Social media for a pharmaceutical company
Regulatory compliance is a constant concern for a pharmaceutical company that is active on social media. Industry codes govern how a company monitors what is said about it, guidelines have been written where regulators have issued none, and monitoring and measuring social media have not yet supplanted traditional methods. A company uses social media to connect with patients, to market through influencers, to recruit for trials and study rare diseases, and to follow what physicians discuss.
Regulation and the industry codes
Regulatory compliance for social media activities, and dealing with each of the relevant regional authorities, is a constant concern and challenge for pharmaceutical companies, but codes of practice and guidance have been painfully slow to be established. The code of practice of the Association of the British Pharmaceutical Industry permitted a company to monitor social media, to "listen to" or "see" what the public was discussing about the company, the diseases and conditions it treats and its treatment options. It required the company always to declare its presence and to monitor all content on an ongoing basis, especially for adverse events and product complaints. The guidance of the US Food and Drug Administration (FDA) addressed the correction of misinformation about prescription drugs and medical devices posted on social media by independent third parties, but it did not survey influencers or their posts, because tools to search for and report non-compliant content were limited. Preprint servers such as bioRxiv further complicate regulation, because social media comments on the non-peer-reviewed studies posted there may flag issues and concerns with the studies' disclosures of conflicts of interest and their funding statements.
Social media guidelines for companies
Quintiles, a global pharmaceutical services company, published the social media guidelines it developed for its employees and contractors, and first released them via Twitter. One writer judged them a great starting place for companies considering guidelines of their own, especially those that, like Quintiles, already have an extensive social media programme.
In the absence of specific FDA guidance for pharmaceutical companies on social media, the curation service Webicina drafted open-access social media guidelines for pharmaceutical companies and released the first version in December 2011. The collaborative document identified several key principles of social media, such as protecting patients, informing healthcare professionals, being transparent, reporting adverse events, and following the applicable codes and regulations in social media. The draft was not meant to be the final word but to start the conversation and encourage collaboration among consumers, professionals and pharmaceutical companies, and so to serve as an impetus for the FDA to develop guidance of its own.
Monitoring and measuring social media
Pharmaceutical companies have shown limited interest in tools that track social media, a reluctance driven by concerns about the sharing of fake or fraudulent research and the risk of genuine research findings being misinterpreted. They continue to take traditional approaches to success metrics, primarily citations and publications. One factor underlying this reluctance, especially in communicating with physicians, is that research conclusions are often simplified and overly extrapolated in the media. Although the potential value of social media monitoring and measurement is increasing, with some interesting opportunities for further exploration, it is not currently in a position to supplant more traditional methods, for example in pharmacovigilance or product marketing. Despite these limitations, five areas offer pharmaceutical companies opportunities to explore, and they are the future priority areas for social media monitoring:
| Area | Priority for social media monitoring |
|---|---|
| Rare diseases | Facebook groups that allow direct interaction between pharmaceutical companies, researchers, clinicians, patients and carers |
| Clinical trial patient recruitment | Search tools, combined with social media channels, can help patients find and enrol in trials with eligibility requirements matching their profiles |
| Scientific conferences | Harnessing the increasing growth in social media use by physicians during major scientific meetings |
| Supplementing traditional data sets | Further development of computational methods for processing large data volumes, and of natural language processing methods for more detailed and sophisticated data analysis |
| Regulatory compliance | Development of technologies and universal standards to monitor and police compliance |
Connecting with patients
As companies move from engaging with patients to being patient-centric, they are forecast to do more to connect with patients and carers through social media. The industry still found it difficult to use digital and social media tools as a natural source of information for patients and healthcare professionals alike. Patient apps had become easier to provide, but uncertainty over the regulatory response remained. If patient-centricity is to reach its full potential, social media content and interactions must be measured as accurately and honestly as any other activity or variable in drug development and delivery.
Influencer marketing and disclosure
In marketing, companies were beginning to adapt to advertising strategies and to partner with influencers to promote new drugs and medical devices. Social media lets users connect over shared interests, locations and illnesses, and healthcare companies locate potential influencers who can use these commonalities to reach an audience and build its trust. Instagram, for example, has a particularly high user-engagement rate, a projected 1.1 billion users, half of them aged 18 to 29, and influencers with paid advertising partnerships. One such influencer, Louise Roe, has psoriasis and 698,000 followers, and has a paid partnership with Celgene, maker of the patent-protected psoriasis drug Otezla.
The Word of Mouth Marketing Association (WOMMA) developed disclosure guidelines for people who use social media to market pharmaceuticals or other products. When commenting on a blog or other online discussion, the guidelines suggest a disclosure statement such as "I was paid by [company name] to review…" or "I am an employee of [company name]". They recommend posting a disclosure and relationships statement, or a link to one, on the profile page of a blog or other social networking site. Twitter users should use hashtags when disclosure is needed: #spon for sponsored, #paid for paid and #samp for sample.
Clinical trials and rare diseases
Patient recruitment and retention are the two biggest reasons for delays in completing clinical trials. In the USA, for example, only a small percentage of eligible patients take part in clinical trials, although 70% are estimated to be inclined or very willing to.
Social media can influence the development of drugs for orphan and rare diseases by assisting the study of these diseases, increasing awareness of them and playing a vital role in the clinical trial process. As early drug development begins with understanding the needs of patients with orphan diseases, a company can use social media to study disease progression at much earlier stages than traditional communications from physicians allow. Social media increases patients' awareness of orphan diseases and of orphan drug developers. Because many patients with these diseases spend years seeking a correct diagnosis, they are more likely to engage actively in social media and web searches. Through content-rich social media activity, a company can give them valuable information on orphan diseases that helps them understand their symptoms, while promoting the credibility of its brand and gaining their trust. Social media is a powerful tool for recruiting, retaining and monitoring patients who are geographically dispersed or have transportation challenges. It is also vulnerable to breaches of patient privacy and to the collection of unrepresentative data of uneven quality, and it may be compromised by unblinding. Nevertheless, it has great potential for improving the efficiency and economics of orphan drug development, if companies consider the positive and negative aspects of using it.
Physicians' discussion online
Physicians share clinical opinion in established online communities such as Doctors.net.uk, Doximity and Sermo, most of which are closed and validate their members as health professionals, which increases trust and transparency in the sharing of knowledge. Physicians' use of social media rises during major scientific meetings, resulting in global sharing of predominantly scientific content. At major cardiovascular meetings, for example, Twitter use by physicians grew explosively. Widespread international use of Twitter should allow real-time scientific discussion and the immediate dissemination of potentially practice-changing information to a large global audience. Future studies of the demographics of users, and of the educational content and value of tweets, are warranted, because routine use of these platforms by physicians could significantly affect patient education, disease awareness and research.