PHARMA
                       Ranking the digital competence of
                                 pharmaceutical brands


M...
I.     INTRODUCTION                          .......................................... 3


        II.    METHODOLOGY    ...
INTRODUCTION
The Killer App                                               tion with highly trafficked health portals, and f...
METHODOLOGY
  PLATFORM - 40%
  Site Effectiveness: Reinforcement of core brand          • BRAND TRANSLATION
  associations...
RESULTS
The Digital IQ Index ranks brands according to their digital
competence, with each falling into one of five categor...
PHARMACEUTICAL BRANDS RANKED BY DIGITAL IQ SCORE

   Rank     Brand        Parent                 Disease State          I...
Rank     Brand       Parent                 Disease State      IQ    Label        Comments

   21       ADVAIR      GlaxoS...
Rank     Brand       Parent                 Disease State      IQ   Label        Description

   41       OMNARIS     Sepr...
DISCOVERIES
The Tipping Point                                                                    PETER
Consumer appetite f...
Learn by Doing                                                                                                            ...
Innovation Silos                                                  SCOTT                                                   ...
Younger “Age of Onset”                                                                          SCOTT
Brands Lead         ...
Patent Cycle’s Impact                                         AVERAGE TIME TO PATENT EXPIRY

Brands categorized as Genius
...
FINDINGS
Platform
Branded sites inform consumers and encourage patient compliance at different              PETER
stages o...
Forty-five percent of sites offer savings
to current users, effectively diminishing
the profitability of those sales, althou...
Search Engine Optimization
Search engines are the primary tool         pharmaceutical paid search advertising is primarily...
Off-Platform Messaging
In 2009 pharmaceutical industry online advertising spend was up 31%              SCOTT
year-on-year...
Email                                                                           QUICK STATS
Email is a low-cost way to eng...
Mobile
Pharmaceutical branded mobile
                                                         NOTABLE DISEASE MANAGEMENT A...
SELECTED HEALTH PORTALS

                                                                           Unique
               ...
Social Networking                      company channels (Ambien and                  QUICK STATS
Only 19% of pharmaceutica...
cite regulations about adverse-event
reporting as the reason for their hesi-
tation to embrace social media. Yet, a
Novemb...
TOP PARENT COMPANY TWITTER EFFORTS

                                                               Total
                 ...
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Digital I Q Pharma

  1. 1. PHARMA Ranking the digital competence of pharmaceutical brands MAY 2010 Prepared By: Industry Partner: A THINK TANK !!!!"#$!!PRESTIGE BRANDS PHD Media © L2 2010
  2. 2. I. INTRODUCTION .......................................... 3 II. METHODOLOGY .......................................... 4 III. RESULTS the rankings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5 IV. DISCOVERIES ............................................ 9 V. FINDINGS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14 VI. OBSERVATIONS by disease state . . . . . . . . . . . . . . . . . . . . . . . . 25 ASTHMA & ALLERGY . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 25 CARDIOLOGY . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 28 GASTROINTESTINAL . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 32 NEUROLOGY. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 35 PSYCHIATRY. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 38 RHEUMATOLOGY. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 41 UROLOGY . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 44 WOMEN’S HEALTH . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 47 VII. TEAM . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 50 © L2 2010 2
  3. 3. INTRODUCTION The Killer App tion with highly trafficked health portals, and forays onto Facebook and YouTube put brands like Gardasil and The killer online app isn’t porn or social media, but med- Viagra at the top of our ranking. However, the industry ical advice. Arguably, no medium has so much influence as a whole disappoints, as most brands offer obsolete over so much spending—one sixth of the nation’s GDP . technology, anemic site content, lack of search optimiza- In 2009, the number of Americans seeking pharmaceuti- tion, and scant social media programs. In sum, there are cal information online reached 102 million1. Pharmaceu- millions of unregulated conversations taking place online tical companies continue to search for a voice that can regarding prescription drugs, but the voice of the phar- rise above the digital cacophony. Although the emerg- maceutical companies is largely absent. ing direct-to-consumer relationship on the web allows for robust patient discovery and education, the online Our thesis is that digital aptitude will be a defining compe- efforts have experienced fits and starts because the tence that separates winners from losers in a medium too ambiguous regulatory environment leaves pharmaceuti- powerful to ignore. Key to managing and developing apti- cal brands paralyzed. tude is an actionable metric. This study quantifies the U.S. digital competence of 51 pharmaceutical brands