Driving In Traffic

As many of you know, I started blogging in 2005 for business at the encouragement of a close friend. The blogging bug bit me and bit me hard. What started as an academic experiment to boost the company’s google juice, eventually took me to places I never expected and led me to a wonderful set of friends and colleagues.

My enthusiasm over the potentials of this relatively new technology morphed me into an evangelist that had me trying to convince those I met that they, too, could use the technology. Subsequently, over time I began working with people and organizations to help them set up a blog and a successful strategy for meeting their goals.

In the past, I have been hesitant about soliciting for business, given that I had so much on my plate already. Honestly, in hindsight, it just wasn’t the time. However, now the journey that began with me starting the business blog, launching my personal blog (here), then launching my do-good blog, and now being invited to participate in the iVillage social network issues related to philanthropy and giving back, has led me to a place where my confidence that I can help is getting close to being equal with my desire to help.
For a while now, I’ve known that I was on a path toward doing something new. Being one that loves structure and routine I’ve struggled against it. However, the recent technology trials and tribulations with my domain name and blog hosting- gave me the cosmic kick in the pants to get off my duff and try to do what I really want to do— help healthcare and nonprofit organizations use social media strategies to boost their communications internally and externally, with the goal of building stronger relationships.

So with that said and the emotional support of my family (Jump in the water is fine.)— I’m taking the leap. www.drivingintraffic.com will be the online homebase for my services and consulting. Subsequently, with the change in URL of this blog, comes a change in focus.

Drivingintrafficblog.com will now really focus on supporting the efforts of my consulting. As much as I hate to say it– it will likely become more wonky but hopefully not too boring. However being more of a woman of action rather than musing about what can be done, I will still have the business blog and the do-good blog to give me real and genuine experience of the spaces I want to help others join.

I look forward to the new opportunities and meeting new folks on the path ahead.

Thanks to Michael Russell for the heads up about an article published from an interview I did a couple of months ago with Kayt Sukel on the influence of blogs and social media in healthcare.  She also interviewed Nick Jacobs and Mike as folks who get how blogs can be a valuable tool.
Mike purchased the reprint rights and you can read the entire article HERE.

In a previous post I wrote about the pros and cons of pharmaceutical companies partnering with big philanthropy to help cure/treat diseases.

Now, Fard Johnmar at Envision Solutions has posted on how the public is becoming skeptical of alliances between pharmaceutical companies and nonprofits that are aimed to educate and improve health. As his post indicates, Fard’s company commissioned a big study (available for purchase) of this very issue and has found that

“43% of US adults believe that pharmaceutical companies fund groups like the American Heart Association and the National Kidney Foundation in order to get more people to buy their products or medicines. “

I haven’t purchased the report, but this one fact alone is evidence of the consumer cynicism that is a result of the numerous scandals associated with the pharmaceutical industry and a few greedy practitioners. Call me an eternal optimist, but it continues to amaze me what a few bad apples can do.

Here’s where the rant begins…

Fard’s research is intelligent and insightful. In my view, the research is very helpful in that it simply takes the temperature of what is going on — here and now— in the thoughts of the consumer/patient. Honestly, I think studies like this give us quantitative insights to what we all know… the healthcare industry is changing and consumers/patients are playing a larger role in how, when , where, and what care is delivered. Honestly, I have no beef with the report or with Fard– but it just got me started thinking about the one sided nature of this discussion.

What I do have a beef with is the extremists that continually bash the pharma industry without any thought about bashing those industries (hint–mainstream media and unethical education companies who took research reports and published them unedited as gospel) and prescribers who failed to think for themselves.

Afterall, it takes two to tango. –Right? And since the dawn of time every scientific study has had limitations that need to be examined before applying the findings to real life. I think it is dangerous to focus on the the actions of the largest kid in the room and forget to share the blame with other individuals for not being analytical, skeptical or simply failing to fulfill their responsiblity/duty to think for themselves. (I hear the echos of my mother’s voice… “You wouldn’t jump off a cliff it Sally told you to, would you?”) Afterall– temptation and influence are not torture techniques that make us do things that are against our better judgment.

