with them or use an outside trainer). They would issue a monthly questionnaire asking about my satisfaction with the gym and if I had any suggestions for improvement.

As you've no doubt guessed, I chose the second gym. I provide this example because I believe that as marketers we spend too much of our time and resources pushing our brand messages onto our target audiences, focusing on who we are and what we want rather than focusing on how we can help our patients and physicians. While it's important that we deliver our brand messages, we need to do more than that to properly market our brands. Competition in our industry is too great, our products too similar and our target audiences too smart for us to rely only on brand impressions and marketing noise to drive adoption of our products. We need to find a new way to differentiate ourselves: we need to offer programs that provide inherent value to our physicians and patients. That, I believe, is what our audiences want.

Mobile technology is one way to give them what they want. And what is it that our audiences want from mobile technology? Physicians want to optimize their workload and improve patient outcomes. Patients want the self-management of their conditions made easier. Both audiences want more out of their communication with the other. And the great thing is, these audiences are already using mobile technology to do these things.

Physicians are early adopters of mobile technology...This year, smartphone usage is up to 72 percent among physicians and is expected to be at 81 percent by 2012.

Meeting physicians' needs with mobile

Physicians are early adopters of mobile technology. In 2001, 30 percent of US physicians already had mobile phones. This year, smartphone usage is up to 72 percent among physicians and is expected to be at 81 percent by 2012.¹ Physicians and their hospitals are increasingly using smartphones for patient care and workload administration. Smartphones have occupied an important niche in healthcare for years, but they have mostly been used for specific clinical tasks (e-prescribing and accessing drug information and formularies) and general administrative ones (maintaining their calendars and appointment schedules). Recently, however, physicians and hospitals have ingrained mobile even more deeply into their daily workflow. For example, Mount Sinai Hospital in Toronto has linked 66 mobile functions to a homegrown system that enables physicians to order drugs and diagnostic tests, check on lab results and trend vitals data and access nursing documentation as well as reference apps.²

Giving patients what they want

Now let's take a look at patients. I don't think I need to make the case that the general public is increasingly using smartphones. What is worth pointing out is that people use smartphones to manage their health. In 2010, 78% of Americans expressed an interest in mobile health solutions, including interaction with physicians via mobile and wireless monitoring for a variety of medical conditions. In a prime example of this patient interest in action, the WebMD mobile application for the iPhone was downloaded 1.6 million times in its first three months in the App Store.³ Why so popular? Because WebMD focused on what patients wanted: easy-to-use, patient-centric tools that make managing their health easier. This application provides many helpful features. For example, it has a Symptom Checker, in which users may select the part of the body that is troubling them, choose their symptoms and learn about potential conditions or issues. Additional helpful features are a first aid guide, a pill identification tool and a drug database.

Patients also use smartphones for personal fitness, nutrition and general well-being. iBody is a mobile application that helps patients to keep track of health and fitness factors, including blood pressure, weight loss goals and pulse rate. And FatSecret enables patients to count calories and track their weight from their smartphones.

Improving patient–physician communication

So we've now discussed some applications that help physicians optimize their workload and improve patient outcomes, as well as patient-centric tools that help them manage their conditions more easily. Additionally, the patient-centric applications help improve physician–patient communication because the data they gather are often the type of information physicians want to see; a common language is developed because patients and physicians are focused on the same data, and the time spent in the physician's office is spent more intelligently, because it is focused on the most essential data.

But more than that, there are healthcare mobile apps that get directly at the heart of physician–patient communication: a common language that both parties can understand and use. One great example of this is an application that EC-Europe has designed. The Miniatlas Series of Apps fosters more impactful physician–patient communication by using clinical illustrations drawn at a level that the nonphysician can understand. This series gives physicians a convenient method of discussing medical topics or illnesses, such as diabetes mellitus, lung cancer and asthma, with patients.⁴

The rush is on

Healthcare and wellness companies are rushing to meet patients' and physicians' demands for mobile tools for healthcare. As of February 2010, there were nearly 6000 healthcare mobile apps within the Apple App Store. Of these, 73% were intended for use by consumer or patient end-users, while 27% were targeted to healthcare professionals.⁴ Some examples include an app to help future nurses prepare for their licensing examinations (NCLEX Q&A), a tool to help parents make the best decisions when their children feel ill (KidsCheckup) and an appliance that walks physicians through specific elements of the ACC/AHA 2007 guidelines on perioperative cardiovascular evaluation and care for noncardiac surgery (STAT Cardiac Clearance).