across The Innovator's Dilemma eight disease states and ranks them by their Digital IQ™. The Food and Drug Administration’s Division of Drug Our aim is to provide a robust tool to diagnose a brand's Marketing, Advertising, and Communications (DDMAC) digital strengths and weaknesses relative to its peers to has expanded under the Obama Administration. As achieve greater return on incremental investment. digital accelerates in new directions—mobile, geo- targeting, and healthcare information technology—the As in each L2 study, we brought in experts from aca- uncertainty surrounding regulation threatens to ham- demia and industry to provide color and commentary string pharmaceutical companies and shift power to on our findings. We were fortunate in this study to have third-party portals and content sites. Brand managers insight from Peter Golder, professor of marketing at Dart- are faced with a decision: take an aggressive approach mouth's Tuck School of Business on innovation, Scott and face possible regulatory wrath, or wait and lose Hagedorn, U.S. CEO of PHD Media, on media trends in ground to more innovative, risk-tolerant peers who are the industry, and Kristen Goelz of Flashlight interactive garnering skills, fans, and followers. When it comes to on web site messaging. marketing and regulation, it may be heads the digital media win and tails digital wins again. Despite the uncertain regulatory environment, some Scott Galloway companies are innovating online and building a founda- Clinical Associate Professor, NYU Stern tion for digital growth in anticipation of an unshackling. Founder, L2 (LuxuryLab) Robust branded sites, visibility in search, collabora- 1 !"#$"%%"#&'()("*+$ © L2 2010 INTRODUCTION 3
  4. 4. METHODOLOGY PLATFORM - 40% Site Effectiveness: Reinforcement of core brand • BRAND TRANSLATION associations and values through aesthetics and • Aesthetics and Messaging interactivity. Also includes technology incorporation, • Interactivity navigation, consumer funnels, relevant content, and • SITE ELEMENTS customer service. • Technology Integration • User Interface • Customer Service • Content: Disease Education, Conversion, Community Content OFF-PLATFORM MESSAGING - 25% Digital Marketing Efforts: Online advertising on and • PORTAL AND OTHER ONLINE ADVERTISING off consumer healthcare portals, mobile compatibility, • MOBILE email marketing, and other messaging. • EMAIL MARKETING SEARCH ENGINE OPTIMIZATION (SEO) - 20% Visibility: Organic and paid search visibility on • TRAFFIC popular search engines. • KEYWORDS • WEB AUTHORITY • SEARCH ARCHITECTURE SOCIAL MEDIA - 15% Social Media Presence: Following, content, and influ- • FACEBOOK ence on major social media platforms, and buzz on • TWITTER blogs and other web 2.0 forums. • YOUTUBE • USER-GENERATED CONTENT © L2 2010 METHODOLOGY 4
  5. 5. RESULTS The Digital IQ Index ranks brands according to their digital competence, with each falling into one of five categories: 140+ GENIUS Digital competence is a point of competitive differentiation for these brands. Their sites are search optimized, aesthetically engaging, functional, interactive, and offer clear calls to action. These brands are highly visible advertisers on consumer health portals and elsewhere online and experiment on the edge of the network with social media content. 110-139 GIFTED Sites are crawlable, brand enhancing, and include calls to action. Brands typically advertise on health portals, are highly visible on top search engines, and offer email marketing. 90-109 AVERAGE Brand sites are functional yet predictable. Innovation efforts are uninspired and lack ambition. Boilerplate marketing online and in email. 70-89 CHALLENGED These brands offer little content online. Bare-bones sites provide only basic drug information. Engagement is limited to web property, and digital campaigns are an afterthought. <70 FEEBLE Brands have largely ignored the digital phenomenon. Sites lack basic functionality and navigability, and brands disregard digital marketing initiatives. © L2 2010 RESULTS: the rankings 5
  6. 6. PHARMACEUTICAL BRANDS RANKED BY DIGITAL IQ SCORE Rank Brand Parent Disease State IQ Label Comments 1 VIAGRA Pfizer Urology 149 Genius Site tech and interactivity are industry standouts; brand leverages iconic name in search and online buzz 2 NEXIUM AstraZeneca Gastrointestinal 143 Genius This social media maven offers best-in-class lifestyle support tools, including online access to dieticians 3 CHANTIX Pfizer Neurology 140 Genius Connects digitally with consumers both on and off site with (Smoking Cessation) email, short messaging service, and a dominant presence on health portals 4 ORTHO TRI- Ortho-McNeil Women’s Health 137 Gifted Top in the competitive Women’s Health category; brand CYCLEN LO Janssen (Birth Control) boasts interactive tools and desktop reminders 5 CRESTOR AstraZeneca Cardiology 135 Gifted Strong onsite tech integration and activity on portals and blogs elevates top brand in disappointing cardio category 6 GARDASIL Merck Women’s Health 131 Gifted Rallies community online with pioneering Facebook (Infectious Disease) page and strength in search 6 YAZ Bayer Women’s Health 131 Gifted YAZXpress site offers interactive community content; (Birth Control) brand also connects with users in mobile and email 8 SYMBICORT AstraZeneca Asthma & Allergy 130 Gifted Interactive video journey customizes site for best-in- category user experience 8 NUVARING Merck Women’s Health 130 Gifted Brand boasts innovative web advertising and strength (Birth Control) in search 10 LUNESTA Sepracor Neurology 126 Gifted A YouTube channel coupled with strong off-platform (Insomnia) efforts keeps brand awake online. 