I suppose what set me off was the ridiculous and sensationalized segment, last night by Brian Williams from NBC Nightly News on physician perks– which interestingly has a huge ad for an antidepressant on the page. (Hmmmmmm….) I suppose that is a rant for another day.

Nonetheless, I’m telling you– for a vast number of clinicians, a dinner, a pen, samples, or a sticky pad does not make a prescriber write a prescription. It just not that simple…

• Nor does the drug rep’s technique of rearranging sample cabinets so that his/her product is eye level and center make a prescriber write a prescription.
• For that matter, nor does the hate mail from insurance companies and PBMS (medco)– that innundates prescribers asking for them to consider other more forumulary friendly medicines.
• and just one more…Prior authorization processes are also a big failure too.

For most clinicians, they prescribe a treatment that they think will work given a complex set of individual patient parameters. Medicine cabinets can be arranged just as easily as paperwork can be refiled… that is why they have a staff.

What alarms me most is underlying unspoken belief that pharmaceutical companies have eliminated or brainwashed all analytical and skeptical thinkers in medicine.

• Yes, of course there are idiots who will believe anything.
• Yes, in the past, pharma has had a lot of influence.
• Yes, we are seeing a timely and healthy correction of this.

But — lets not get carried away and vilify the entire industry to exclude any good they do.

To me, this new statistic from Fard’s study simply means our age of innocence is officially a thing of the past. We all are simply going to have to use our brains a little more– which honestly, we should have been doing anyway.

Thanks for letting me indulge in a rant. I promise– I’ll try to be a little less emotional in my next discussions of this.

I just read a Reuters article by Ben Herschler on the potential influence of the Gates Foundation on the pharma industry. A quick quotation to get you started:

“The billions of dollars thrown at global health problems by the Bill & Melinda Gates Foundation are changing the game in drug discovery, posing big challenges to the world’s top drugmakers, according to a report on Tuesday.

Pharmaceutical information group IMS Health Inc. said the emergence of megabuck philanthropy was both a threat and a collaboration opportunity for manufacturers.

“Pharma companies need to develop an explicit strategy to deal with this phenomenon,” IMS said in its annual Intelligence.360 report on factors shaping the industry.”

Now my day job is in healthcare and I’ve done a lot of work with the pharma industry over my career. I have helped with clinical research, written patient education materials and consulted on launch strategies and professional education efforts on new treatments.

Yes– major philanthropic associations can do a lot to bolster the research efforts of pharma. Additionally, pharma gets good karma points for partnering with good causes. Nonetheless, one must always remember that in economics and business, nothing is ever free. Afterall, today’s new era of empowered philanthropy, generous giving rarely means “without strings.”

Just looking forward: How will pharma handle the philanthropist’s demands for affordable prices on these new treatments that they have helped to bring to market? Afterall, right now most new treatments are priced based mostly on what the market will bear and competitor prices, rather than any real analytical plan to recoup costs plus a reasonable profit.

Or will philanthropic organizations require a “return on investment” when partnering. If so, what would this look like?

Not to leave out the megabuck philanthropies, I also have questions for them. What happens when an ethical question comes up about the research on a treatment? How will you ensure that your altruistic and philanthropic missions are not compromised by a greedy and immoral few? All it takes is one poorly designed study, one failure to disclose financial relationships, or one questionable and tragic death to occur in one of those studies to ruin all the good work being done.

We need only look back as far as 1933 and the Tuskegee Syphilis Study to see how unethical research can ruin the trust of individuals who need care. Growing up and working in the south, I have seen the unfortunate legacy of this experiment. I have personally heard many African Americans voice suspicions and be doubtful of treatment offered to them. Some people going so far as to avoid doctors and hospitals at all costs and dying because they refused to seek treatment. I can only imagine what would happen if something similar happened in AIDS/HIV ravaged areas. It could completely undo all the work being done and send us tumbling toward the loss of multiple generations of people who really deserve better.