Who's leading the charge in pharma?

Let's take a look at a couple of pharmaceutical companies who go beyond brand message delivery to inspire brand loyalty using the mobile channel.

Sanofi-Aventis, which provides diabetes care products, recently introduced the first medical device that physically plugs into the iPhone and iPod touch. It's a USB-sized glucose meter they're calling iBGStar. It's coupled with the new iBGStar Diabetes Manager program, a free mobile logging app that users will be able to download from the iTunes Store when the new product hits the market around January or February 2011. According to the press release, “The ultra-compact iBGStar™ can be plugged into an iPhone^® or iPod touch^® and displays results on a full-color, touch screen.” In addition to helping patients track their glucose levels and view the results away from their desktops, iBGStar also gives patients a convenient way to transport and display crucial data to their healthcare provider and increase the value of the physician–patient communication because they are bringing sound data to the conversation.

Astellas Pharma US, Inc. has announced the launch of the appropriate use criteria (AUC) for the Cardiac Radionuclide Imaging mobile app for Android, iPhone and BlackBerry. This application allows physicians access to published criteria needed to assess whether or not a patient requires cardiac radionuclide imaging (RNI). The app guides physicians step by step through the criteria to evaluate patient history, clinical factors and other important information to receive an instant AUC score for RNI. By entering information, physicians will receive a rating on a scale of 1–9, suggesting whether the patient indication is appropriate (7–9), uncertain (4–6) or inappropriate (1–3) for RNI. Ratings can be viewed either by indication/category or patient algorithm.

As you can see, pharma's leaders in mobile development are using mobile technology to improve the lives of the physicians and patients who are their audience and their customers. If your brand offers mobile that gives your audiences what they want and need, you will be right where you want to be: in the daily lives of physicians and patients, building brand loyalty and advocacy, not simply recognition. Why do we believe mobile applications can help get you there? Because mobile meets your physicians and their patients where they increasingly spend more time: on smartphones.

So, with 6000 healthcare apps on iTunes, what ground are you going to stake out? It might be easier to replicate what is already out there, but then you aren't really differentiating yourself and your app might get lost in the crowd. If you are looking for real success with your patient and physician audiences however, find a need in the marketplace that isn't yet being met. This might not be as difficult as you think. You know your products. And you know the unique ways physicians and patients use them to manage patients' overall health. Use that knowledge as you lead your company into the mobile marketplace.

REFERENCES:

Dolan, Brian. “72 percent of physicians use smartphones.”
(accessed September 23, 2010).
“Making the most of mobile I.T.”
(accessed September 23, 2010).
Cronin, Mary J. “Best practices, surging demand for mobile apps that improve patient outcomes revealed in new report.”
(accessed September 23, 2010).
iMedicalApps Team. “Informed EMS guide: Advanced life support - a welcome addition to the EMS provider's armamentarium (app review).”
(accessed September 23, 2010).
Sarasohn-Kahn, Jane. “How smartphones are changing health care for consumers and providers.”
(accessed September 23, 2010).

Get the gold.

webmaster@closerlook.com (closerlook) — Wed, 16 Jun 2010 00:00:00 GMT

Everything about being a good, sophisticated marketer within pharma for the next decade or more will be about better understanding physicians—at the physician level, not in aggregate—and what they need to practice medicine, as well as determining how you, your products and your company can help them. eDetailing, for all its perceived faults, has provided great initial opportunities for pharma to better understand its physicians, provided it is enlisted as the true relationship marketing force it can be. And, eDetailing may provide a solid step toward generating critical and continuous physician insight that can be used to create new opportunities of competitive advantage.

I know all about eDetailing, but why should I believe it is better than any other tactic?

The truth is, it may not be—it really depends on how you've implemented it and what success measures you've put in place. The interesting thing about eDetailing is that in any given program, there exist several touch points with a physician across a set period of time and through a variety of channels:

Recruitment (e-mail, direct mail, web, SEM, rep-delivered invites)
Content engagement (website, eDetail viewing, Q&A, surveys)
Fulfillment (rep follow-up, honoraria delivery, sample delivery)
Re-recruitment/retention (e-mail, direct mail)

That's several opportunities to make a brand impression, and several opportunities to learn a lot more about the physician you're targeting. The amount of behavioral visibility you have into ALL of those touch points is a key indicator of how strategically valuable the program can be. Good programs provide a lot of visibility, with clean physician-level data, and bad programs provide little or no visibility at the physician level. Visibility is important in order to assess the relative efficacy of all of the sub-components that make up the program. Ultimately it can lead to physician-level profiles that indicate channel preference, promotional sensitivity, message preference and overall level of engagement.

