Healthcare Agency Roundtable 2013

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For the 10th year, the leaders of selected MannyAward-winning and nominated communicationsagencies respond to key industry-related questionsfrom Med Ad News.

Med Ad News: How do you see next year’s ACA rollout impacting the way you do business? What will marketing agencies have to do better or differently under ACA in order to continue to thrive?

Jay Carter, senior VP, director of strategy services, AbelsonTaylor: The biggest changes that ACA is driving are the effects upon our client’s physician customers. The requirements for EHR have driven many practices to either consolidate into larger groups or sell themselves outright to regional hospitalhealthcare providers. It’s been said that fully one-third of the oncologists in the United States have become employees of such groups since ACA was enacted. That presents changes in the way that specialty products are purchased and distributed, and we’re very focused upon this change.

Jon Sawyer, president and chief operating officer, closerlook: In large part, the ACA is going to mean more patients for physicians and more patients on product for pharma but with increased scrutiny on cost. Pharma can play an important role in helping physicians manage that increased load with more effective and efficient communication and programs that keep patients informed about their conditions, compliant with their therapies and embracing a plan for disease management “beyond the pill” for better longterm outcomes. Agencies can be good partners to pharma by helping industry understand their physicians and patients better so that these programs and their associated communication have as much impact as possible. The belief that the solution to our marketing challenges lies in shiny new tactics must

end; investment in strategic programs that enrich the relationships between physicians, payers, pharma and patients in the interest of better outcomes is the answer to what ails our marketing efforts.

Ed Mitzen, partner, Fingerpaint: As a small business owner, we will continue to provide health insurance for our staff. We are expecting that it will cost us more as small businesses bear the brunt of subsidizing the newly covered individuals who didn’t have insurance before. Our clients may reduce their marketing spend to cover the “hit” the firms will take in rising healthcare costs. Obviously, rising healthcare costs is nothing new to any of us. ACA is going to increase pressure to reduce marketing budgets, as companies look for ways to recoup the increase in healthcare spend. Marketing agencies need to be able to find ways to have their clients’ dollars go further. Nothing new.

Adam Gelling, principal, Giant Creative/Strategy: On the surface more insured patients should be a boon for pharmaceutical companies, and stock performances over the past year seems to bear this out, but the ACA will change the way products are marketed. Marketing agencies and their sponsors will need to expand their promotion and support throughout the continuum of therapy. It will no longer be about just obtaining prescriptions. Support and access strategies will be elevated alongside clinical benefits; validating positive outcomes and providing mechanisms to report those outcomes among HCPs, patients,

and caregivers will be a necessary component of persistence and brand use. Also, new product approvals will face increased scrutiny from payers to demonstrate a significant benefit over other available therapies, so the number of launches could decrease as compared to prior years.

Dan Renick, president of Precision for Value and Hobart Group Holdings: The ACA, from its passage, has intensified the strategic focus required to help clients navigate the evolving healthcare landscape. Beyond developing a deep understanding of the Act itself, this requires a thorough portfolio assessment to determine what impact the ACA will have on access and reimbursement, and within which channels. For example, next year will primarily see an increase in the Medicaid population (the majority of enrollment observed to date), so posing questions about upside potential and downside risk in this line of business is a natural starting point. Marketing agencies will have to better appreciate how value is assessed by various decision-makers that now hold some level of risk due to the ACA, and accountable care in general, and how to best communicate this at the stakeholder level.

Dominic Viola, management supervisor, ICC Lowe Trio: As the ACA mandates, we’re going to see an increasing need for physician success metrics. We’re already seeing the beginnings of the shift in healthcare provider compensationfrom fee-for-service to pay-forperformance.We’re continuing to see theevolution of what’s considered “effective”and “successful” care become increasinglyquantified with hard metrics.Another important way the ACA willapply to the evolution of pharma is ensuringvalue beyond the drug: Insurancecompanies and accountable care organizations will continue toinfluence how and which drugs are prescribed. So a drug itself isbecoming just one key part of the overall brand value: the full valuealso resides in the bundle of services the drug company offersto patients and doctors, including behavior modification toolsand techniques, patient and professional education, counseling,

and training, to name a few. All these additional measures of success– and more – will need to be factored into brand promisesand will drive competitive advantages and brand differentiation.

