Pharma on Facebook: past, present and future

Wendy Blackburn

Intouch Solutions

There’s been much discussion around the pharmaceutical industry’s use of social media, especially Facebook. Is it worth the risk for pharma to engage in this uncontrolled space? Will consumers really “like” a medication in a place where they’re more likely to play Farmville? And what options does pharma have considering Facebook’s recently-announced policy changes?

Can pharma and Facebook still be friends?

Pharma and Facebook: the story so far

To answer these questions, let’s look at where things are today. How many Facebook pages are sponsored by pharmaceutical companies?

“Will consumers really “like” a medication in a place where they’re more likely to play Farmville?”

Some might be surprised to know there are many. Seventy-seven pharma / healthcare Facebook pages are listed on the Pharma / Healthcare Social Media Wiki alone, as of July 2011. But I found the list is neither current nor exhaustive. I estimate there are more than 150 live Facebook pages across pharma, device, and animal health, representing a wide variety of approaches. Below is a quick tour of some representative examples:

• Corporate pages – many pharma companies have a corporate presence on Facebook to represent the company globally (Boehringer Ingelheim Corporate), locally (Pfizer Turkey), or to recruit employees (AstraZeneca Careers). Corporate sites make a lot of sense from a public relations perspective, representing many angles and reaching many audiences.

o One of the earliest examples was Abbott’s Labs are Vital page.

o Generic companies are there, too, like Teva Pharmaceutical.

Figure 1: Boehringer Ingelheim’s official Facebook page

Branded Pages – Branded sites are rare, but include Tobi, Lysteda, LAP-BAND, Latisse, and Juvederm, among others. Prescription medication pages that allow comments are even more uncommon.

o Gardasil’s “Take a Step Against Cervical Cancer” page (no longer live) had over 100,000 members and was among the first pharma Facebook pages. Its popularity made sense, considering the product category and target audience.

o OTC or health-related CPG pages can be more easily open for obvious reasons. Although they’re not as prevalent as one would think, a few include Zicam, Cetaphil, MyAlli, and Nicorette. If Rx marketers are looking to see what an open conversation on their Facebook pages might look like, these serve as a good gauge.

o A few medical device pages exist as well, such as NeuroStar TMS Therapy and Cyberknife.

o Animal health pages are scarce, though Facebook does host plenty of anti-animal testing sentiment.

Unbranded Pages – Pharma’s unbranded Facebook pages representing conditions or franchises are more prevalent. See CF Voice, ADHD Allies, sanofi’s U.S. Diabetes page and 50 Years of the Pill.

Games and Apps – Pharma companies also have leveraged Facebook in ways other than a standard Page, such as games and apps. Boehringer Ingelheim’s Healthseeker, with nearly 5,000 monthly users, is an example of a health-related game that engages consumers. In the apps category, the C.H.O.I.C.E. Facebook “Causes” app leverages an existing app to spread the word about the campaign. More than 2 million people click “allow” on Facebook every day. Farmville and Cityville represent a combined 125 million monthly average users! If done well, apps and games are a viable option.

Most of these are consumer or “general public”-facing, but a few target healthcare professionals, such as Vidacare’s On Control Bone Marrow System aimed at physicians and the active J&amp,J’s Nursing Notes. And Pfizer Animal Health and Pfizer Animal Health– U.S. Livestock speak to veterinarians.

“Seventy-seven pharma / healthcare Facebook pages are listed on the Pharma / Healthcare Social Media Wiki alone…”

Facebook changes the game for pharma

“Starting today, Facebook will no longer allow admins of new pharma pages to disable commenting on the content their page shares with people on Facebook,” Facebook told pharmas in a May 17 email posted by Intouch Solutions on its blog. “Pages that currently have commenting disabled will no longer have this entitlement after August 15th. Subject to Facebook’s approval, branded pages solely dedicated to a prescription drug may (continue to) have commenting functionality removed.”

Medical Marketing &amp, Media Magazine

Things just got more complicated.

Some say a review of pharma’s non-engaging Facebook pages support the idea of pharma walking away from Facebook altogether. But I maintain there is still opportunity – depending on the brand and category – for pharma to connect with customers on Facebook.

More and more, social media is where people are seeking information about healthcare, products, and related information. Almost every pharma is considering social media and Facebook as a way to reach customers. Looking at our own agency website (intouchsol.com) April – June 2011, the daily average external visits resulting from searches using “facebook” in the search phrase grew by 581%!

And it’s not just Facebook. Google confirmed it will be offering business profile pages on its new Google+ social platform.

Perception vs. reality

There exist some very serious risks to pharma for engaging on Facebook. People who are immersed in the industry understand this, those on the periphery do not. The more I speak with patients, media and other industry outsiders, the more I realize what a huge misunderstanding there is around the essential gag order FDA has on pharma.