There are a lot of data from a single tactic, much more than are generally obtained from any stand-alone tactic, and data are critical in making informed marketing decisions. Unfortunately, most programs are rarely established with full data transparency being a key success measure, relying instead on the binary pass/fail nature of ROI, so most product managers never end up pressing for this level of insight.

Ok, so now I get that eDetailing can provide a lot of data, but seriously, what do you expect me to do with them? I've only got so much time in my day.

Unfortunately, this is what we hear more frequently than we'd like, and it's a view (you should know) that is shared by many eDetailing companies (“...they'll never do anything with that information anyway…”).

The question you need to ask yourself is, “Do I think I have enough information to know that I'm making the best use of my marketing investment?” Most likely your answer will be “no” because most of us are operating on the “go with what you've got principle.” But let's examine what you might be able to learn by conducting a good eDetailing program, what the data might tell you and what you might be able to do with them:

Transactional/relationship data

Clicks
Open rates
Promotional response
Time on site
Channel preference
Number of solicitations to cause a return visit
Opt-ins, opt-outs
Follow-up requests

All of this amounts to extremely valuable insight into what it takes to enroll and keep physicians in your program. It's also, incidentally, what most third-party tactic providers charge you handsomely for, because they use all of this information to maintain their relationships with physicians, which they in turn rent to you. It's a strategic decision to determine whether your company wants this insight for itself, but until you do have it, you will always have to pay for it and it's only going to get more costly as access becomes a tougher issue. Beyond cost alone, this information can be used to more selectively work with list vendors and channel partners to maximize your reach and frequency, in ways that find your target physicians with greater efficiency.

Behavioral/observational data

Content preference (charts, illustrations, text, audio, video)
Click paths
Engagement
Prescribing behavior

Why put a lot of time and investment into video when your physicians would rather download and read a study? Or perhaps some of your primary care physicians enjoy podcasts, and some specialists would like to see a video presentation by a national key opinion leader? Beyond listening to what physicians tell us they like, watching them to see what they do tells us a lot about where we should invest, and what types of media we may want to merchandise to a specific physician upon his or her return to the website. People like to learn and be informed in different ways, and physicians are no different. The bottom line is, getting a physician's attention is pretty difficult these days—getting the next part right with the content is pretty important to keep them coming back.

Attitudinal data

Survey response
Q&A

Much like your qualitative and quantitative studies, but without the rigor of a formal market research effort, this information rounds out the data you've already collected on participating physicians to help explain what is apparently important to them. This mitigates the need to project responses to a larger population of physicians—these folks have told you directly what they care about, giving you a wonderful opportunity to respond and enrich the experience for them.

Fine, I get all this, but it all seems like a lot of work. Why should I care?

Well, the simple truth is everything in pharma marketing is changing at some level, and no one really knows how it's all going to shake out. We feel this every day and it's making it increasingly harder to know what to do next. For several years there existed fairly tried and true marketing approaches to pre-launch, launch, new indications and late life-cycle conditions. But now, with smaller markets, tighter budgets, decreased access and legislative and regulatory pressures, it's not as easy to know what will necessarily work. We really don't have much choice but to raise the level of intimacy with physicians so we know how to serve them better, and ultimately, how we can help them serve their patients better.

Done, I'm sold, what do I do next?

If you're currently conducting eDetailing programs, do an assessment of the level of data you're getting from your partner. The e-mail address of your participants is important and should be mandatory for any program, as is the physician's individual identity. Be wary of any partner that refuses to share this information. Audit what additional transactional/relationship data are available to you so that you can better assess how each participant interacts with your program. Match this information up against your learning objectives for the program, and test the value of that information by assessing how it provides value to and informs other tactics.

If you're new to eDetailing, resist the urge to do a pilot. There's really nothing new to learn here structurally, and most eDetailing pilots are really code for underfunded budgets and loose objectives. Experience has demonstrated that these programs work if the objectives are sufficiently thought out ahead of time and the programs themselves are well executed. If you have concerns about primary care physician vs. specialist response rates, recruitment or honoraria options, or media to enlist, speak to a seasoned eDetailing provider who will be able to fill you in.