Wendy Blackburn, executive VP, IntouchSolutions: It’s true that more insuredpatients in the system means morepotential customers for pharmaceuticalproducts. Looking deeper into the pool,many of these newly insured representyounger generations. And we cannotoverlook the tech-savvy of these digitalnatives and the expectations they have forcompanies seeking to connect with them.That, in turn, places a premium on agencies that offer muchmore than just basic competence in digital media. Agencies thatalready know how to communicate two-way, in real-time and responsivelywill quickly replace others who tend to communicateone-way and build brochure-ware Websites.We’ll be looking at an even more fractionated landscape and aredefinition of pharma’s “customer.” Brands must learn to speakto managed care organizations; to understand what an ACO isand who the decision makers in ACOs will be. They must talkto pharmacists, hospital systems, government agencies, and consumerwatch groups. And brands must understand the diverseneeds and definitions of value that each of these influencers hold.

Leerom Segal, president and CEO,

Klick Health: This is a sea change inthe market and we need to respond byproviding more of the information thatpatients demand: formulary and access issues.Yes, we still need efficacy and safetyinformation, but the one thing missingfrom patient information, access, is whatthey crave. Insurance and payment has alwaysbeen an issue in the background ofevery physician/patient conversation, but it’s now the dominantagenda item. According to the PwC report Customer experiencein the pharmaceutical sector: Getting closer to the patient, patientsare paying a greater share of the costs, 250 percent morein fact. This increased “skin in the game” means that patients arebeginning to shop for medical treatments in much the same waythat they shop for other important “big purchase” items and costhas become the dominant concern. In fact, 89 percent indicatethat insurance coverage is the number one issue, with physicianrecommendations number two at 74 percent.

Kim Wishnow-Per, president, McCannManaged Markets: The next round ofACA rollouts in 2014 has an impact onour business in several ways. McCannManaged Markets considers the managedmarkets landscape to determine a medication’svalue and place in the market. Wework with our clients as their guide, bysharing our access intelligence to developtools they need to shift the marketplace.The ACA has created new market dynamics, and our clients mustcarefully consider these as part of their brand planning for 2014.These include essential health benefits (EHB) for pharmaceuticaldrugs mandated by the ACA for the newly formed Marketplaceplans in each state; Medicaid expansion and hospital 340B drugpricing programs; evaluation of opportunities with organizedcustomers, such as Accountable Care Organizations (ACOs) andIntegrated Delivery Networks (IDNs); and Medicare and Medicaidelectronic health records (EHR) incentive programs – meaningfuluse requirements.We educate our clients on the evolving payer landscape anddevelop strategic and tactical plans to consider how componentsof the ACA might or might not affect their brands.Marketing agencies need to understand how the local marketpayer dynamic affects the prescribing habits of healthcare professionals.It is no longer enough to deliver just a clinical message tothe HCP. Providers also need to be confident their patients canafford the drugs they prescribe. Therefore, we must now include acustomized local market “cost and coverage” message along withthe clinical message. Tis messaging must be easy for the salesrepresentative to deliver and for the HCP to understand.This is no small task; the marketplace is becoming even morefragmented with the implementation of the new state Marketplaceplans, ACOs, and the evolving benefit designs being deployedby insurers in response to the ACA. It is essential for marketingagencies to understand how these payer market dynamicsaffect local markets and develop relevant messaging to instill confidencein HCP prescribing.

Med Ad News: The ACA enrollment website launch is a populartopic in the news of late. What do you think went wrong,and how would your agency have handled it differently?

Kyle Barich, president, CDM NewYork: Of course it’s easy to pass judgmentin hindsight, but no agency wouldbe proud of the rolloutto date. If we were awarded that assignmentand were able to manage throughthe likely inflexible contracting process,we would have put a lot of effort behinduncovering the user design and experienceneeds. And we certainly would have builtin a more comprehensive testing plan that allowed adequate timefor QC and user acceptance testing prior to launch. Perhaps astate-by-state phased approach could have been explored, becauseif it isn’t cooked, it shouldn’t be served. Once the site waslaunched, we would have developed broad and compelling driversto get people to the site. Finally, if things didn’t go as planned,we would face harsh reality with some good old- fashioned truthfulconversations with everyone involved.

Jon Sawyer: Politics aside, websites can be very complicated anddemand particular conditions under which their developmentcan be successful. The several disparate entities involved in thecreation of seemed to erode those necessary conditionsfor success. The bottom line is, regardless of the scope orthe high profile nature of any technical endeavor, there needs tobe enough time allocated for quality assurance in the beginningand quality control throughout the effort or problems are almostcertainly guaranteed.

