An update of earlier presentations on physicians' social networks, but with a focus on oncology, one of the most e-reliant specialities in medicine. First presented at Sales & Marketing for Oncology Therapeutics, Brussels, 16 March 2010.

1. Physicians’ Social Networks Am Emergent New Engagement Channel in Oncology Len Starnes Head of Digital Marketing & Sales General Medicine Len Starnes Head of Digital Marketing & Sales General Medicine Bayer Schering Pharma Enhancing Sales & Marketing Performance for Oncology Therapeutics Brussels, 15 -16 March 2010

3. Source: Manhattan Research Strategic Insight, ePharma Physician v9.0 #4, 2009 Oncologists are highly e-reliant physicians Gather product information online > 75% of time

4. Physicians’ social networks The Big Bang

5. Actually, it all began with sushi…

6. First reactions What does it cost? Is this something really new? How does it work? What is Sermo? Great sushi! Why is Pfizer always first? I must talk to my brand teams about this Black cat cartoon: with thanks to John Mack, Pharma Marketing Blog http://pharmamkting.blogspot.com/2007_10_01_archive

7. Transforming the way medical information is exchanged Based on Pfizer/Sermo press release 15 October 2007 http://www.sermo.com/news/media/press/pfizer It’s all about… Pharmaceutical industry Initiating an open and honest discussion Medical profession

8. Global dimensions Physicians’ social networks

9. USA Setting the pace Sermo Physician Connect Student Doctor Network Healtheva Relaxdoc SocialMD Sosido Clinical Village iMedExchange Tiromed Ozmosis Medical Plexus Within3 Rad Rounds MyPacs MedTrust MedicSpeak Peerclip Syndicom Spineconnect QuantiaMD MDsConnect Number of networks Diversity of networks Attracting VC Pharma participation

10. 112,000 members each

11. Significant long tail of niche players

12. Europe Heterogeneous doc2doc (Global) Doctors.net.uk (UK) OnMedica (UK) Coliquio (D, CH, AT) DocCheck Faces (Int’l) DocCheck Faces(D) DocCheck Faces (F) DocCheck Faces (ES) DocCheck Faces (IT) Dooox (D) Esanum (D) Esanum (ES) Esanum (IT) Esanum (CH) Esanum (AT) Esanum (F) Docactus (F) Med Universe (SE) UK and Germany lead Fewer players Catching up with USA

13. 17,000 members Open and closed areas Integrated with BMJ Group medical content Global 130 countries

14. Focuses on D, CH, AT 16,000 members Partnership with leading German medical journal Ärzte Zeitung Expanding to other EU countries 2010

15. Asia Pacific Emerging opportunities High growth rates Significant membership numbers Good Doctor’s Forum (CN) China Asthma Alliance (CN) dxy.com (CN) China obgyn.net (CN) Orthochina (CN) Public networks (BBS) (CN) Doctors Hangout (IN) Doctor.VG (IN) Medtitans (IN) Protomedica (IN) HelloDr (IN) Smartdoc (IN) M3.com (JP) MedPeer (JP) Carenet (JP) NM Online (JP) MT Pro (JP) Medigate( KR) Misc medical news sites (KR) Australian Doctor (AU) New Media Medicine (NZ)

16. China: www.dxy.cn 1.7m members - No authentication - 50% physicians - 30% biomed researchers - 20% medical students With thanks to Kevin Lin, JSure Healthmedia

17. Japan: www.m3.com Authenticated physicians 177,000 members

18. South Korea: Medigate Authenticated physicians 67,000 members

19. Anatomies Physicians’ social networks

20. Authentication All specialities Includes pharma 1 st dimension taxonomy Authentication Single speciality Includes pharma Authentication All specialities Excludes pharma No authentication All specialities Inc & excl pharma

21. Pure play Social network only Sermo Ozmosis Coliquio 2 nd dimension taxonomy Hybrid Social network + online med resource Physician Connect doc2doc Doctors.net.uk

22. Participation by scientific liaison staff in community discussions Support speciality communities Post information and services germane to discussions Post questions to a specialist community Conduct surveys Establish panels based on pre-selected criteria Unmet needs Treatment trends Drug usage monitoring Future Rx volume Unknown side-effects Off-label usage Early identification of critical issues Engagement Research Observation Pharma partnering options

23. Key learnings Physicians’ social networks

24. Membership growing everywhere

25. Sustained growth in USA Physicians in 2012: Manhattan Research, Taking the Pulse v9.0, 2009 Already using + very interested + somewhat interested % respondents Physician Online Communities: Social Networking Manhattan Research, Taking the Pulse v8.0, 2008

26. Source: Coliquio

27. 25,000 visits/month on Doctors.net.uk oncology area Source: Doctors.net.uk, Feb 2010

28. Not just younger physicians

29. Sermo members markedly older than average internet Age of Sermo users Percent total Source: Sermo

30. Coliquio: 55 – 59 age group dominates Similar age distribution in Europe

31. Physicians welcome pharma participation … but only on their terms. No selling or advertising

32. Majority of physicians interested in interacting with pharma Source: Manhattan Research Strategic Insight, ePharma Physician v9.0 #6, 2009 I am interested in interacting with pharma on physicians’ social networks (% e-physicians) 56% Agree 44% Disagree

33. Top specialities interested Source: Manhattan Research Strategic Insight, ePharma Physician v9.0 #6, 2009 Obgyns Oncologists Urologists Neurologists Dermatologists

34. What do physicians really want from pharma? Source: Joel Selzer, Ozmosis, February 2010 Fast, simple, reliable answers to product questions Peer-to-peer interaction and trusted feedback Rep-like services but on members’ terms

35. Pharma’s challenges mainly internal

36. Marketing Sales Medical & Scientific Legal & Regulatory Functional collaboration essential

37. Real-time poll update: http://polls.linkedin.com/poll-results/28204/lakmg

38. Physicians’ social networks Marketing beyond 2010

39. During the next decade Predominance of e-savvy physicians Routine use of SNs by majority of physicians Dwindling of sales forces Predominance of multi-channel engagement models More physicians expecting e-self service from pharma More physicians willing to engage with pharma on SNs

40. Inevitable shift Fewer sales reps Multi-disciplinary engagement teams Less selling More dialogue

41. What will influence oncologists’ prescribing behaviour more Open dialogue on social networks Pharma marketing as we know it? or