Opinion: Pharma and healthcare marketers evolve cautiously toward mobile media

The pharmaceutical industry is on the cusp of its biggest transformation yet. In what many are terming 'Pharma 3.0', it has begun a descent from a focus on manufacturing to a call-for-attention for creating a healthcare ‘ecosystem’ of sorts.

From new patent laws to the shift in marketing dollars from sales reps to non-traditional alliances, pharma marketing seems to be coming of age at a time when most other industries seem to have passed their prime. Despite the commonly acknowledged fact that espousing the potential of new media technology such as eHealth and mobile health is the only way for pharma stakeholders to stay ahead in the game, nearly every one of them believes that they are not prepared for the needed colossal change.

While baby steps have been made by the industry to enter the dominion of new media marketing, marketers still lack a clear perspective on the best practices to reshape the role of pharma in healthcare marketing.

Pharma 3.0

A 2010 Ernst & Young report, “Progressions: Pharma 3.0” reveals how the industry perceives ‘digital’ as disruptive technology, but continues to partake only to survive. The key findings of the survey, which involved 24 companies, including 11 of the 15 largest global pharmaceutical companies and members of new industries expected to enter the Pharma 3.0 ecosystem, were:

• 92 per cent of respondents believed new entrants will enter the Pharma 3.0 ecosystem, with e-health, mobile-health and new medical technology firms being the most likely new entrants
• 67 per cent of respondents said they are not well prepared for valuation and modeling potential deals with nontraditional partners

The story so far
The irony of a tight regulatory framework on doctor-patient interactions, along with the lack of clearly defined guidelines, has played a large role in the slow evolvement of pharma marketing from traditional to newer channels. Yet with changing patient profiles—where healthcare is increasingly being sought as an integrated digital offering—a number of pharmaceutical companies have attempted to stretch beyond their present marketing patterns.

PR firm Burson Marsteller studied the 100 largest companies in the Fortune 500 list and found that 79 per cent of them use Twitter, Facebook, YouTube or corporate blogs to communicate with customers and other stakeholders. Although it started late, pharma initially warmed up to websites and community portals, where the interactions could be controlled to a much higher extent than on open platforms such as Facebook. The highest risks were perceived to be in creating trust and an authenticity factor on sites such as Facebook and Twitter, where the probability of compromising patient privacy is much higher.

However, taking tiny steps, pharma finally seems to have befriended social media. A PwC Health Research Institute Consumer Survey in 2011 found that more than 1,200 hospitals now participate in nearly 4,200 social networking sites, including Facebook, Twitter, YouTube, LinkedIn, foursquare, and blogs. More than 60 per cent of US physicians already use or are interested in using online physician communities, such as Sermo, where they collaborate and share information.

Pharma marketers have also understood that to rely on only one web presence is not enough and thus steps are being taken to include a broader perspective from consumers. Multiple identities are being created online to provide a targeted, relationship-oriented experience.

From a customers point of view, Search Engines (64 per cent) emerge as the most used/preferred online platform facilitating access to healthcare related information, followed by newsletters/online journals and company/brand websites.

Mobile HealthCare

To date, no standardized definition of mobile healthcare or 'mHealth' has been established. A definition used at the 2010 mHealth Summit of the Foundation for the National Institutes of Health (FNIH) was “the delivery of healthcare services via mobile communication devices.”

However, the scope of 'healthcare services' has been witnessing multiple changes, going from enabling information exchange to including a more participatory outlook, brought on by rapid advances in mobile technology, a rise in new opportunities for the integration of mobile health into existing eHealth services and the continued growth in coverage of mobile cellular networks.

The role of technology in healthcare is no longer just about creating access for the consumer but creating solutions to the question, ‘What are users doing with that access?’

According to the International Telecommunication Union (ITU), there are now more than 5 billion wireless subscribers, of which more than 70 per cent reside in low and middle-income countries. The GSM Association reports that commercial wireless signals cover over 85 per cent of the world’s population, extending far beyond the reach of the electrical grid. But have mobile health marketers truly leveraged the potential of these facts?