11 SEROQUEL AstraZeneca Psychiatry 124 Gifted Site provides strong educational content and community information 12 LIPITOR Pfizer Cardiology 121 Gifted Site branding and online advertising form the pulse of this brand’s digital efforts 12 LEVITRA Novartis Urology 121 Gifted Humorous multichannel ,#&-(. video campaign generates online buzz 14 SEASONIQUE Teva Women’s Health 120 Gifted Brand understands how to integrate digital content and (through Duramed) (Birth Control) user behavior 15 AMBIEN CR Sanofi-Aventis Neurology 118 Gifted Site highlight is a downloadable tool that tracks and (Insomnia) analyzes sleep patterns 16 CYMBALTA Eli Lilly Psychiatry 113 Gifted Strong visibility on WebMD portal 17 ORENCIA Bristol-Myers Squibb Rheumatology 111 Gifted Strong presence on health portals 17 ABILIFY Bristol-Myers Squibb Psychiatry 111 Gifted Impressive site funneling and substantial traffic raise brand’s profile 19 KAPIDEX Takeda Gastrointestinal 110 Gifted Strong branding and video content differentiate site 20 SYNVISC Genzyme Rheumatology 107 Average Search architecture and informative videos are brand strengths © L2 2010 RESULTS: the rankings 6
  7. 7. Rank Brand Parent Disease State IQ Label Comments 21 ADVAIR GlaxoSmithKline Asthma & Allergy 106 Average Asthma.com unbranded site incorporates education and technology 22 SINGULAIR Merck Asthma & Allergy 105 Average Site aesthetics, disease education and flash features are strengths; some presence on health portals 23 ZETIA Merck Cardiology 104 Average Presence on health portals and brand translation on site give IQ a boost 24 PLAN B Teva Women’s Health 102 Average Site offers eligibility calculator and find-a-pharmacist (through Duramed) (Birth Control) feature 24 SPIRIVA Pfizer and Asthma & Allergy 102 Average Multichannel disease awareness campaign tests the Boehringer Ingelheim waters on Twitter 26 VYTORIN Merck Cardiology 101 Average Strong site disease education and presence on top portals, but crippled by poor visibility 27 CIALIS Eli Lilly Urology 100 Average Although SEO is strong, customer relationship management program that directs users to PO Box shows digital failings 27 CELEBREX Pfizer Rheumatology 100 Average Status quo online advertising keeps this brand average 29 ACIPHEX Elsai and Ortho- Gastrointestinal 98 Average Playful animation on site and strong keyword visibility McNeil Janssen 30 RITUXAN Biogen and Rheumatology 94 Average Site incorporates elegant flash features, but efforts in Genentech search and online advertising get lost in the crowd 31 HUMIRA Abbott Rheumatology 93 Average MyHumira site for current brand users offers support for patients 32 ANDROGEL Solvay Urology 92 Average The Low Testosterone Lowdown sponsored content on WebMD has minimal visibility 32 ENBREL Amgen and Wyeth Rheumatology 92 Average Customer service standout offers find-a-doctor feature and toll-free phone access to nurses 32 MIRENA Bayer Women’s Health 92 Average Trails strong Birth Control peers; interactive site (Birth Control) elements are absent 32 PLAVIX Bristol-Myers Squibb Cardiology 92 Average Portal ads keep this brand in the middle of the pack and Sanofi-Aventis 36 LOVAZA GlaxoSmithKline Cardiology 87 Challenged A strong site is brand’s only notable effort 37 AVODART GlaxoSmithKline Urology 86 Challenged Leverages GSK customer service features 37 NASONEX Schering-Plough Asthma & Allergy 86 Challenged Although “Don’t Blow It” game on Facebook disappoints, it scores points for social media effort 39 VERAMYST GlaxoSmithKline Asthma & Allergy 85 Challenged Allergyrewards email marketing program offers savings and tips 40 LYRICA Pfizer Rheumatology 84 Challenged Strong presence on WebMD, but site is poorly organized to reach users interested in newly approved Rheumatology indication © L2 2010 RESULTS: the rankings 7
  8. 8. Rank Brand Parent Disease State IQ Label Description 41 OMNARIS Sepracor Asthma & Allergy 82 Challenged Robust SEO 42 FLOMAX Astellas Pharma and Urology 71 Challenged Bare bones, text-heavy site with dated technology and Boehringer Ingelheim no call-to-action 42 PRISTIQ Pfizer Psychiatry 71 Challenged A New Day patient support program has email marketing component; site is repurposed TV branding 44 LESCOL XL Novartis Cardiology 65 Feeble Obsolete site features newspaper-style cartoons 45 TRILIPIX Abbott Cardiology 63 Feeble Anemic site content, but ad presence includes spots on Hulu 46 CADUET Pfizer Cardiology 62 Feeble PDF downloads abound on this brand’s dated site 47 NIASPAN Abbott Cardiology 61 Feeble Brand fails to be brought to life on site and limited web advertising 48 PATANASE Alcon Asthma & Allergy 60 Feeble Worst in search; find-a-doctor feature is strongest element of site 49 TOPROL-XL AstraZeneca Cardiology 59 Feeble Mention on AstraZeneca’a YouTube channel is this brand’s lone social media effort 50 PULMICORT AstraZeneca Asthma & Allergy 52 Feeble Brand does little digitally beyond light display advertising 51 ASTEPRO Meda Asthma & Allergy 42 Feeble Miserable web site and absence from other digital media © L2 2010 RESULTS: the rankings 8