Ed Mitzen: It would be incredibly arrogant of me to think thatour agency could produce a website that is on this order of magnitude.And we are an incredibly talented digital shop. I wouldlike to think that more time would have been allocated to testingand QA control. The massive integration project between and all of the various insurance carriers (all withdifferent back-end technology) is not something that can be executedwithout an equally colossal QA/QC procedure.

Christine Armstrong, senior VP, managingdirector brand experience, Giant:What happened to HealthCare.govis not an uncommon problem. It stemsfrom three main pitfalls we face often asan agency that provides digital services.1) A convoluted procurement process foran unprecedented project requiring manyvendors to partner together without one“lead” agency. While it’s not uncommonto encounter collaboration with three to five vendors on complexprojects, 55 agencies contributed to (the failure of) the developmentof 2) Poor program planning. The websitewas designed as a single launch with a finite beginning and end.No good agency approaches site development in that way anymore.Sites are more than just a single project; they are more likeliving beings that need to be monitored, nurtured, and evolved.Phased goals needed to be developed and designed with room foruser feedback and iteration. 3) Poor communication protocols.The government did not have the right in-house technical “quarterback”to lead the team and call the shots.Additionally, communication and transparency protocolsneeded to be established to avoid “coding in a vacuum” with noone taking accountability for how their piece fit into the greaterwhole of the site.At Giant, we hold both agency and client accountable forthe milestones and validation points along the way. There aremany check-ins that allow for more small, iterative success andcommunication that builds confidence between all parties. Thisapproach allows for greater management of expectations, discussionof risk, and ability to respond quickly to requests or changewithout causing alarm, effecting scope and timelines. We avoidthe “big reveals” which tend to over promise and under deliver.

Dan Renick: While there appear to be numerous technicalglitches involved with the website fiasco, the underlying issue ismore about how the administration wanted consumers to be presentedwith information – or rather, how they didn’t want themto be presented with information, specifically the cost of coveragewithout subsidies included. So instead of consumers simply beingable to browse available plans and associated “retail” prices,those exploring coverage first had to provide complete applicationinformation, after which plan options and prices were returnedless the subsidy amount for those qualifying. While thereis some merit to this approach from the standpoint of trying notto discourage those who will be subsidized by not displaying thefull price up front, it adds tremendous burden to the system andconverts what many thought would be a “shopping” experienceto an “application” experience, and to date that has not workedwell. The primary thing to do differently is explain the processright up front so that consumer expectations more closely alignto what the actual experience will be.

SophyRegelous, chief digital officer,ICC Lowe Trio: When developing anytype of digital environment, the creationof user-case scenarios is a critical step inthe discovery and design phase … especiallywhen lots of users are expected tovisit the site.When working towards hard deadlinesof high profile sites, it is often difficult tomanage and meet all expectations. There is a tendency to rush

through or skip steps in a standard software development life cycleplan, however taking time to follow the correct process almostalways results in shorter development and QA cycles, leading tomore successful launches. User case scenarios and a functionalprototype tested by sample users can head of any usability issues,resolving them prior to code being started.In addition, based on the ongoing progress and tracking ofprojects, when it becomes clear that the appropriate amount oftime for load balance and thorough QA testing is not possible, itis worth creating a plan B failsafe, to roll out as soon as a site startsreporting issues. For example, a redirect URL with an advisingpage that the site is experiencing heavy traffic or a sign-up formto receive a time to return when they can be guaranteed service,may have been appropriate.

David Windhausen, executive VP, IntouchSolutions: To me, it sounds asthough they approached the project allwrong. They approached it like other bigdevelopment efforts in the past: spend aneternity documenting requirements ina vacuum; build, build, build; and thentest late. You end up delivering somethingthat doesn’t meet the customer’s needs.A better approach would have been an iterative one – one thatincluded real-end users – those that would be signing up for insurance.Ten the cycle becomes launch, test with users, plan,launch again, etc.It also feels there were way too many “cooks in the kitchen.” Alean approach would have been much better than the approachthey took. It seems as though they had an inordinate amount oftime and budget. (I wish we had that kind of time and budget forsome of our projects!) Think of all the time and resources consumedby just trying to keep all of the parties on the same page.This was brought out a bit in the hearings with all of the back andforth finger pointing between agencies involved.The final thought was because they approached this project ina very traditional waterfall manner, they didn’t begin testing untilway late in the cycle. That led to an inevitable timeline crunchand the bad decision to launch when the site wasn’t working.

