Medical communications and CME in Asia – how are they different?

Lisa Sullivan

In Vivo Communications

In our medial communications month, Lisa Sullivan addresses the medical communications environment in Asia and explores how it differs from western medical communications.

How are med comms and CME in Asia different from what we see in the “west” and how do we cover this huge topic in so few words? We need to start by separating them so let’s begin with med comms – the more advanced area of medical communications than CME.

Asia is huge – we all know that much…sometimes it includes India and Pakistan and sometimes not while China is always included albeit differently across Pharma in the region. Japan tends to be on its own due to it’s being SO completely different to the rest of the region. In essence though, Asia includes almost 1/3 of the world’s population with many, many millions of burgeoning middle class all pushing for better conditions and more remuneration.

The interesting thing about the “emerging markets” is the perception that Pharma is spending more money here than ever before. I’m not sure this is actually true as our experience shows that although there is lots of med comms work being done, it is not to the level that fewer companies did some 10 years ago and nothing like the sort of spend seen in Australia, Europe or the US.

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“The interesting thing about the “emerging markets” is the perception that Pharma is spending more money here than ever before.”

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If we go back to the turn of the century there were few med comms agencies in Asia all of whom were doing well with sound returns. Now there are lots of companies offering med comms (albeit not always of the highest quality) so the returns are less and the competitive nature of each “sale” makes the business here very tough. Fundamentally, some Asians can have difficulty valuing the work prepared by companies who consider quality their primary goal. If you want sound experience and capable people to deliver high quality med comms you cannot do this with small budgets and even smaller appreciation of the work involved. The talent pool in Asia (particularly with medical writing) is still predominantly “western” – the quality can be high but then so is the cost.

If we break med comms into meetings and publications, it is fair to say the predominant activity is still the face-to-face meeting. Whether an advisory board, expert panel or scientific stand alone/satellite symposium attached to a congress, most Asians still prefer to meet together and be lectured to. A lot of this relates to the hierarchical nature of learning here where the head of the department or professor is still the most important person and “lesser” medics still want to be ‘taught’ or learn from senior and more experienced professionals.

The greatest challenge is getting the audience interaction we westerners are used to. I have found that an Indian audience will like to talk so if your audience is Indian then you can expect lots of talking and interaction – including disagreement. In my experience, a culturally Chinese audience (which covers countries including Singapore, China, Taiwan, Hong Kong etc) will be quiet and contribute very little.

Language can be an issue. Although almost all medical doctors speak some English there are some countries were a large proportion of communicating still needs to be in the local language. I’ve found that doctors from Korea, China, Vietnam and Indonesia are more likely to interact if the meeting or congress is in their own language due to concerns of their ‘poor’ English, they feel they would “lose face” by attempting to interact. Many other health professionals (nurses, physios etc) in countries like Thailand, Vietnam, Indonesia, Korea, Taiwan often speak very little English so their medical communications need to be localised for language and therefore nuance.

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“If you want sound experience and capable people to deliver high quality med comms you cannot do this with small budgets and even smaller appreciation of the work involved.”

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CME is completely separate and ‘owned’ by the Universities, Hospitals and Associations

The CME world in Asia is very different to the developed world and is still in its infancy. Universities, hospitals and associations are the ultimate controllers with commercially accredited providers being considered anathema.

Although online learning is improving with some associations providing this medium from their websites, there is a limited amount of education being delivered online and it tends to be focused more at primary than secondary care.

The Chinese government is committing a large sum of money to provide distance learning to its medical community but this is taking time to implement and is basically being driven by western companies and universities.

Across Asia the Pharma industry spends quite a lot on what they call CME but this is usually not accredited and tends to consist of small group meetings with a KOL presenter covering both disease management and drugs. The accredited CME sponsored by Pharma is now more often managed through the medical department and is definitely of a higher quality and more disease oriented than that which is managed through marketing.

Accredited CME in Asia is patchy. With accredited CME still not a requirement in many countries, the commitment to advanced principles and a variety of topics is limited. Hospitals and associations are the major players but even they do not have the resources or experience to develop and deliver vast quantities of high quality CME across numerous disciplines.

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“The talent pool in Asia (particularly with medical writing) is still predominantly “western” – the quality can be high but then so is the cost.”

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Outcomes – the missing link in Asian CME

Outcomes measurement is the missing link in Asian CME. With the western world so focused on securing improved patient outcomes from CME / CPD, Asia really needs to step up and consider this imperative in their CME development and delivery. Outcomes are difficult to quantify and to measure and require more rigid consideration of the process, content and delivery of education, requiring time, experience and know-how – all variables which I fear are lacking in most Asian countries. While the convenor of the CME department is often someone given the responsibility for the next 12 to 24 months (while still doing their “real” job of doctoring or running the department), there is little incentive or experience to encourage a wider application of CME / CPD principles and knowledge translation.

An important change I feel we need to see in Asia is the removal of the traditional CME terminology with a change to the more widely accepted CPD nomenclature as I believe this will provide more guidance towards improved professional development and hopefully enhanced patient care.

If you’re in the business of CME / CPD development and delivery, come to Asia with your eyes open…it is complex, fascinating and a lot of fun – but also a lot of hard work.

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About the author:

A veteran of the global pharmaceutical and medical communications industry, Lisa Sullivan is the founder and Group Managing Director of In Vivo Communications, an Australasian medical communications agency established in Sydney in 1996 and Singapore in 1999.

With more than 30 years of direct industry experience, Lisa has fostered and galvanized her reputation as a senior executive with proven leadership credentials and strategic insight. A marketing graduate of Australia, Lisa’s long career has included 8 years in pharmaceutical sales and marketing followed by many many years in the medical education and communications arena. She is accredited by the Royal Australian College of General Practitioners as a provider of Quality Improvement and Continuing Professional Development (QI&amp,CPD) programmes, and is a board member of the Global Alliance for Medical Education (GAME).

Email: L.Sullivan@invivocom.com

Telephone: +61 414993302

Do you think outcomes measurement is the missing link in Asian CME?