Earlier this week, I examined who seemed to be developing the most clout on Twitter, and the winner was clearly Novartis.  Today, I want to examine YouTube successes and failures.

Most pharma companies came to YouTube in 2008, though some, such as Novartis, were late-comers in 2009.  But to put it mildly, ventures by pharmaceutical companies into YouTube have been, with some exceptions, largely abysmal.  The efforts are, for the most part, unsustained, uninteresting and uncoordinated.  And the numbers sort of tell that story.  Overall, the number of subscribers for the channels is anemic, and companies have failed to socialize the channels and integrate them into a broader communications effort to engage patients.

Below is a list of the YouTube channels of which I am aware with one exception - the channel for Insmed, while still up, appeared completely abandoned and no one from that company had signed in for months.  I therefore did not include it.

 One can see that Johnson & Johnson's JNJHealth has maintained the largest video foot print, having attracted a whopping 1,343,434 viewings of its videos.  They also have a lot of videos - some 240.  The vids there span a whole range of topics and you'd have to be completely aloof not to find something of interest in this large compilation of video.

Other companies have done a great deal with a great deal less.  Specifically, Sanofi-Aventis has been able to attract a large viewing of its videos where patients tell their stories about having diabetes and using insulin with its aptly named goinsulin channel.  AstraZeneca, which has more than one channel, has done something similar, but with less success, with its branded channel on asthma called myasthmastory.  Though one has to ask oneself in light of the recent FTC rulings on testimonials, whether patient story channels that mention specific medical product use are viable under the new rules.

Genentech on Genentechvideo is doing something interesting and letting employees talk about the corporate culture there as a means to introduce the company to prospective talent.  Success for this channel, then, does not rely on the numbers, but whether in fact it is reaching its intended audience.  How is the company steering prospective employees to the vids?

Non-U.S. firms have even ventured into YouTube.  GSK's GSKVision, when if first appeared, seemed to be looking around for something to say.  Now it seems to be focused on the company's philanthropy, which is not a bad idea, but which doesn't seem to be attracting much of a following. Perhaps it needs better marketing.  And Sanofi Pasteur has posted some interesting videos on vaccination and has them available in various languages, which is a nice touch.  

Lastly is the channel I found the most interesting, and which was the first, having been put up in 2007, which is Tibotec's channel.  The company seems to do little to promote it or drive traffic to it, but the subject matter is very interesting.  The videos all provide visuals on how the mechanism of action works in their products.  

The balance of the companies on the list have channels that are just a hodge podge of videos.  The channels, it appears, have not captured the interest of the companies sponsoring them and therefore have failed to capture the interest of viewing audiences either.  For the most part, there has been a "if you build it, they will come" mentality about the YouTube channels that does not, in fact, work well.  

Some of the companies, it should be mentioned, allow both commentary and ratings for their videos, as well as the ability to embed them by third parties.  Many, however, do not.  This is, after all, "social" media - it will be hard to build a channel without being social.  Here are some tips for YouTube channel success:

• Socialize the channel - become friends with other channels, subscribe to other channels and let people embed your video.  You are putting it up there because you want it to be seen.
• Promote the channel - put the link into signature lines on emails, put it up at product booths, stick the link in as many places as you would the Web site.  Whenever you post a video, tweet it.  You are responsible for driving the traffic.
• Engage the viewer - The success of goinsulin is easy.  People submitted their stories and got to see them up and others got to meet patients virtually.  Find out what patients want and give it to them.  Don't just throw up any old video that you think is interesting.  In fact, if you are putting something up that is all about you, it probably isn't as interesting as you think.

And, by the way, visit the Eye on FDA YouTube channel regularly!  Haha.  

 Can search save the FDA?

It is safe to say that the FDA has not been exactly an innovative thinker when it comes to the Internet.  The agency has done some nice work with widgets (peanut recall, e.g.,) and has begun its own Twitter feeds and even its own transparency blog.  (Though it is interesting to note that if the agency twitters mentioning a specific drug name, if the company would re-tweet that tweet, under FDA's current point of view, the FDA might see that as promotion and in violation of fair balance rules and could theoretically result in a notice of violation letter to the company that re-tweeted the FDA's original tweet.  Make sense?) 

It is not that the agency lacks technical savvy, but DDMAC has been so focused on the rules, it has at times lost sight of the vision for the whole - promoting good public health - hence the 14 Notice of Violation letters sent out in the Spring of 2009.  Those letters provided abundant evidence of the fact that the agency was more bent on enforcing a rule, than in considering how the violation of the rule by the pharmaceutical industry represented a sea change in the way people use the Internet.  