Finally, be clear about what you want to learn about your physicians, in addition to your required ROI thresholds. Make a list, and hold the program to it. Be honest with yourself about the company's ability to react to the information you obtain, and push as hard as you can for a highly personalized experience. Your physicians will appreciate it and will reward you with their participation.

Make a better impression.

webmaster@closerlook.com (closerlook) — Wed, 14 Apr 2010 00:00:00 GMT

I spend more time these days—with clients and within closerlook's four walls—thinking about new ways to communicate with and reach physicians.

But more than ever, my discussions with clients are about channels—probably because there are so many channels, and new ones coming to market every day. We know 'em all—banners, websites, social media, e-mail, mobile, face-to-face, print journals, SMS and even that service that feeds medical content to physicians via TiVo. There might be more—and there will be new ones tomorrow. But channels alone, new or old, cannot solve any of the problems we face in pharmaceutical marketing.

The truth is, reach is not a problem. We can reach people anywhere and at anytime and through dozens of devices and channels. The problem is this: We, pharma, have nothing to say.

Recently, I was having a conversation with a smart guy in biotech, musing on the application of Apple's new iPad to pharma. The conversation was summed up with, “How many physicians do you think have already asked a colleague, 'So, how long before we'll be assaulted by a rep with a shiny new sales aid on that thing?'” Even in all the iPad's newness, will we have anything new to say?

Channels and tactics are not going to make or break the pharmaceutical industry or its marketing partners in the next 10 years. Our collective success will be driven by engaging our customers in a better conversation. That's it. There's really nothing else.

Let me back up. You're in a bar. You're single and available. You summon the courage to walk up to someone, say hi and see how things go. If you're skilled in the art of conversation, you will do a better job of listening than talking. Your goal is to find out something interesting or unique about the other person, something that gives you a way to connect with him or her. (If you're missing the marketing 101 parallels here, please stop reading, because, truthfully, we're just not on the same page.)

Now imagine that, while you still know very little about the person other than what he or she looks like or what he or she drinks, you are suddenly armed with a superpower. You can force messages to his or her cell phone, you can have the bartender serve glasses with your name engraved on them, and you can project images of your face on the bar. And with this power behind your approach, you start talking constantly, promoting your best features, using the same pickup lines you've been using for 20 years. You don't pause once. You don't ask any questions. See it now? It's that bad.

In a nutshell, we've been doing the same thing with pharma marketing—shouting in multiple channels, without doing any listening. Now, before that pisses you off, which it should, let's be fair. We can only say what we can say—we have our friends at the FDA to thank for that. But thank goodness they are there. Imagine what we would say about our products if no one were there to stop us. I'll leave that there.

The first step in improving your conversation with your customers is assessing whether you have the resources to make it happen.

The bar scenario is a bit contrived, but consider this: We love to talk about our brands and our products, and we should—that makes sense. But do we also talk about issues that interest our physician customers? Perhaps, but only when the conversation very quickly gets back to us. In fact, we're so persistent in promoting our products—no matter what we pretend to be talking about, no matter what channel we use—that access has increasingly become a concern. More and more physicians are closing their doors and e-mail inboxes to us. Doing nothing but yelling the same old approved messages is at best boring and at worst totally irrelevant. This is all talking and no listening. This is all speaking and no conversation. This is a bad approach at the bar, and it stands very little chance of forging a good relationship with a physician.

Beyond channels, beyond tactics

The pharmaceutical companies and partners that do the hard work of learning how to engage physicians in a better conversation are going to lead the next decade. It's that simple. Topics covered in this better conversation will include patient care, outcomes, disease management, trends as well as the efficacy and safety of our products. The better conversation will also enhance a physician's relationship with patients. But most importantly, the better conversation presents us with the opportunity to listen, and to learn many things we don't know yet—that kind of learning is one of the cool potential outcomes of any good relationship, is it not?

There is incredible strategic value in figuring out what better conversation you should be having with your physician customers. And have no doubt that the better conversation is achievable. If you don't achieve it, one of your competitors will. That is, as they say, “it's a matter of when, not if.”

The pharma marketers and partners that rely on channels and tactics without improving the conversation will fail, left in the dust by those who have figured out how to have the better conversation with physicians.

So what should you do?