  9. 9. DISCOVERIES The Tipping Point PETER Consumer appetite for digital health content is voracious and grow- GOLDER ing: the number of Americans accessing health information online is Tuck School of up 159% from 20041. Health portals including WebMD, Everyday Health, Business at Dartmouth and About.com Health attract millions of unique visitors. In addition, traffic to branded pharmaceutical sites increased 82% last year, suggesting brands “Companies must have a legitimate role in the online conversation. Disparity in the quality of the move beyond a DTC mentality and digital content produced by pharmaceutical brands leads discriminating con- adopt a DFC mentality (i.e., direct sumers to vote with their browsers. While brands categorized as Genius or from company). Instead of companies Gifted experienced average traffic growth of 175% from March 2009 to March pushing information to customers, 2010, 40% of the brands in the study realized negative traffic growth. customers will pull information from the company. An even better approach is DFC + P2P, direct from company Anti-Social Pharma plus peer-to-peer redistribution.” Despite hearings in November 2009, the FDA has remained silent about social media marketing regulation, restraining movement to platforms such as YouTube, Facebook, and Twitter. Although 80% of parent companies are starting to dip their toes into social media, only 19% of SCOTT pharmaceutical brands maintain a presence on at least one site. Parent com- HAGEDORN PHD Media pany efforts lack sophistication, offering little more than glorified PR content and one-sided conversations. As a result, they have attracted few followers. Bright spots include Johnson & Johnson’s YouTube channel, viewed more “We often get than 1.6 million times, and Merck’s Gardasil human papillomavirus (HPV) asked if social activation should play awareness Facebook page, with more than 100,000 fans. Patient demand for a role in brand efforts. Our advice online networking opportunities has been validated by the emergence and is that it isn’t a matter of ‘if’, it’s a growth of condition-specific patient networking sites such as PatientsLikeMe, matter of ‘when’. It comes down to which doubled subscribers from December 2008 to December 2009, Juvena- mapping the brand introduction time- tion, and Bayer’s MS-Gateway. line and knowing when to use social and when not to in order to increase impact while also mitigating risk.” 1 !"#$"%%"#&'()("*+$ © L2 2010 DISCOVERIES 9
  10. 10. Learn by Doing Deserted Islands (Visibility) Brands with a higher Digital IQ demonstrate more After the FDA submitted warning letters regarding risk tolerance when approaching digital marketing. paid search to more than 40 pharmaceutical brands Based on an assessment of regulatory compliance on in April 2009, most suspended search engine mar- branded sites, brands ranked Average and below err keting. Although paid search has rebounded, and 70% on the side of caution regarding FDA Web guidelines of brands currently purchase search terms, many brand- while brands ranked Genius and Gifted employ broader ed sites are not optimized for organic search. As a result, interpretations. Genius and Gifted brands have greater site visibility on major search engines for upper-funnel social media penetration: 37% are present on at least disease-relevant terms lags that of such popular health one platform, compared with 9% for Average and below portals as WebMD, Yahoo! Health, and HealthCentral. brands. High IQ brands also returned to search marketing faster than their laggard peers: 89% of Gifted and above brands participate in paid search versus 59% of Average and below brands. SOCIAL MEDIA PENETRATION Brands Brands vs. Parent Companies Parent Companies YouTube Facebook Twitter 0% 10% 20% 30% 40% 50% 60% 70% HEALTH PORTAL AND BRANDED-SITE TRAFFIC Health Portals Monthly Unique Visitors to Health Portals and Branded Sites Branded Sites 20,000 18,000 Monthly Unique Visitors (thousands) 16,000 14,000 March 2010 12,000 10,000 8,000 6,000 4,000 2,000 D LTH H ES H E E NG AL M CIA RA FY A BM EA ALT AD ALT AL AG LIN RO TR XIU EN VIT ILI GR WE YH ! HE GR Y HE RE LTH ST EN NE OR LE AB VIA DA OO H LIT HE A E HC Y H ALT A LIV ALT ER YA HE QU HE EV © L2 2010 DISCOVERIES 10
  11. 11. Innovation Silos SCOTT PETER The average dispersion in brand- HAGEDORN GOLDER level Digital IQ among pharma- PHD Media Tuck School of Business at ceutical companies with more Dartmouth than one product in the study is 40 points. This large spread high- “Pharma is one “The results of lights a silo mentality—digital com- of the few remaining categories with the Digital IQ studies present petence within large companies sits this level of disparity around ide- companies with the triple threat of isolated, with minimal shared learn- ation. It is hard for vertical teams innovation. First, with incremental ing among brands. Although some structured around specific brands to innovation, companies can upgrade companies leverage small econo- share best practices with other brand each of their own web sites to match mies of scale (e.g., AstraZeneca teams. It is up to the agencies that internal best practices. Second, sites are sometimes templated, and touch multiple brands to step up and through radical innovation, com- GlaxoSmithKline sites offer universal help replicate innovative best practices panies can adopt and improve upon customer service tools), digital efforts across the client brand verticals.” industrywide best practices. Third, appear largely uncoordinated. The for truly breakthrough innovations, lone exception is in social media, companies can look to unrelated in- which is primarily deployed at the dustries for inspiration in developing parent company level with little completely new approaches to digital brand-level integration. communication.” DIGITAL IQ DISPERSION Range of Brand Digital IQ Scores and Average Digital Score by Parent Company Viagra GENIUS Nexium Chantix 140 Crestor Gardasil Yaz Symbicor t NuvaRing Lunesta GIFTED Lipitor Seroquel Ambien CR Cymbalta 114 112 110 Singulair Advair 107 106 104 Zetia 104 105 AVERAGE Vytorin Celebrex Cialis Humira 90 91 Lovaza Plavix * Mirena Avodar t Lyrica Veramyst CHALLENGED Omnaris 72 70 Pristiq Trilipix Toprol-XL FEEBLE Caduet Niaspan Pulmicor t IZE R EC A RC K INE TT CO R LY NT IS YE R PF EN ME KL BO RA LIL VE BA Z TH AB P ELI A T RA MI SE FI- AS OS NO AX SA GL * in par tnership with Bristol-Myers Squibb © L2 2010 DISCOVERIES 11