“Where things get sticky is when patients post comments about the medications that are off-label.”

The perception: Pharma companies don’t have open, two-way dialogue in social media because they:

1. do not want to hear or address negative comments

2. do not want to address tough questions and concerns people may have about products / their condition

3. do not want to report to authorities (such as FDA) the product side effects / adverse events that may be posted

4. want to have 100% control of the conversation for the wrong reasons (i.e., they don’t want competitors mentioned, etc.)

5. just don’t understand the meaning of “social” in social media

The reality: These are not the key issues. Where things get sticky is when patients post comments about the medications that are off-label. “Off-label” means a statement or use of the product not approved by FDA (or other governing body). Any of the following hypothetical comments could apply:

• “[Drug X] was FDA-approved for asthma but my Dr. prescribed it for COPD and it worked great!”

? Drug X wasn’t tested / approved for COPD so FDA would take issue with this

• “Whenever I self-inject [Drug X] I use ice to make the injection feel better and I also take ibuprofen. You should try that.”

? Unless it’s in the label, pharma co’s shy away from giving what could be construed as medical advice

• “I’ve learned that if I cut my pill in half, I still feel okay, but my prescription will last longer and costs less.”

? This is a problem not because pharma will lose money on the prescription, but because this pill wasn’t tested and isn’t approved for half its dosage amount

• “My wife is in clinical trials for your [Drug X] and we truly believe it is helping her more than any other treatment else has.”

? This is pre-approval promotion and also makes an unsubstantiated comparative claim

• “[Drug X] cured my son! I’m so thankful for this medication for changing our lives.”

? Very few drugs – if any – are indicated as a “cure.”

So even comments that are benign, positive, well-meaning, and honest can be problematic in subtle – yet critical – ways.

In the U.S., until FDA says pharma companies are not liable for comments on their pages, these companies will continue to assume they are – and will take steps to manage the conversation.

“…even comments that are benign, positive, well-meaning, and honest can be problematic in subtle – yet critical – ways.”

Regulatory professionals understand just because FDA hasn’t issued a letter for user content on a pharma Facebook page doesn’t mean they accept it categorically. DDMAC’s staff of 60 receives more than 80,000 #2253 submissions annually. They can’t keep up with submissions, let alone police the entire Internet.

Just because FDA hasn’t issued a letter for user content on a pharma Facebook page doesn’t mean they accept it categorically.

So what do we do now?

My agency specializes in digital marketing for pharma. While we see opportunities for pharma to leverage social media, we recognize it is not for everyone. And we encourage clients to use social media as the medium was intended – with authenticity, transparency, and as “real-time” as possible. Case- by- case, our clients determine their own risk tolerance level, balancing potential benefits with inherent hazards. We support them either way.

For companies that decide they still want to be on Facebook, there are a number of options:

1. 24/7 monitoring and moderation or a “community management” model

2. Moderation applications that place a temporary “hold” on comments prior to publication

3. Branded Facebook pages, where Facebook will still allow comment disabling

4. Personal representation or company “spokesperson”

5. Advertising

6. Word filters

Does moderation enable or destroy dialogue?

For many, moderation is the balance between control and conversation that pharma needs. I spoke with someone recently who was fundamentally against moderation apps on Facebook. (My company offers one, called PharmaWall). He hates them because he is “fundamentally against anything that blocks conversation.” I understand his viewpoint – especially from those outside the industry that aren’t close to the regulations. Moderation apps smell of Big Pharma censorship.

Figure 3: pharmawall

But my response to him was that PharmaWall and other tools like it aren’t conversation blockers, they are conversation enablers. In the end, more pharma companies will engage on Facebook because apps like PharmaWall exist. In many cases, the alternative is simply to pull the page down.

Unless the regulatory environment shifts, this is the way it is going to be.

What’s your take? What has your company decided to do about Facebook pages that are currently live or in review?

As an industry, I hope we all continue to work collaboratively to navigate the maze FDA and other regulatory authorities have created. And I hope we remember that it’s all about improving the health and meeting the needs of our customers in the best ways we know how.

About the author:

A face familiar in pharma social media circles, Wendy Blackburn has more than 16 years’ experience in pharmaceutical and health care marketing. With a background in PR, B-to-B, and digital, today she is responsible for client strategy, client service, and business development for Intouch’s top-20 pharma clientele. Her blog,

ePharma Rx, and Twitter handle, @wendyblackburn, have become the go-to authorities for discussions around all things pharma marketing, digital, and social.

Phone: 913.956.4328

Email: wendy.blackburn@intouchsol.com

Is it worth the risk for pharma to engage in this uncontrolled space?