Figure out who you're working with. The first step in improving your conversation with your customers is assessing whether you have the resources to make it happen. The following questions give you an idea of how much evangelizing you will need to do, and whether or not you will need to find some new partners to work with.

Consider your internal teams:

Do they want to experiment? Do they want to learn?
Do they start conversations with return on investment rather than return on learning?
Do you have political, positional and monetary support to do things differently?

Consider your partners:

Do they seem satisfied with the way things are? Or are they bugging you with questions of how we're going to continue to compete in the next ten years?
Do they demonstrate a willingness—even a desire—to work with your other partners to improve the conversation? (Read: Do they concede that they don't do everything well themselves? Because, well, no partner does.)
Do they seem to think that their tactics alone will win the day? And my favorite—do they really think that social marketing is just the best thing ever?

Find out what you already know. How much information about your physician customers is readily available? How much is available but will be a pain in the rump to collect and make actionable? Your ability to demonstrate your knowledge of your doctors will enable you to engage them in a better conversation. You can't improve the conversation without better insight. No channel, no tactic can change that fact. Creating a base line of your current knowledge will help you quantify the work you and your partners need to do to develop real, actionable insight. Some of you will be better off than you think, but others will find they know very little about their customers.

Start. This is the hardest part, because every pharma company has different barriers in place to hinder the learning you need to improve the conversation. The good news is that formal insight development is already underway at several big pharma companies. All of these programs are in their infancy, but pilots are being conducted, physicians are being shown new value, and the experience and knowledge of the teams running these programs are growing every day. The bad news is if you're not working on this every day, then you're falling behind and losing competitive advantage that, in the long run, will be almost impossible to regain.

So get a team together, grab a partner that you trust and think is smart, or both. Start the thinking. Start the listening. Start the learning. Test a few things and let the measure of success be insight first and sales second. Take that insight and test again. What you learn will make it obvious what to do next.

Better together.

webmaster@closerlook.com (closerlook) — Thu, 29 Apr 2010 00:00:00 GMT

When eDetailing first appeared 10 years ago, a common misconception took root: online detailing would ultimately make sales reps obsolete. Pharma marketing managers and brand teams fueled the myth by keeping sales managers and reps out of the loop when planning and executing an eDetail. For their part, reps typically viewed “e” tactics warily and did little to encourage their targets to reap the benefits of six-to-eight uninterrupted minutes on message.

It wasn't until we actually took the time to measure the impact of eDetailing that the truth set brand teams free. Independent analyses conducted by IMS and others repeatedly told the same story: the more effective the integration of a brand's sales and eDetailing efforts, the greater the positive change in prescribing behavior. Nevertheless, the positive data didn't always translate into a change in eMarketing strategy.

Let's take a look at a simple example. For years, database technology and ZIP code lists have made it possible to prompt a physician watching an eDetail to request product samples or a sales-rep visit. Such requests could then be routed in real time to the appropriate sales reps via e-mail. But pharma was slow to take advantage of such opportunities. Then the industry saw that the majority of all physicians who had completed an eDetail requested samples or a rep follow-up visit if given the opportunity. More startling, most of these physicians were self-described “hard-to-see” or “no-access”— which meant the eDetail actually increased rep access to physicians. Today, the evolution of back-end technology enables physicians to choose a specific day and time for a follow-up visit from a rep. With such a request in hand, a sales rep can walk into a physician's office and honestly tell the receptionist that Dr. Jones has requested a sample delivery and even scheduled the timing of the visit. Amazingly, some pharma marketers continue to bypass this rep-request feature, missing the opportunity to maximize the impact of their programs.

These same ROI analyses can often provide other valuable insights related to sales-force integration. In general, NRx increases markedly among both called-on and white-space physicians who complete eDetails, whereas prescribing levels remain flat among physicians who don't watch eDetails.

However, the rise in NRx is usually greater among eDetailed physicians who are also called on by a sales rep, vs. physicians who complete eDetails but do not receive a sales rep visit. Just as significantly, the sustainability of the NRx lift may nearly double (e.g., six months vs. three months) among eDetailed, called-on physicians versus no-see physicians. It is worth noting that eDetails can lift sales of both the eDetailed brand and its competitors among no-see physicians, a fact that further emphasizes the important role that sales reps play in reinforcing and tailoring the brand message.