  12. 12. Younger “Age of Onset” SCOTT Brands Lead HAGEDORN As one would expect, brands that market to younger consumers have PHD Media higher Digital IQs. In an attempt to reach a generation raised on Google and Facebook, brand marketers in categories such as Birth Control, HPV and “We’ve seen the Psychiatry have worked to understand how to design informative and interac- internet emerge as the medium all tive web sites, incorporate community content and technology, attract users segments of the population say they to branded sites, and test social media. Yet, this is a case of not seeing the could not live without. There is clear- forest from the trees as the vast majority of prescription drugs are consumed ly an opportunity for pharma brands by older adults who are increasingly online— in the five-year period from 2004 marketing to a senior population to to 2009 Internet usage increased by 55% to 17.5 million users2 for seniors. increase their web presence.” Furthermore, the fastest growing cohort on Facebook is boomer-age women. 2 /0(1)(# DIGITAL IQ AND AGE OF ONSET Average Digital IQ Score and Age of Disease Onset by Disease State Category HPV Human Papillomavirus GENIUS BCL Birth Control 140 PSY Psychiatry HPV ASM Asthma & Allergy GIFTED RHM Rheumatology BCL GST URL Urology 110 GST Gastrointestinal PSY URL AVERAGE CDV Cardiovascular RHM 90 ASM CDV CHALLENGED 70 FEEBLE 0 0 0 0 E2 E4 E6 E8 AG AG AG AG © L2 2010 DISCOVERIES 12
  13. 13. Patent Cycle’s Impact AVERAGE TIME TO PATENT EXPIRY Brands categorized as Genius 12 and Gifted have an average of 1.7 more years before patent 10 expiry than brands categorized Average and below, suggesting 8 digital marketing is correlated YEARS 6 with the patent cycle. 4 Pharma brands typically invest heavily in online disease education 2 and awareness efforts before FDA 0 approval. Drugs also invest early Genius Gifted Average Challenged Feeble in the patent cycle, one year after FDA approval, as they are building DIGITAL IQ awareness for the brand. Brands new to the market have higher Digi- tal IQs, suggesting a greater digital investment and focus. © L2 2010 DISCOVERIES 13
  14. 14. FINDINGS Platform Branded sites inform consumers and encourage patient compliance at different PETER stages of the disease cycle. Sites for drugs with multiple indications face the ad- GOLDER ditional challenge of tailoring content to different conditions. Because of the variety Tuck School of Business at of patient audiences, clearly directing users and prospects to appropriate informa- Dartmouth tion is the hallmark of a strong site. Among branded sites, Symbicort and Abilify's “Quantitative are among the best at funneling visitors by condition and stage of diagnosis. measures are most useful for bench- Although all sites offer basic drug information, the best include disease educa- marking and upgrading sites on tion, like Crestor’s scientific videos, and community content, like Nexium’s site established performance criteria. with patient success-story videos and lifestyle tools. The biggest divergence Qualitative insights are most use- among pharmaceutical sites is in the use of technology to amplify content. ful for generating and introducing Although strong sites offer videos and interactive features with anatomic im- entirely new performance criteria.” ages, doctor interviews, and patient testimonials, 55% fail to incorporate flash elements, popular for adding animation and interactivity to web content and a barometer of web sophistication, beyond the home page. QUICK STATS Every site aims to influence visitors to act through one or a combination of Branded Sites: symptom assessment surveys, doctor discussion guides, coupons for a new or • 85% offer a Doctor Discussion continuing prescription, and tools to encourage compliance with a prescription. guide Many of these tools are PDF documents, which in many cases is not the best • 62% offer little or no community way to leverage the speed and convenience of the digital medium. Exceptions content include Spiriva and Synvisc, which offer to send assessment results via email. • 57% offer savings for first-time CALLS TO ACTION ON BRANDED SITES prescriptions • 47% have an unbranded site, 60% typically devoted to disease 50% education 40% • 45% offer a compliance tool, Frequency such as email, text reminders, or 30% a downloadable PDF calendar 20% • 42% offer savings for current users 10% • 26% have no access to customer service 0% Visit Doctor New Rx Rx Savings Compliance Call to Action Message © L2 2010 FINDINGS 14
  15. 15. Forty-five percent of sites offer savings to current users, effectively diminishing the profitability of those sales, although there may be gains in market share when the drug is in a head-to-head battle with a major competitor. The creation of unbranded education- oriented sites is a popular technique to market drugs before approval by the FDA. Once a drug is FDA- approved, the use of unbranded sites declines. Still, 47% of brands in the study maintain a microsite to comple- ment their branded site’s disease education content. Comparatively, the unbranded site www.symbicort.com typically generates significantly fewer unique visitors than a branded site, even when offering better disease education information and technology integration. For example, Advair.com has more than 16 times as many visitors as its arguably superior un- branded counterpart, Asthma.com. Low traffic combined with the danger www.viagra.com of competitive brands benefiting from www.viagra.com other’s unbranded efforts, calls into question their longer-term value. www.abilify.com © L2 2010 FINDINGS 15