Leerom Segal: We have a view of what went wrong on (see our blog), and from our perspective, this is another example of bigger is not better. The code base has been estimated at an obscene 500 million lines of code. Anything that big is just poorly designed, usually because there are too many, not too few, people on the project. A smaller team of highly skilled individuals will always create a better product than a huge team of moderately skilled people.

Med Ad News: From where we sit, it appears that the general trend of consolidation in marketing services procurement – i.e., clients demanding more services at lower cost and the big guys merging or buying themselves bigger in order to meet that demand – appears to be accelerating. What is your response to that point of view?

Jay Carter: When consolidations happen, it’s big news, whether the announcement comes from a victorious agency network or a happy procurement group. It’s not so big a story whenthe pendulum swings the other way, and nobodyshouts about it. In 2013, our agency wasapproached by two different large pharma organizationswho were contemplating eliminationof their network consolidation efforts due todiminution in services. One resulted in a newbusiness win. At the same time, we partneredwith a very large agency network for a clientconsolidation, because our relationships aidedin the network’s chances of a win. Net/net, Ithink that there’s going to continue to be changein the way that agency services are acquired, allalong the continuum from single agency networkto a different agency for each brand in aportfolio. All of those options offer opportunitiesfor the independent agency.

Kyle Barich: Indeed many of our larger clientshave already consolidated their marketing servicesat the holding company level while othersare carefully observing before joining the trend.At the same time however, several are in theprocess of unraveling their earlier consolidationefforts. That being said, consolidation has takenhold in our industry and is having an influenceon the ways agencies behave and are structured.For it to work on the agency side, the holdingcompany offering has to be authentic, with nottoo many moving parts, and where everyone inthe mix ultimately benefits by participating. Onthe client side, we are finding that this requires ahuge degree of behavioral and structural changeas well. We, and our partners in procurement,are seeing that consolidation is not the right answerfor every situation. The manufacturer’s organizationneeds to have patience and be committed– senior management, global marketers,and local units around the world. There needsto be some level of stability; if clients restructureseveral times in a year, it is unlikely that thenecessary cultural and behavioral changes willhappen. Otherwise the consolidation pendulumcan easily swing away from these models.The industry is searching for a perfect and costeffectiveanswer to the complexities of moderncommunication and consolidation can help.But only if all parties involved are willing to takeon the necessary organizational change.

Jon Sawyer: Certainly it’s a macro event facingour industry, and we don’t blame clients forwanting value for the investment they make inprocuring services. However, we believe thatgreat efficiencies can be gained through partnershipand honesty with the smaller independentfirms as well, and that the conglomerates don’thave an exclusive lock on delivering greater efficiency,strategy and creativity or – at the endof the day – lower cost. Profoundly good workis the result of great working relationships betweenclient and agency based in trust. Bothparties need to feel like they are in that partnershipwillingly and only as long as they can dogreat work together. When it comes down tothe actual people doing the work, these largeroll-ups often put agencies and clients togetherthat are unwanted bedfellows. This often doesn’tlead to the best output or the most cost-effectiveapproach.

Ed Mitzen: Both large pharma and large advertisingconglomerates are in a tough spot. Theycan’t save their way to prosperity, and they arecreating a huge talent drain. More senior staff are bolting (voluntarily or involuntarily) tosmaller firms where they can do great work andavoid all the corporate bureaucracy.

Adam Gelling: Sponsors commoditizing the strategic and creative product through heavyhandedprocurement is extremely short sightedand ignores the forest through the trees. Switchingor excluding agencies over a nominal discountin hourly rates discounts the investmenta brand makes in a true marketing partner andignores true performance metrics such as totaltime and cost of project and overall brandperformance. Our model to put senior staff onthe front lines of client business to ultimatelyreduce client budgets and accelerate brand performancegets lost in a straight procurement ratecomparison model. We believe in the role ofprocurement and appreciate their support andguidance, but encourage them to re-evaluatetheir success metrics or else risk lagging behindtheir competitors who have a holistic view oftheir marketing objectives and partners.