An engaged sales force can dramatically heighten the impact of a strong eDetail

But the evolution of rep involvement in eDetailing didn't end with sample and rep-visit requests. A savvy sales rep suggested that the field sales force become further involved in the online program by hand-delivering eDetailing invitations to their physicians. As the length of an average sales call dipped under the one-minute mark, delivering eDetail-program invitations via a nurse or office manager became a crucial tactic for sales reps. This tactic signaled that sales reps had finally come to see the value of eDetailing to their brand and their sales numbers.

Nevertheless, for various reasons, some pharma clients still resist the idea of involving their sales force in any eMarketing initiative. Among brand teams, an increasingly common question of even the most impactful eDetail is its breadth of reach: If only 5 percent of the target market actually view it, it's getting dangerously close to the old “tree failing in the forest” metaphor. But even with only 5 percent of the audience engaged, eDetailing can often deliver ROI of three to one (or better) when integrated with sales-force efforts. And the educational depth of a good eDetail means that these doctors are well-informed and are potentially valuable influencers.

Our experience shows that eDetails should not be planned, executed or evaluated in a vacuum, nor treated as a stand-alone tactic. They should be integrated and synthesized into every online and offline initiative a brand undertakes.

An engaged sales force can dramatically heighten the impact of a strong eDetail and probably salvage a mediocre one. The more effectively you integrate the sales force in your eDetailing program, the more likely you'll be to profoundly and quantifiably affect prescribing behavior, see a sustained lift in market share and get full credit for a job well done.

Get personal.

webmaster@closerlook.com (closerlook) — Thu, 14 Jan 2010 00:00:00 GMT

Spam remains one of the most aggravating aspects of e-mail. According to Google, e-mail spam during the beginning of 2009 increased at a rate of 1.2% every day. Marketers know they must tread lightly when using e-mail marketing.

In the first article of this series, I discussed different types of e-mail marketing. Transactional e-mail marketing works best with impulse-buy commodities or well-known products that simply require reminders. Because it's relatively inexpensive to “batch and blast” thousands of e-mails to meet reach and frequency goals, it can also be confused with spam. It doesn’t take too many of these types of e-mails to sully a reputation.

Relational marketing, on the other hand, is based on the rules of reciprocity. As discussed last week, relational e-mail marketing starts with an attitude of asking and listening, not telling. Its goal is to build a relationship through a two-way process of gathering insight and responding with relevant content.

By learning how to ask good questions and listening carefully to the answers, relational e-mail marketing can become a market research channel.

The heart of a campaign

At the heart of a relational e-mail marketing campaign is the database. Campaigns can be run using an in-house database or, more often, a third-party service provider. The key to success, however, is that the marketing model is built to capture everything and consider every piece of data as an asset. It’s not enough to get typical reach and frequency reports (deliverability, opens and clickthroughs). Relationship marketing collects data from the e-mail campaign at the individual level and allows for analysis at the individual level.

A large global pharmaceutical firm has been experimenting with this approach for a new product with a unique mechanism of action. By incorporating attitudinal, behavioral and practice management questions over the course of several e-mail campaigns and website visits, the brand has been able to capture valuable insight into its target physician audience. For example, one question asked whether a physician’s willingness to try a new therapy was based on whether there were samples in the office. Although the average response was that samples were not important, more than 25% of the physicians claimed that it was very important. What is unique about this e-mail marketing approach to market research is that then the marketing team knew specific customer needs at the individual level. When physicians begin to see that there is a tangible benefit to their providing personal information, there is increased trust and confidence in the integrity of the brand.

An engaged sales force can dramatically heighten the impact of a strong eDetail

Three steps

There are three steps to turning an e-mail marketing campaign into a market-research channel. The first step is to audit your e-mail marketing provider and determine whether it has the capability and willingness to help you build a custom database. This database will hold the proprietary market research data that will come from your e-mail marketing campaign, and it shouldn’t be shared or available to your provider's other customers. Your provider should have the capability to analyze the data and provide you with detailed profiles of your customers. You and your team will use these profiles to look at segmentation differently and to begin to consider how you will communicate and serve your customers differently.

The importance of Golden Questions

The second step is to create the master list of golden questions, or those questions that will help you better understand your customers and learn how to serve them more effectively. These questions will help to fill in research gaps or may be used when market research reports a lack of unanimity on a particular issue and you need to know how individual physicians feel. Golden questions can cover beliefs about a disease state or treatment options, practice habits or attitudes about novel therapies. You might ask 8-10 questions in the course of a multi-wave e-mail marketing campaign, but only one or two at a time. Or you might develop a regular McKinsey-esque survey that captures attitudes and provides aggregate results back to the participants.