  16. 16. Search Engine Optimization Search engines are the primary tool pharmaceutical paid search advertising is primarily limited to two types of ads: consumers use to seek health infor- brand-reminder and help-seeking. Brand-reminder ads incorporate a brand’s mation online, and search remains a name and are restricted from explaining drug treatment uses and benefits; digital priority for most pharmaceuti- help-seeking ads tout the uses and benefits of a drug, but do not mention cal brands1. Brands strive for search its name. Brands in the study strongly favor brand-reminder ads, particularly engine visibility, not only for consum- for patients further along the disease cycle using more specific, lower-funnel ers seeking specific drug information, terms, and also because consumers may perceive help-seeking ads as con- but also for those learning about a fusing and potentially misleading. In November 2009, Google proposed two condition. Generating awareness new types of ads: product-claim ads, which would link to a product site and among upper-funnel consumers explain drug benefits, and black-box ads, both of which link to full text black- helps brands acquire diagnosed box warnings. Yaz is the lone brand in the study to use black-box ads. but untreated patients. Research has found that consumers who visit a brand’s site are three times more Brand-Reminder Ad { likely to request a drug by name2, and 44% of physicians prescribe Help-Seeking Ad { a requested drug3. Weak search engine optimization by pharmaceuti- Black-Box Ad { cal brands allows health portals to dominate in organic search visibility for every disease state. RELATIVE TRAFFIC OF TOP BRANDED SITES In 2008, more than 30% of pharma- ceutical search engine traffic was directed from paid ads4. Because of March 2010 space limitations and FDA regulation, 1 02*3))0#4 2 !"#$"%%"#&'()("*+$ 3 5"0)(* UM A A Y RA IX R A N X NG IR EL X 4 LT 60%70)( CI TR NE TI IF TO RI AV VA BR AG RI AN IL XI EN BA TO VI SO PI PL AD VA AB EN NE VI LE CH OR LI M VY NA NU CY QUICK STATS BRANDS BY DISEASE STATE ON PAID SEARCH SEO: • 70% of brands engage in paid 100% search on Google or Bing 80% March 2010 • 62% of brands engage in branded 60% paid search on Google or Bing 40% • Google Page Rank average for branded pharmaceutical 20% sites is 4.75 0% AL Y GY Y GY Y TH Y • Pharmaceutical sites have an OG OG RG TR AL IN LO LO IA OL OL LE ST HE IO O H AL UR AT UR TE YC RD average of 91 inbound links ’S M NE IN & PS CA EN EU RO A OM M RH ST TH W GA AS © L2 2010 FINDINGS 16
  17. 17. Off-Platform Messaging In 2009 pharmaceutical industry online advertising spend was up 31% SCOTT year-on-year, to $117 million, while consumer ad spending overall remained HAGEDORN virtually flat5. Digital spending represents about 4% of total DTC budgets. As PHD Media online advertising becomes a larger part of pharmaceutical marketing bud- gets, brands are looking for innovative ways to reach consumers, however, most efforts remain focused on boilerplate ad offerings on highly trafficked “In addition to consumer health portals, like WebMD or Quality Health. shifting ad dollars, marketers are re-examining their overall market- Fifty-eight percent of brands in the study advertise on WebMD, Everyday ing investments. We see a shifting of Health, or About.com Health and 60% of these brands advertise on more than dollars to platforms that offer deeper one of the portals. Branded presence on portal sites ranges from traditional engagement with consumers. We be- display advertising to sponsored editorial content and diagnostic tools. The lieve this is driven in part by the richer most effective advertising is highly visible on primary pages about a specific experiences that digital media offers.” condition on the most popular sites. This coveted space sells out quickly, often relegating competing brands to less desirable pages. Notable advertis- ing initiatives beyond the portals are Cardiology drug Trilipix’s ads on video platform Hulu, HPV drug Gardasil on the CW TV Network’s site, and allergy QUICK STATS brands' display advertising on AccuWeather and Weather.com. Portal Collaboration: • 58% of brands advertised on 5 WebMD, Everyday Health or !(.0+"18&!"*9(%0#4&:&!(.0" About.com Health in February 2010 • 42% of brands had a noticeable presence on WebMD • 47% of brands had a noticeable presence on Everyday Health • 13% of brands had a noticeable presence on About.com Health • All Psychiatry and Rheumatology brands were visible on top health portals www.webmd.com www.qualityhealth.com © L2 2010 FINDINGS 17