A lady called physician’s office with whom I am working. She was distressed because all of a sudden she was unable to get one of her medicines because she needed our office to submit a prior approval application.

She was frustrated, upset and worried about what she was going to do since she was almost out of medication. She was also feeling singled out and picked on by the insurance company.

With that experience fresh in my mind, here are 10 things to know about the medication prior approval process.

1. You certainly are not alone. Increasingly, insurance companies and pharmacy benefit managers are implementing prior approval requirements for certain medications (mostly brand names where generic alternatives are available).
2. Every insurance plan has their own custom prior approval requirements. Many think that their insurance plan is the name of the company that insurance plus the product (example: Blue Cross Blue Shield PPO, Aetna HMO, Blue Cross Blue Shield POS). Actually, your plan is customized for your group. So there may literally be thousands of different plans underneath the umbrella of the type of insurance you have. Subsequently, it is next to impossible for your prescriber to know which medications need prior approval and what the approval criteria is for specific medications.
3. Brand name medications that are used to treat attention deficit disorder, insomnia, asthma, allergies, erectile dysfunction, irritable bowel syndrome, rheumatoid arthritis, osteoporosis, osteoarthritis and elevated cholesterol levels often require prior approval.
4. To get drugs approved, most pharmacy benefit companies have forms that must be completed by the doctor. Some companies do have phone numbers to call, but here again, this needs to be done by someone in your doctor’s office.
5. Medication prior approvals usually expire after a year.
6. Some medication prior approvals are for specific doses of medications. If the dosage changes, you may be required to seek another prior approval.
7. Because of the increasing numbers of medicines being added to prior approval lists, medical offices are very busy responding to requests for prior approval. Please give your provider’s office at least a week to complete the process.
8. Once the medical office completes the process, sometimes it takes up to three days for the approval to get into the system so that the pharmacy can fill the prescription.
9. Information that is needed for medication prior approvals can include: your name, your insurance subscriber number, your birthday, your diagnosis, and prior medications used to treat your condition, dates of treatment and reasons they were discontinued.
10. Patients/consumers can really be of assistance by keeping up with the expiration dates of medication prior approvals. Many prescribers are happy to help a patient that is trying to make this process easier.

The second post of my Niche Marketing Series is up at Trusted.MD. Drop by to leave your comments and thoughts on the power of being a resource to your colleagues and how this can further you niche marketing efforts.

As I stated in my last post- I’ve got a big case of blogger guilt. Too much to do and Driving In Traffic is suffering. When I write a post for Trusted MD, I usually try to cross post it here. Well… in an effort to save a lot of time not having to reformat and such, this week I have decided to just post the link to the post. CLICK HERE
This week I’m discussing Niche Marketing in healthcare.

Tags: healthcare marketing niche marketing Trusted MD

Once again I will be participating in the Healthcare Blogging Summit to be held in Las Vegas on April 30th. Like the one in December, Dmitriy Kruglyak has gathered a number of thought leaders in the area and the agenda is packed with a lot of interesting discussions.

As a moderator for a panel on the use of blogs for medical and health education, the nice people at the Consumer Directed Health Care Conference have offered me a free pass for someone (not in my organization) who would like to attend.

Click here to see the conference agenda.

If you would like to go, drop me a line at carol{at}drivingintraffic[dot]com. I’ve only got one pass, so first come first served. However, I also can put you in for a discounted registration as well.

Tags:Healthcare Blogging Summit Consumer Directed Healthcare Conference Las Vegas

I just saw this You Tube Video by PharmedOut, an independent physician-run project funded through the Attorney General Consumer and Prescriber Education grant program. This Video interviews a gentleman who was previously an Eli Lilly Drug rep about is experience marketing olanzapine.