Dan Renick: It depends on where you sit. Ifyou are a leader in a highly specialized space likepayer marketing, focused on access and reimbursementneeds in a complex market, consolidationmay be viewed as a positive since it willdrive even less differentiation among the giants.While a lower blended rate for consolidatedservices appears attractive on the surface, notreceiving the necessary strategic support and relatedexceptional execution to secure profitableformulary access will cost far more than anyprocurement exercise will ever save. Marketingsupport is like any other area of purchasing –you get what you pay for.

Joe Daley, president,GSW: Pharmaceuticalmarketing and commercialorganizations are under significant pressureto bring forward thelevel of innovation thathas been the cornerstoneof R&D – and to do sowith ever increasing efficiency and productivity.Leaning into this dynamic requires our bringingtogether ever broader complementary, nonduplicativeskill sets and knowledge that allowsus to complete a tight, focused partnership teamwith our clients; a simple, single team that worksin a connected fashion across all customer segmentsdriving a high value, consistent, impactbrand experience. In my opinion, it’s going tobe difficult to address this environment withoutaccelerated evolution and change that includescombining resources in more aggressive ways,including mergers.

Renee Wills, president,ICC Lowe Trio: Agenciesthat are consolidatingto achieve cost efficienciesand round outtheir capabilities mustkeep this in mind: Biggerisn’t necessarily better.While change isaccelerating across theindustry, it’s important to think carefully aboutwhat mergers can promise, and what they can’t.The fact is, all shops are making moves tobetter position themselves to handle current andfuture client demands: as procurement wantsgreater efficiencies, and brand directors want toleverage new and emerging technologies, someshops have consolidated. For example, a fewtraditional, full-service shops have merged withspecialty digital agencies. Some that started outas digital shops are now part of bigger entities.Searching for efficiencies through large-scaleconsolidations seems to make sense – on thesurface – but when clients are seeking biggerand better ideas and more creative solutions,those ends may be better achieved in otherways, for example, through resource sharingand inter-agency collaboration.The danger with consolidation is that thereare so many variables affecting the outcome,the agencies’ joint specialties could get “lost inthe sauce.” Agencies also need to make sure ourwork product doesn’t become a commodity. Afterall, we don’t make widgets.In our business, the currency is still greatideas: there will always be tremendous valuefor agencies that come up with novel ideas thatconnect brands with target audiences, and drivethe preference for and selection of those brands.Delivering those great ideas is still predicated onagency talent, philosophy, and culture.

FarukCapan, CEO,Intouch Solutions: Asan independent firm,this is something wewatch closely. We haveseen the trend wax andwane for the 15 yearswe’ve been in business,with mixed results both ways. The mega-mergerof Omnicom and Publicis has again put thisprocurement trend back into the spotlight.The reality for us is, we have continued togrow 30 percent or more year over year, and thatgrowth is coming from both existing and newclients. Over time, clients find the consolidatedservices or “preferred network” model doesn’talways meet their needs. And they discoverthey aren’t saving any money after all, becausethose contracted networks aren’t incentivizedwhatsoever to be efficient. So clients find waysaround it. That’s where some of our most recentgrowth has come from – from clients lookingfor innovative ideas and specialized digital consultingthat they are just not getting from theirarranged-marriage agencies.

Leerom Segal: The issue of cost is a red herring.It’s not about cost, it’s about efficiency, efficacy,and quality. If you make the right decisionsbased on the right information, then createthe right artifacts, and place them in the rightplaces, you can have the effects on the marketthat you need. If you don’t, then no amountof money will save you, it will just be wasted.Right message, to right person, at the right timemight sound like old news, but it’s more importantthan ever and it ultimate comes down to apredictable and consistent execution capability.

Kim Wishnow-Per: Will the consolidationtrend continue? Yes. Will it accelerate? I thinkso. For our clients, the trend is less about “morefor less” and more about “better more efficiently.”The ability to get best-in-class resources underone umbrella is one that intuitively makessense. Connected experts in each core disciplineis a powerful tool for today’s marketers. Our clientshave broken down their internal walls andagency networks have followed suit. This approachsets up fertile ground for better thinking,but does so in a way where organizations canrealize cost savings through team efficiencies.Bigger networks don’t necessarily translate tobigger teams. They foster connectivity allowingfor more focused teams providing better overallsolutions.

Med Ad News: What are clients asking fortoday in the mobile marketing front? Thesocial media front? What will they be askingfor next year? What do you think are the keysto successful mobile and social strategies forpharma brands?