Finally, develop a pilot and look for ways to include sales, market research and managed markets in the experiment. Each group has questions about their customer base or would welcome the opportunity to test the validity of some of their assumptions. By leveraging an existing e-mail marketing budget to ask questions, these various stakeholders will get value from your efforts and, by sharing the results, you will help to shape the sales and marketing messages so they are more relevant and valuable to your physician audience.

Avoiding the pitfalls

There are potential pitfalls to committing to a relational e-mail marketing approach. Trying to bite off too much too quickly or attempting to move to relationship marketing with an e-mail provider who is more adept at delivering transactions can lead to frustration and failure. Providers who compete on the size of their database or the speed of getting an e-mail drop out the door may not be the right partner.

True relationship marketing involves not only recognizing customers when they respond, but also capturing and analyzing their responses. Using the online channel to simply increase brand awareness is becoming a vanishing tactic. Social networking has raised the bar of expectations for trust and engagement, and e-mail marketing, if it wants to survive, has to meet those expectations.

Read the first article of this series, “Are you listening? The give and take of e-mail campaigns.”

A version of this article, titled “The Self-Fueling Marketing Machine,” appeared in the December 2008 issue of Pharmaceutical Executive magazine.

Are you listening?

webmaster@closerlook.com (closerlook) — Thu, 12 Nov 2009 00:00:00 GMT

Frank Leontis is an experienced marketing manager for a large New Jersey-based pharmaceutical company who has a reputation for experimentation and pushing the marketing envelope. He was one of the first managers to take on the e-business title in 1999, and now in his senior role, he is a regular speaker at e-marketing conferences.

For the first time, Frank is very concerned about his company. Just as the pharmaceutical industry is beginning to seriously rethink the traditional large field sales force model and look for alternative, non-personal channels, he is reviewing data that shows that the average web user receives 70 spam messages a day, 69% of e-mail recipients report e-mail as spam based solely on the subject line and 30% of subscribers change e-mail addresses annually. How can a pharmaceutical product marketing team expect to build a business on such a fickle channel?

Two faces of marketing

Marketing can be separated into two categories: transactional and relational. Transactional marketing is focused on short-term results and looks for low-hanging fruit. Its value is short-lived.

Transactional e-mail marketing can work well as a promotional tool for commodities such as retail (John Grisham's new novel available now for pre-sell on Amazon!) or general broadcast announcements (Register Now for the AMA conference in New Orleans!). It is used for general customer acquisition or as part of an opt-in e-mail newsletter program. These "batch and blast" campaigns think of recipients as numbers used to meet marketing reach and frequency goals. Although there may a rudimentary level of segmentation (specialization, decile), the targeting and messaging are based on aggregated results from focus group market research.

Transactional marketing builds its content from a lowest common denominator approach to reach as many customers as possible instead of creating a targeted message strategy.

Give to get

Relationship marketing is qualitatively different. It is based on the rules of reciprocity, or "give to get," in which there is a two-way and balanced value relationship. Relational e-mail marketing is based on the CRM principles of identify, differentiate, interact and customize. It uses the channel as a way to listen, learn and respond in ways that are both relevant and value driven.

Relationship marketing takes traditional market research as a starting point, but then uses e-mail interactions as opportunities to refine the research at the individual customer level. By using e-mail to ask insightful questions that get to the heart of a customer's need, marketers can sharpen their interactions and focus their messaging.

Relationship marketing takes traditional market research as a starting point, but then uses e-mail interactions as opportunities to refine the research at the individual customer level.

Every two weeks or so, McKinsey Quarterly sends out a short e-mail to its database of subscribers. The e-mail is about a single business issue, and it invites the subscriber to take a short survey with the promise that all participants will receive the aggregate report within a week. The topics are timely, the surveys are well written, and there is often an additional offer of a recent white paper from their business journal as a thank you.

McKinsey has taken a very progressive approach to its e-mail marketing strategy, using a business survey to create relevance and the promise of timely insight to provide engagement. It is classic relationship marketing, and over the past several years, McKinsey has built rich profiles of its members' interests, perspectives on business and responsiveness to e-mail as a communication channel. The rules of reciprocity are in effect, with both parties receiving value from the ongoing conversation.