  18. 18. Email QUICK STATS Email is a low-cost way to engage patients and ensure they stay current on Email: their drug regimen. More than 80% of brands offered opt-in email from the • 72% of email programs branded site, although less than 60% of these brands corresponded in a six- contain a clear call to action week period. Often a brand email effort is touted as a support program and is to prompt doctor discussion or complemented by an offline effort, including direct mail. prescription fills. The number one reason consumers opt in to email programs is to receive • 70% of branded programs coupons6, and 30% of email programs specifically offered savings. The personalize emails. purpose and content of email campaigns ranged from calls to action (75%) • All Cardiology brands have email to branded-drug-specific information: (75%), disease education (50%) and marketing programs. community content (30%). • All Neurology brands have email marketing programs with clear In the best cases, emails were customized and personalized like Pristiq’s A calls to action. New Day support messages. Some brands, including Ortho Tri-Cyclen Lo, Yaz, Humira, and Lovaza, offer patient reminder emails to support compli- ance. 6 ;<)013# Lescol XL email Humira email Pristiq email © L2 2010 FINDINGS 18
  19. 19. Mobile Pharmaceutical branded mobile NOTABLE DISEASE MANAGEMENT APPS activity is scant with the exception of SMS reminder alerts sent by 15% MOBILE Disease Customer APPLICATION State Rating Comments of brands. Third-party companies Enhanced $5.99 version allows are also offering reminder and users to log, track, and analyze compliance apps, including the Chronic Pain Tracker Rheumatology 3/5 pain and download data into PDF for healthcare provider “Pill Phone” and “PillBoxer.” discussion None of the brands in the study $4.99 app allows users to have applications available in iTunes, iHeart-Pulse Reader Cardiovascular 5/5 monitor and track their pulse over time however many iPhone apps exist for both general and specific disease $0.99 app offers customizable PureSleep AmbiScience Insomnia 3.5/5 audio programs to promote management purposes. Notable in sleep the general category is WebMD’s $0.99 app provides tools to app, “WebMD Mobile,” which pro- Live Happy Psychiatry 3/5 track mood and exercises to vides information about symptoms, promote happiness drugs, and first aid. Apps are com- Free app tracks number of Smoking mon for disease state management Quitter 3/5 smoke-free days and cost Cessation savings for conditions such as smoking ces- sation, insomnia, allergies, rheuma- $0.99 app reminds users to Pink Reminder Women’s Health 3/5 tology, and cardiovascular disease. take medication QUICK STATS Mobile: • Merck and Sanofi-Aventis are the only pharmaceutical parent com- panies with iPhone apps. No brands have iPhone apps i-Heart Pulse Reader App ThePill.com App Livehappy.com App © L2 2010 FINDINGS 19
  20. 20. SELECTED HEALTH PORTALS Unique Monthly Advertising Visitors Brands PORTAL Description (millions) Key Advertising Tools include Educational content, expert commentary, medical reviews, 17.4 • Banner ads Chantix community services, and health management tools. Cymbalta • Sponsored editorial Content includes information about conditions, a drug Enbrel • Sponsored “health checks” database, healthy living advice, and news. NuvaRing • Technology superior to other Message boards and newsletters serve as a precursor to Viagra sites its upcoming Health Exchange community site. Educational health content for more than 100 health 6.4 • Banner ads with flash and video Abilify categories ranges from information about common health • Sponsored editorial Chantix conditions to interactive symptom checkers to nutritional • Custom email campaigns Lipitor and exercise tips. Orencia Community section incorporates 2.0 tools, including blogs, Plavix personal profiles, and photos, to promote interaction among site visitors. Seroquel Viagra Vytorin Content organized by condition centers with information No • Banner ads Cymbalta on the condition, symptoms, treatment options, and data • Video ads Kapidex support resources. Seasonique The site also features healthcare news, videos, interactive Zetia symptom checkers, and community content in the form of health newsletters and such social media tools as blogs, chat rooms, and forums. Offers news, videos, tips, drug guides, and interactive 6.3 • Banner ads Cialis health tools across a number of disease-specific • Video ads Lunesta categories. NuvaRing Social media tools are integrated to promote community, Pristiq and offer condition-specific groups, message boards, and expert advice blogs. Editorial content and videos often courtesy of third-party health content providers. Provides educational health content across more than 45 2.9 • Banner ads with flash Cymbalta disease categories, with information on causes, symp- • Video ads Kapidex toms, and treatments. • Sponsorship of health centers Vytorin The portal offers videos, news, expert advice, drug guides, • Sponsored editorial and interactive tools, including symptom checkers and quizzes. 2.0 tools include blogs and support groups. Features informative health and fitness content, interac- 2.8 • Banner ads with flash Chantix tive tools, resources, expert advice, videos, specialized • Video features Enbrel reports, and community content across more than 50 Lipitor disease centers. Lyrica Disease centers include content in line with that of other NuvaRing portals, such as news, information on symptoms, and treat- ment options. Partners with third-party content providers. Pristiq Viagra © L2 2010 FINDINGS 20