Kyle Barich: Most of our senior clients grew upin a world of controlling the message, reach andfrequency, share of voice, and outbound marketing.And then most everything changed. Forbrands to be recognized and relevant in a digitalworld, they have to engage in social media. Sowe started with social listening, whether passiveor active (research). Ten we helped somebraver clients launch corporate Twitter accountsand YouTube channels. But the magic two-wayconversation about our brands or disease contentacross social media channels remains elusivefor the most part. While the ideas reside inmost tactical plans, so many barriers and fearsremain. As policies evolve and we find “safer”and more compliant ways of engaging withHCPs and patients, we will decrease our senseof risk and increase our collective sophisticationin healthcare social marketing.What will they be asking for in 2014? Mobile

Apps, Social Gaming, Responsive WebDesign, Virtual Conference Support, In-appBranded Experiences, and continued improvementof the iPad personal selling experience topthe list. Clients want more seamless integrationof digital into their broader plans. They wantbetter and more cost effective ways to developand deliver digital marketing globally. Relationshipmarketing is enjoying a renaissance withimmense improvements in data collection andanalysis. Clients are pushing us to better leverageinteractive visualization of data, to explorecontent marketing strategies, to customize andpersonalize content to drive relevance and engagement,and to integrate more deeply withour digital media partners. Frankly, it’s exhaustingbut exhilarating.

Jon Sawyer: Look, mobile and social are justchannels. They’re certainly remarkable in thatthey are almost ubiquitous today, but ultimatelythey are just channels. Our clients are asking forsound counsel on when and where to leveragemobile and social and are no longer feverishlyclamoring to get on the bandwagon just becausethey’re there. Fundamentally good strategy callsfor digital content to be at least mobile friendlyand even better enabled to serve a mobility-drivenpurpose. Social has far-reaching, importantimplications for patient connectivity – perhapsless so for HCPs, but pharma is just beginningto understand the respectful and appropriaterole it can play in social. We believe next yearmobile and social will evolve and be contextualizedinto broader strategies and be less of astand-alone focus of attention.

Erin Keefe, senior VP, group director, digitalstrategy, and Michael Pruskowski, VP,group director of strategic planning, DraftfcbHealthcare: One mobile question we’re beingasked more frequently and from a broaderarray of our clients is what should my brand’siPad 2.0 or next generation strategy be? It’s anexciting question to hear because it signals anincreased demand for more than just front-endonly focused iPad-based applications, especiallywhen it comes to the rep-based sales tool. Bothreps’ and physicians’ expectations for the iPadcontinue to rise. They tell us they’re looking forthe “ experience.” They wantiPad experiences that offer more customization,utility, and convenience. So the task at hand forthe next generation ofpharma’s iPad applicationsis how to best leverageboth the front- andback-end technology.This means the continuanceof strong creativeand story-telling alongwith a steady increasein more data-enabledmarketing capabilitiesincluding better collectionand use of customerintelligence; more targetedand personalizedcontent; more closedloop and relationshiporientedmarketing. Theend goal is an experiencethat leaves the physicianand rep more satisfiedwhile improving the marketing performance ofiPad-based marketing efforts.Another mobile question we hear from clients,especially those in organizations wherethere’s been a clear mandate to prioritize mobile,is how can I get access to mobile innovationwhile not breaking the bank? We believethe answer is collaboration, funding and creatingnew partnerships with third-party technologycompanies. With the implementation ofthe HITECH Act of 2013, there is an increasinglylarger world of technologies accessible toevery developer as well as Pharma. This will fuela surge in technology entrepreneurship and innovationwithin and outside of Pharma. We believefor our clients and ourselves that more efficientaccess to these technologies and energeticpartners will expand pharmaceutical companies’mobile offerings and lower the opportunitycosts related to innovation.Regarding social, there is an interesting evolutionof ask here. For our clients, especially onthe DTC side, the question is no longer focusedon how can I do social in the current regulatoryenvironment, but where, when and withwhat messages that will align with a broader integratedmarketing strategy? Two-way, pharmasponsored social has been proven in the unbrandedspace. Gated/moderated is happeningin branded. In 2014, we expect these trends tocontinue along with greater social media marketingexperimentation and activity.