Redefining e-mail marketing

To think about e-mail marketing as a market research channel requires rethinking both activities. It means broadening the definition of e-mail marketing and using it more as a social networking tool than as electronic direct marketing. And it means opening up the constraints on valid market research by capturing and analyzing response data from e-mail marketing as a way to improve individual interactions and provide tailored value.

There are three steps to turning an e-mail marketing campaign into a market research channel. In Part 2, I'll describe each of the steps in detail and give you tips on how to sell a relational e-mail marketing campaign in your organization.

A version of this article, entitled "The Self-Fueling Marketing Machine," appeared in the December 2008 issue of Pharmaceutical Executive magazine.

Take the plunge.

webmaster@closerlook.com (closerlook) — Thu, 10 Sep 2009 00:00:00 GMT

For several years, pharma has enjoyed record-breaking profits, market expansion and the rise of blockbusters. In such a market doing a lot of shouting (broadcast), and treating the market as one homogenous pool of physicians and patients, has been effective, largely because the markets themselves have been growing. Further, in a growing market, the need to understand your customers better than your competitors do is important, but not critical to success—given the size of the new markets, there's simply enough business to go around.

Things are changing. R&D spending is on the rise, but the rate of NDA's and FDA approvals is in rapid decline. Physicians are closing their doors to reps. The use of incentives is becoming increasingly scrutinized, if not flat out disallowed. Federal legislation is sure to play a role in pricing, and the declining blockbusters are on the brink of patent expiration. In short, Pharma will be forced to find ways to grow within a different set of market conditions, in which they will have limited products in the pipeline, more drugs that serve smaller groups of patients, restrictions on the ability to market directly to those patients and decreased access to the physicians that write their products.

Smell the smoke? Feel the heat? The platform has been set afire.

From a marketing perspective, the burning platform creates a series of interesting challenges. For certain, the tried and true playbook that can be easily picked up by a marketing manager on rotation from the field will not continue to work. These tactics were effective based on a set of market assumptions that no longer apply. Today's product managers need to think differently and consider some of the following questions: What specific physician segments are most important to the long-term growth of my brand? How can tactics be tied together so that each interaction learns from the physician and informs the next? How can my vendors work better with each other and provide better collective value than they can individually? What is the true value of share of voice when the conversation with physicians has been reduced to a few key selling messages that must be communicated in 90 seconds or less? And, perhaps most importantly, what will happen to share if my brand's competitors understand the needs of target physicians better than I do?

Fortunately, there is time to retool. The industry is largely unchanged in the way it communicates to doctors, which means that pharmacos and their brands have a short window of opportunity to innovate and create competitive advantage that is driven by more relevant dialogue based on better insight about the physicians they serve. How? The successful marketer will invest in a comprehensive store of physician behavior, interactions and insight across all tactical touchpoints to provide a single view of the physician. This proprietary database can be leveraged to augment the declining intimacy between physicians and sales reps. Such a database does not replace formal market research, nor does it replace the rep-physician relationship. It simply extends those discrete insights into a living and evolving understanding of physicians' needs that can be used to enhance marketing communication and develop tools of real, inherent value.

A single view of the physician can provide immense value.

The bottom line is, this level of insight will either continue to be held by vendors that currently rent access to physicians online, or pharma can begin the process of obtaining that insight for themselves. In either case, relying on a rented relationship with customers in an uncertain economy and in an industry undergoing change is a risky proposition. It's time to invest in physician relationships before your competition does.

Wyeth has made great strides and investment in the way it manages physician relationships. Most of the heavy lifting and innovation was done by Wyeth personnel, which signals a profound commitment to rethink how the company intends to communicate with physicians. Several pharmacos have started to invest in their own centralized database of the physicians they serve—in large part to monitor compliance issues. Ultimately, this database should be used for broader marketing purposes as well, provided the data enables a single view of the physician across all interactions. In any case, despite the original motivation, this single view can provide immense value. Marketing can better assess aggregate marketing investment against prescribing behavior. Sales can better understand prescribing factors to aid in pre-call planning. The brand generally will benefit from a systemic longitudinal understanding of physician attitudes, behaviors and needs—which will only serve to enhance the development of more relevant, valuable materials to serve its physician customers. All of this, of course, hopefully results in increased sales. The platform is afire and now our choices as marketers are no longer balanced, but weigh heavily in favor of having to do something. But marketers need not be reactive. Smart pharmacos and smart marketers will embrace this new market as an opportunity to get to the next platform before the others do.