Mobile health apps
The arrival of “third-generation” (3G) smartphones brought powerful new applications that empowered patients to monitor and manage their healthcare in real time. To put things in perspective, The Pew Internet Project’s latest survey of American adults, conducted in association with the California HealthCare Foundation, found that 85 per cent of all adults use a cell phone. Of these:

• 17 per cent of cell owners have used their phone to look up health or medical information and 29 per cent of cell owners ages 18-29 have done such searches.
• 9 per cent of cell owners have software applications or “apps” on their phones that help them track or manage their health. Some 15 per cent of those ages 18-29 have such apps.

As of 2010, there were more than 250,000 total apps available for the iPhone, of which 6,000 were specifically created for the health, fitness and medical category; an increase of 850 per cent from the year 2009. In January 2010, more than 1,700 medical apps were available which were downloaded by 1 million users.

The function of these apps range from counting calories and providing nutrition information to logging fitness workouts and providing health tips. The more recent, sophisticated ones have included apps that monitor vital signs, calculate disease risks, keep personal health records and provide users’ health information to physicians and emergency workers. 

Mobile Health 2010, a report by Susannah Fox for the Pew Research Center, conducted a survey of 3,000 respondents and found that cell phone users between the ages of 18 and 29 are more likely than older cell owners to use mobile health apps: 15 per cent do so, compared with 8 per cent of cell users ages 30-49, for example. African American cell phone owners are more likely than other groups to use such apps: 15 per cent do so, compared with 7 per cent of white and 11 per cent of Latino cell phone users. Urban cell phone owners are more likely than those who live in suburban or rural areas to have a mobile health app on their phone. There are no significant differences between men and women, nor among income groups.

Challenges in mobile healthcare

Geographic
Consistent with eHealth trends in general, the challenges to mhealth seem to be higher in lower-income countries than more industrialized ones where the advancement of mobile technology has been several times higher than even in markets with an absolute higher number of cell phone users; for example, in India. Despite the proliferation of mobile and online opportunities, healthcare and pharma marketers in India have not been able to break the stronghold of traditional marketing to reach its population of 1.2 billion.  The search for health information amongst most adults in India, in both, urban and rural spaces, still remains anchored in the offline world. Friends, family and health professionals are approached for information and potential cures. Meanwhile, the internet and mobile, while playing a growing role, still remain supplemental rather than primary sources. Countries in the European region are currently the most active and those in the African region the least active.

Language barriers pose yet another problem. Not being able to develop multilingual applications or just having not given it a thought has been the myopia of mhealth marketers, offering significant disadvantage in terms of convenience, flexibility and reach. 

One of the main challenges in mobile healthcare is the demographic use versus ease of ease. People who are most in need of healthcare are usually more aged and are far less comfortable using sophisticated mobile technology.

Technological
The screen size of cell phones is an important technical issue in healthcare. The screens of mobile devices are smaller, thus limiting the type of medical information that is sensible to view. Also, operational costs for voice communication, data transfers, creating reliable networks, connectivity such as Wi Max and a mature 3G and 4G network are higher than the returns currently established by the limited market access. 

Privacy reasons
Just as in eHealth in its earliest days, mhealth faces user-based concerns about security and possible breaches through applications and text messaging where the suspicion is on companies with ulterior motives to collect health data. This could also be seen as a subset to a bigger concern – that of the lack of knowledge amongst users and also country and regional policies on eHealth that could have slowed down the approach.

Opportunities
In 2010, the Pharma industry cut more than 40,000 jobs globally. With fewer sales reps, brand and marketing managers are forced to invest in alternative channels to reach HCPs. It is estimated that 500 million people will have health apps on their Smartphone to manage fitness, exercise, and health issues by the year 2015. Remote mhealth is expected to be a US$2 billion to US$6 billion industry by 2015.

The future of the mobile healthcare mainly depends on how people are using the applications, the quality and reliability of the information dispensed, and the relevance of local disposal. Partnership and collaboration with private and government sources will lead the way to innovation and the harnessing of technological advancements, especially in emerging markets.