Ed Mitzen: Clients continue to look for innovativedisease awareness programs that canbe implemented through mobile and social.While FDA ambiguity continues to be a concern,companies seem to be more open to differentways to reach their potential customers.Responsive-design sites are the standard now aswell, as are well-thought out landing pages. It’sbeen encouraging to see clients’ understandingof mobile and social increasing, and they areopen to us teaching thembest practices.

Jonathan Peischl, seniorVP, director of innovationand digitalmarketing, Giant: Mobilebreaks out into threekey areas: tablet detailing,point-of-care access,and patient/consumer/caregiver informationaccess. On the tablet,specifically the iPad, each of our clients is movingin that direction; some have gone so far as tonearly eliminate paper from the sales call, whileothers offer the sales force the choice. Regardlessof the mix, the convenience of a single pointof access for all brand and disease educationmessaging, as well as program promotion andenrollment, has won over sales organizations.Meanwhile, access to rich customer insights viaengagement metrics has won over marketingand business analytics. Once tablet detailing isof the ground and embraced by the sales organization,the hunger for new content and freshfeatures keep our teams busy day and night.Point of care access to drug and disease informationis alive and well. Physician adoption ofmobile is of the charts, and HCPs have a wealthof resources they rely on every day in their practice.The opportunity for pharma is significant,from the simple step of mobile brand site optimizationto HCP toolkits offering features thatmay not be found on some of the third partysites and apps that are commonly used. Additionally,with HCP adoption of tablets we seegreat opportunity for patient education toolsthat can be used in the practice, ultimately replacingthe printed HCP-to-patient educationpieces.For patients, consumers, and caregivers, theneed is there. Consumers expect to be able tofind what they need in mobile-optimized form,whether it be banking, travel, dining, etc. Whyshouldn’t our industry address the need as well?This is the greatest area of opportunity for ourindustry. Apps are nice for chronic conditions,but consider the waiting room or exam roomscenario where a patient is faced with a diagnosisor prescription that they immediately need toknow more about. The iPhone comes out, andthe search begins. We must be there for them.Social remains somewhat of a one-of area forpharma. It’s important that we listen and use theinformation we hear to make smart decisions,and participate or drive the conversation onlywhen the need is clear. Transparency is essentialin social media, so anything less than a genuineinterest in helping a community will result infailure. We need to be present, but we cannotbe leaders in the conversation, it’s simply not inkeeping with the nature of the media.

Leigh Householder,chief innovation officer,GSW: Multi-screenmarketing is a criticalnew skill set our clientsare focusing on this year.Specifically creating theright experience for everycontext that involvesa screen. Depending onthe audience, that could mean snackable, scannablecontent a physician can browse on histablet during morning coffee, a debate-endingvideo that a daughter can pull up on her smartphoneto show her mother, or even a smart reptrainingtool that delivers a different experiencewhen he’s looking at the screen vs. when he’sdriving to a meeting.On the social front, video is huge this year.It earns more attention in social than any othertype of media plus it already earns 50 percent ofmobile traffic. In healthcare, video can play a keyrole in motivating people. Disease makes peoplefeel isolated and alone. Video lets us bring theminspiration from people who are dealing withthe same decisions, the same therapies, the samedisease, in documentaries and storytelling thatare authentic and peer-driven.

Dan Renick: A significant key to success inthese areas will simply be understanding therules and regulations as they are generated andapplied, and then being as creative as possiblewithin that framework. We have seen that eachof these areas presents novel creative challenges,and one-size-fits-all solutions have been shownnot to work well. Right now, clients are activelytrying to figure out the right balance – toomuch investment in high-growth areas like mobileand social media at the expense of more establishedmethods runs the risks of losing touchwith traditionalists, while too little suggestsan overly conservative approach that is out oftouch with the realities of today’s digitally connectedworld.