In any case, the Internet and the people who use it are changing, and changing much more rapidly than the ability of the agency that regulates it - FDA and DDMAC - to keep up.  The anachronistic process for developing a guidance after the public hearing is going to provide too little, too late.  

An example of how quickly things are changing is with search.  In Saturday's rare posting, it was pointed out how real time search by Google transforms crisis communications.  Today's is about how, theoretically at least, real time search could transform pharmoacovigilance.

Google has already demonstrated its prowess in the ability of search to impact public health.  Look at Google Flu Trends.  Google Flu Trends looks for particular search terms that people use to find information about the flu which allows nearly real time tracking of flu trends by geography - which are not only accurate but run at least two weeks ahead of the published reports by the Centers for Disease Control.

If that can be done for flu, why can't it be done for the top twenty or so prescribed drugs to look for trends in issues?  The agency could track in real time searches about the compound and determine if a safety signal is showing itself.  It would be far more timely than the current system of waiting for a physician or a patient to file a report with the FDA and have it processed.  It might be reasonably, if not absolutely accurate, if done right.  

In fact, there might even be a role for Google search trends in risk management.  What if you could discover the existence of search terms that indicated misuse of opioid based pain killers?  You might not only be able to discover the existence of a problem, but see the emergence of a problem geographically or demographically.  Or perhaps not, but it is certainly worth exploring.  

Come on FDA, connect the dots here.  Think strategically.  Huddle down with Google and see if you can make this happen.  It could save lives.  It could go a long way to restoring the agency's battered image as a protector the public's health.  And it would demonstrate that the agency finally "gets it" in understanding how people use the Internet for health information.  

In my mind, the best use of social media is two-fold.  First is that the use of social media is not done for its own sake, but in support of a communications plan that is reflective of business goals. Second, in this day and age, it is ensuring that that in a time of crisis, a company has invested in the development of platforms that allow it to track, analyze and respond to developments as they rapidly unfold.   

By my count, there are now a dozen pharmaceutical companies using Twitter.  Twitter has become an increasingly important tool for communications, particularly fast communications, and allows a user to generate news that others can pick up and send to others.  Twitter allows you to reach beyond your immediate constituency to reach those outside your circle - in other words, you reach your friends' friends.  

And there are few social media tools that have had so many new applications built around it.  In particular, there have been applications built that assess the reach and influence of those who twitter.  One of them is Twitalyzer.  Twitalyzer is easy to use and assesses a Twitter user in five primary areas:

• Influence
• Signal
• Generosity
• Velocity
• Clout

These are good areas.  There may be other valuable things to consider, however.  For myself, I think the level to which a user socializes is very important.  In other words, if a user is not following anyone at all, there is a low sociability factor.  

But for purposes of the analysis today, I used Twitalyzer and identified those companies on Twitter who had the highest influence level and the highest clout factor.  All analyses were run on the same day.  

Here is how Twitalyzer analyzes influence:  They consider the following factors to arrive at your score:

• Relative reach measured by the number of followers;
• Relative authority based on the number of times one is re-tweeted;
• Relative generosity based on the number of times one re-tweets others;
• Clout measured by the number of times one is cited by others;
• Velocity based on the number of tweets one has made in the most recent 7-day period.  

In the analysis of pharmas that Twitter, what we see is that one company, Novartis, runs away with the title of having the greatest level of influence and clout, followed by a friendless Amgen in second place and the highly engaging Boehringer in third place.  Roche and AstraZeneca are quite low but still in the upper half of those companies on Twitter.

Why would Amgen, who follows no one on Twitter, and with less followers than Boehringer or Roche or several others still come out in second place.  It is because their content is such that others on Twitter are citing their tweets more often.  That means they are doing more, while engaging less, which certainly stands out and though counter-intuitive, nevertheless is true.

A few companies that had been twittering, or had set up Twitter feeds, were left out because they have either gone silent (Pfizer_News, e.g.- not a tweet out of them since 11/20) or have never tweeted (Allergan, e.g.) or just gone missing.  And for purposes of the analysis, I removed any of the Twitterfeeds that were solely about jobs (Merckcareers1, e.g.).  

Where would FDA have figured into this equation?  They are doing better than most pharmas, but they aren't doing well.  The agency's FDA_Drug_Info Twitter feed has 3556 followers, which is impressive, but follows only 7 feeds, which is not.  The agency is only following its other Twitter feeds, NIH and CDC feeds.  Their influence rating is 1.0 and their clout rating is 0.5 - room for improvement.  