  21. 21. Social Networking company channels (Ambien and QUICK STATS Only 19% of pharmaceutical brands Toprol-XL). Videos range from offer- Social Media: are on at least one major social ing specific information about a drug, media platform: Facebook, You- its benefits and side effects, to playful • 48% of parent companies have a presence on Facebook Tube, or Twitter. Standouts Gardasil content about a disease state, as in • 28% of branded sites have and Nexium maintain pages with the case of Levitra’s InBed videos Facebook as a top-5 referral site rich media content and have at- featuring a cartoon couple dealing • Facebook is a top-5 referral site tracted thousands of fans despite with erectile dysfunction. for all Women’s Health brands prohibiting wall postings to avoid On the flip side, parent company • 60% of parent companies have adverse-event reporting. On Twitter, social media adoption tops 80%. a presence on Twitter, with an the Purple Pill listens to custom- average growth in followers of The disparity in participation be- ers and direct messages an 800 31% from February to March tween parent company and brands number in response to tweets about 2010 highlights the effect of the current the drug. The only other brand ac- • 36% of parent companies have regulatory limbo concerning social tive on Twitter is Spiriva, with five a presence on YouTube media. However, most company Twitter handles, four from celebrity • According to Manhattan efforts are little more than PR or spokespeople, conversing about the Research, almost 50% of con- human resources tools. Johnson & sumers seeking health informa- =*0>(?2@A= campaign. Johnson is a notable exception; the tion watched health videos online Eighteen percent of brands have a company maintains an engaging in 2009 presence on YouTube ranging from presence on all three major plat- dedicated YouTube channels (Yaz forms. Its YouTube channel features and Lunesta) to videos on parent monials to educational pieces. The videos ranging from patient testi- corporate Twitter account retweets and converses with users, while the Gardasil Facebook company’s Facebook page features wall postings of varied and interest- ing content. Some companies are experimenting with sponsored communities tailored to patients of specific disease states. Bayer’s MS-Gateway forum for multiple sclerosis boasts more than 12,000 members and 200,000 posts. Other interesting efforts include Novo Nordisk’s Voices of Diabetes community and Novartis’s CML Earth, an elegantly designed platform for leukemia patients. As social media platforms experi- ence double- and triple-digit user growth, the pharmaceutical industry is missing a key opportunity to con- nect with consumers. According to Yaz YouTube Manhattan Research, more than 80 million Americans use social media for health-related issues. Brands often © L2 2010 FINDINGS 21
  22. 22. cite regulations about adverse-event reporting as the reason for their hesi- tation to embrace social media. Yet, a November 2009 Nielsen study found that only one in 500 online postings, or 0.2%, incorporate the criteria re- quired for adverse-event reporting. Third-party patient communities are proliferating, like PatientsLikeMe, with over 50,000 members, but they seldom offer brand advertising. Con- sumer health portals are also moving into the social networking space. In March 2010, WebMD announced the launch of Health Exchange, a new Johnson & Johnson health social networking platform, to YouTube channel and Facebook page grab share from already entrenched third-party social media communi- ties. Well-known destination sites are also strong on Twitter, Facebook, and YouTube: LIVESTRONG’s CEO tweets, retweets, and direct mes- sages with some 1 million followers, and Mayo Clinic’s YouTube channel has generated more than 1.7 million views. Patientslikeme.com © L2 2010 FINDINGS 22
  23. 23. TOP PARENT COMPANY TWITTER EFFORTS Total Follower Tweets Tweet Re- Company Twitter Followers Growth* ** Growth* tweets? Comments Pfizer pfizer_news 5,146 14.1% 99 11.2% N Mostly PR, some pharmaceutical news and links to blogs and social media news Novartis Novartis 4,652 ND 150 4.2% N Information about the company, products, links to other social media and technology. Company also appears to own protected handle Novartis Trials GlaxoSmithKline GSKUS 3,426 ND 254 13.9% Y Links to GSK blog posts, news, other links; glaxo- smithkline also appears to be occupied by com- pany, but no tweets Johnson & JNJComm 3,201 ND 744 7.2% Y Highly personalized content; retweets and Johnson converses; provides color on industry and more general news Roche Roche.com 3,193 ND 661 7.1% Y Conversations and news about company Genentech genentechnews 2,754 6.6% 81 11.0% N PR news, information, links; brand also occupies genentech handle but no tweets Amgen Amgen 2,124 8.4% 101 4.1% N Corporate PR and financial news Sanofi-Aventis Durbaniak 1,677 ND 1,484 ND Y Vice president for innovation tweets about pharmaceutical social media AstraZeneca AstraZeneca 1,287 17.4% 107 16.% Y PR information, including comments from CEO Sanofi-Aventis sanofiaventisTV 924 6.3% 132 6.5% N French-language handle Bristol-Myers bmsnews 785 31.5% 4 ND N Mostly business news. First tweet March 1, 2010 Squibb Merck merckcareers1 669 8.6% 1,056 10.0% N Posts job openings. Company also appears to occupy Merck handle but account is protected Bayer BayerHealthCare 556 143.9% 48 ND N German and English bilingual account tweets news AstraZeneca AstraZenecaJobs 481 12.4% 888 13.6% N Tweets about available jobs Genzyme genzymecorp 397 26.0% 0 0.0% N No content; unsure if official Pfizer RayKerins 362 ND 31 3.3% Y Retweets Pfizer content and other pharmaceutical posts. Updates about FDA approvals and other industry news Lilly Eli Lilly 205 9.6% 0 0.0% N No content; unsure if official Novartis NVSOncoCareers 128 ND 58 141.7% N Links to job postings Amgen AmgenFoundation 61 103.3% 2 NA N First tweet late February about Amgen’s foundation and philanthropic efforts Galaderma galaderma 38 18.8% 0 0.0% N No content; unsure if official * February-March 2010 ** As of March 2010 © L2 2010 FINDINGS 23

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