With my day job, working in psychiatry with a team that treats real patients, conducting and publishing clinical trials, and producing educational activities for psychiatric nurses and psychiatric clients, I have had considerable experience with drug reps, antipsychotics and pharmaceutical advisory boards. With that said, in my opinion, this gentlman does accurately discuss the marketing mentality of the company during the time he served. However, I am pretty dismayed and considerably annoyed at the subtle message that “all prescribers are idiots and will believe whatever Drug Reps tell them.”

Most prescribers know that drug representatives in the past had a pharmacy background. Now, drug representatives come mostly from a marketing or business background. Especially in the case of schizophrenia and bipolar disorder, where there still are a number of significant questions about what really goes wrong in the brain to create the diseases. We certainly understand the diseases better than 10 years ago, but we cannot claim to understand everything. So…. unless, I’m wrong– this lack of clinical background among most current drug representatives creates a serious scientific credibility problem when talking about advanced interpretations of information included in the package insert and clinical studies (like mechanisms of action for efficacy and adverse effects as well as the projected health impact of side-effects and management suggestions).

Many also understand that drug representatives are rewarded for the number of prescriptions filled in their territory for the agent they market. While not every Rep is soley focused on number of prescriptions, this “moving product” reward system places these individuals squarely in the “Extraordinarily Biased” bucket of individuals who have the potential to influence care.

So I think it is utterly rediculous to think that any clinician would adopt any behavior or prescribe any treatment based solely on what a drug rep said. Much less, continue to do so when it is not working or there is significant risk of hurting a patient.

Now– I realize that the case of this medication also involves some accusations of important side effect information being supressed and withheld. Honestly, I don’t take sides here.
However, clinical experience is a powerful force in the practice of doctors, nurses and other health professionals. There may not be ready explanation, but trends and patterns can be seen. Afterall, where there is smoke there is usually copious oxidation occuring and if left to continue there will soon be a fire. It has been the dogged determination of independent clinician researchers to understand the trends and patterns that have brought this issue to the forefront.

My emphasis has always been that patients have the ability and responsibility to become more active in the selection of their treatments. Part of being empowered is understanding the players in the game. Marketing of treatments to practitioners does play a role, as does, accurate interpretation of research findings, dissemination of those findings and clinical experience and knowledge of the practitioner. Patients should feel free to ask questions to make sure that the proper amount of consideration is given to all the voices.

Yesterday I trundled on down to the mailroom at our office complex in an effort to help out. What I found was simply an excessive amount of high dollar direct mail items with the aim of detailing doctors on medications.

Now– I’m used to seeing a flyer and phamphlet here or there. But By-Mail detailing has gone to whole new levels. The most excessive ones are packaged in boxes and shipped to look like you are getting a book, schwag or something of value. I suppose all those focus groups conducted by Pharma have helped them learn that it is pretty easy to sniff out old time marketing material. Thus its fate is to go unopened directly to the trash bin. I suppose this new packaging is likely to get opened just to make sure that nothing of value is thrown away.

However, folks– the gig is up. Imagine my surprise when I got to the mail room to hear a disembodied voice coming out of our mail drawer. Apparently, the lastest parcel used the annoying talking greeting card technology (Guys– this is annoying for birthdays and other celebrations– why on Earth did you think it was a good idea for marketing?!?!). It had gotten squished by a larger parcel and had activated the push button mechanism which provides you with a voice to detail you on various aspects of the drug. Thankfully it shut up soon after I pulled it out of the drawer. I honestly do not think I could get on the elevator with that thing going off in my arms. Although now, working in psychiatry, I suppose a disembodied voice in an elevator could have been a good way of drumming up some business.

Let me just cut to the chase… pharmaceutical detailing by mail is a waste of money! Unless you employ some sort of intermittent reinforcement (i.e. periodically sending something that is actually helpful) the items never get opened and end up in the trash bin. Oh yea– if you are going to send something helpful– ask before you unilaterally decide cause you pharma marketing guys and gals just don’t get it.

Tags: pharmaceutical marketing pharmaceutical detailing disembodied voices medications pharmaceutical