You shouldn't be too concerned if you are at the bottom of the list because there is a lot of room for improvement by the entire industry.  At least you have established your presence, and if there is a crisis situation, you at least have some capacity.  The companies who aren't on the list don't have that advantage.

Lastly, I have created a Twitter list of all pharma companies on Twitter if you would like to follow it and this list does include the jobs Twitterfeeds as well as the FDA's FDA_Drug_Info twitter feed.

Come back later this week to check out another SocMed look-see.  

Everyone who works in crisis communications, or who may experience a crisis, should read this posting.

The science of crisis communications got both faster, and more challenging with the advent of Twitter and the blogosphere.  Citizen journalists can write a posting, or a micro-blog (Twitter) and within moments, their point of view on a topic can be carried along to thousands of other important stakeholders.  In fact, if the posting mentions a publicly traded company, within a few moments a blurb will appear on the Yahoo or Google Finance page of that company with a link back to the blog. 

Up until now, unless one is monitoring for a particular search term on Tweetdeck or Hootsuite or some other type of tool for tracking and organizing tweets, a people may start talking about a new development that can spread with uncanny speed and a crisis can unfold before you know it.

For that reason, tools like Tweetdeck and Hootsuite are essentials for anyone who might experience a crisis in communications, though I wager that few in the pharmaceutical industry are using it to monitor what is being said about their brands or their companies for fear of seeing an adverse event.  Nevertheless, the tools are important for monitoring - proactively to see if anyone mentions you and reactively to track messaging and velocity once a crisis has unfurled and is blowing in the wind.  And, if you were afraid to monitor for what people are saying about your proactively, you may have reason now to be afraid of Googling yourself (that sounds funny doesn't it?). 

That is because there was another innovation unveiled last week from the brilliant folks at Google (and yes, I am a slobbering Google fanatic).  It is called Google's Real Time search and it changes search forever.  That is because now, when you enter a search term into Google, you will be able to view real time entries, as they happen, on Twitter and in the blogosphere and on Web sites as well as on Facebook and MySpace.  

In other words, you have a crisis unfolding.  Let's say it involves one of your products, or your company.  You go to Google and enter in your company's name.  You will be able to see what people are saying about it in real time from multiple sources.  You will capture messaging.  You will see velocity.  You will see identity.  You will quite literally have your finger on the pulse of the crisis.  

It is nothing short of remarkable.  Look at it and change the way you view your crisis communications planning.  The game just changed.

 Another late Weekly Roundup.  My apologies.  I have been on the road (Chicago this week) and fighting and losing a battle with a flu that is dragging on, and on, and on.

Snow blanketed much of the nation this week.  The Congress is hard at work on a health care reform bill that should be easy, but which they make hard.  It would seem if we can borrow a trillion dollars to go to war, we should be able to spend a trillion to keep people well.  This week's drama was built around drug importation.  

And here is a little of what happened in our world:

• FDA to Hold Crestor Meeting - This week, the FDA posted its briefing materials for an upcoming meeting of the Endocrinologic and Metabolic Drugs Advisory Committee that will be held on December 15 to discuss the sNDA for Crestor.  AstraZeneca is going for an indication for primary prevention of cardiovascular disease.  This should be big news.  
• Stem Cell Development in Treatment of Sickle Cell - Over the years, we have heard a lot about the promise of stem cells.   This week, NIH announced something tangible however, by releasing information about a study of stem cell treatment for sickle cell anemia.   In the treatment, which involved a modified adult stem cell transplant, the course of the disease was reversed in 9 out of 10 people with sickle cell.  
• Grassley Looks for More Sunshine - The sponsor of the Sunshine Act, proposed legislation to make the financial relationship between the pharmaceutical industry and medical societies more transparent, Charles E. Grassley, sent letters out to a gaggle of medical societies to inquire how much money they have gotten from pharma.  If memory serves me correctly, when he tried this with televangelists, some of them told him to get lost, and he did.  Doubt the medical societies will try that.  Nothing in the Sunshine Act, by the way, that would create a mechanism of disclosure for campaign contributions to senatorial campaigns.  Or how about a Sunshine on Earmarks Act?
• AstraZeneca Creates Web Page on SocMed Sites - I wish everyone would do this.  AstraZeneca has kindly created a Web page that lists all of its social media endeavors.  Very forward thinking while other companies have been too timid to utter the words social media. And it is emblematic of how important social media has become as a means to effectively communicate with stakeholders.  Nice going.