Andrew Torn, digitalstrategist, ICC LoweTrio: The principles of“mobile-first” designhave worked their wayinto the fabric of professionalmarketing, whichis a great thing.Our clients are increasinglymore interestedin evolving their Web-based content so it canrespond to immediate customer-centric needs– in their location, in context, and in more conversationallanguage. Pharma companies canno longer “re-apply” Web content for mobilemedia: We all need to think “mobile first,” notsimply adapt one to the other.While many of the most enticing aspects ofmobile marketing (location-based services, augmentedreality, experiential design, social immediacy)remain untapped in the professionallandscape, there is an ever-growing number ofprofessionals who use mobile platforms to satisfytheir need for information, so the potentialin this channel is huge.Social media continues to be another difficult nut to crack in the professional side ofpharma, for well-documented reasons. The increasingawareness of the role social networksplay within the Customer Life Cycle is inspiringus to work even harder to find manageable waysto leverage these channels.According to a 2013 report by Wildfire, theNo. 1 way a customer discovers a new brand/product/service is by seeing ads on social networks.That’s almost double the rate of onlineads. Moreover, search engines (40 percent)barely edge out social networks (37 percent)as a platform for researching brands/products/services.Vital to successful mobile and social strategiesfor 2014 is exploiting analytics to help pinpointthe best way to connect the right messageswith the right professionals. Equally important,however, are customizing experiences for differentplatforms and developing content strategiesthat truly reflect how professionals consume informationwithin these channels.

Wendy Blackburn: With FDA issuing finalguidance, much of the uncertainty aroundmobile medical apps has evaporated. Nowwe can determine with some level of clarity ifFDA would consider a certain mobile app as amedical device, and plan accordingly. We haveheard a collective sigh of relief, and innovationis opening up again.Meanwhile, social has become mainstream,even without guidance. Slowly but steadily, weare seeing interest in long-term engagementprograms vs. one-of campaigns, which is goodfor everyone. We’re seeing clients hire full-timein-house social media staff. And we continue tosee an uptick in utilization of our social mediaproducts that help pharma companies engage ina compliant manner.Pharma companies are seeing that social mediais here to stay, they are getting more comfortablewith it and they are finding ways toengage.

Leerom Segal: Mobile is no longer a separateissue, it is just the current reality. If yoursite does not display well on mobile thenyou are late to the party. Doctors and patientsdo not care about your MRL process,they care about information that is clearand readable on the device they are using.

So, mobile is no longer an afterthought; itneeds to be a consideration in everything wedo.

Social on the other hand is still in regulatorypurgatory. There are a lot of experiments beingtried, but there are still a lot of questions. I don’texpect the FDA guidance scheduled for 2014to really change much for the industry exceptit may provide those moving slowly, permissionto experiment.

Eric Pilkington, executiveVP, digital strategy,North America, McCann Health: 2013 wascertainly an importantyear for pharma, as theirembrace of digital camefront and center. 2013was a remarkable yearfor McCann Health too,as we perhaps began working with our client tobetter leverage digital as THE CHANNEL bywhich to establish and extend relationships withcritical customers and organizational stakeholders.Based on this demand, I think that thereare five critical trends to follow as we move into 2014.

  1. Increased personalization/customization of ad messages

While dynamic ads have been around forsome time in other verticals like retail, we seethem as becoming more prevalent in the pharmaspace. Ads will be customized based on users’behaviors observed both on advertiser-ownedproperties as well as publisher sites. Dynamicads enable pharma advertisers to create multiplecreative variations using a single ad template,which increases marketing performance.

  1. Mobile becomes a basic

The year of the smartphone has come andgone in other industries, but 2014 is poised tobe the year of mobile in Pharma. And as moreand more people move away from the desktoptowards mobile devices, mobile advertising(search and display) will become a standard elementin digital media plans.

  1. Pharma gets social

Pharma companies have struggled to harnessthe power of social media given the concernwith adverse events (AEs) being reported in onlineforums or networks. For this reason, theyhave adapted their approaches to find ways toengage in social in a low-risk way; for example,adding voting mechanisms or social sharing featuresto websites.

  1. Online video as a replacement, or to companionDTC advertising

TV advertising continues to be a mainstayin the pharma marketer’s toolkit. However, withthe extra airtime required to add in the mandatorysafety language, pharma advertisers take ahit on TV media buying – unable to buy theshorter, cheaper spots. Unless you have a blockbusterproduct, cost can be prohibitive. Withthe rise of online video advertising and connectedTV, more and more advertisers are runningtheir commercial spots in the online space. Ourclients are beginning to take advantage of theadditional targeting available with online videothat is not usually available with traditionalDTC buys.

  1. Pharma finally embraces mHealth/DigitalHealth

Consumers are managing their weight, improvingexercise routines, modulating stress levels,and tracking their behavior through a hostof smartphone applications, wireless devices,and wearable technologies. Many of our clientstoday are beginning to look at how they can bestleverage this trend – how apps and technologiescan extend better service and support to patientsand physicians alike, while leveraging the cohortof data to better understand customer behaviorand trends and more individualized levels.