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Internet and CRM technologies could help Big Pharma...

23 May 2005

By Rick Whiting

The Internet simultaneously holds a wealth of useful information and a morass of conflicting data. And that's a big problem when it comes to researching health-related questions, Vita Cassese says. The VP of global business technology at Pfizer Inc. recently needed information on a prescription medication and found that a number of reputable health sites each served up different guidance on the correct dosage.

The pharmaceutical industry is getting better at using CRM software, says Pfizer's Vega (left, with Bennett).

That brought home how far the health-care industry has to go in using IT and the Internet to provide consumers with accurate information and new services in order to improve patient outcomes. Pharmaceutical companies have a prominent role to play in the process. "We know information is a critical component to improving health care," Cassese says. "We believe we're a health-care company, not just a pharmaceutical manufacturer," she says of Pfizer, a $52 billion-a-year company that makes Lipitor, Viagra, and Zoloft.

Pharmaceuticals manufacturing is a massively profitable business. Drug companies were more than three times as profitable as the median for all Fortune 500 companies last year, according to the Kaiser Family Foundation. But the sheer size of the industry also raises concerns and even distrust. A poll of 1,201 consumers conducted by the foundation this year found that 70% of those surveyed say drug companies put profits ahead of people, though most also agree that prescription drugs have had a positive impact on people's lives.

Such perceptions add to pharmaceutical companies' challenges as they move aggressively to use IT and the Web to reach users on important health-care issues, some of which threaten people's well-being and add billions to health-care costs. "This isn't about marketing per se," Cassese says. "This is about health outcomes."

One issue drug companies are reaching out to consumers on is patients' ability to follow medication directions. The ongoing Minnesota Heart Survey finds that as many as half of patients prescribed a statin drug to lower their cholesterol stopped taking it after six months. Compliance problems often are the result of confusion, misinterpretation, or unanswered questions about treatment information.

By playing a bigger role in controlling how their products are used, pharmaceutical companies say they can improve care and foster customer loyalty in the face of competition from generic drugs and potential revenue loss from patients filling prescriptions at lower-priced Canadian pharmacies. Using the Internet to accomplish this is new to most of the companies, and only about 20% of adults go online for drug information, according to Mark Bard, co-founder of Manhattan Research LLC, a health-care marketing information and services company.

The industry spends a significant amount of money each year to understand what physicians want and how to deliver it to them but is relatively new to the whole concept of consumer marketing, as well as customer satisfaction and service, Bard says via E-mail. "Many are looking at how they can offer services while maintaining control over the communication process."

Schering-Plough Corp. sends E-mail to patients taking its Peg-Intron hepatitis C drug reminding them to take the medication and refill prescriptions. Novartis AG uses its Web site to recruit patients for clinical drug trials. And at the Pfizer for Living Web site, consumers can find health-assessment tools and personalize the home page to suit their needs. "There's plenty of room for innovation and to creatively use technology to strengthen the dialogue with patients," says Fred Bennett, operations director at Pfizer.

But the industry needs to tread carefully to ensure that patient data remains private and secure and that drug companies' Web sites reflect the most up-to-the-minute information, both to maintain quality care and ward off potential lawsuits. Web sites can evolve quickly to react to changing market needs, but information dispensed on pharmaceutical companies' sites or by their call centers must comply with the same strict regulations that apply to medication labels. The companies also must comply with the data-privacy requirements of the Health Insurance Portability and Accountability Act, as well as privacy standards around the world. For instance, European customer data can't be held outside the continent's borders.

Pharmaceutical companies also must be sure that IT-enabled services don't cause other problems. No one can afford to repeat Eli Lilly & Co.'s mistake four years ago when a programming error exposed the E-mail addresses of 669 patients using Prozac to one another. The patients, subscribers to the company's pioneering Medi-messenger drug-reminder and -renewal E-mail service, received a message informing them that the service was being discontinued.

That episode is an ever-present specter at Schering-Plough with its hepatitis C online support program. The disease carries a stigma because one common means of transmission is shared needles among drug users, and the side effects of treatment--including depression--can be intense. For Schering-Plough, that adds up to a big focus on ensuring patient privacy. Storing patient data is "a huge issue for us all around," says Kathy Zonca, director of patient access and advocacy.

The limited data Schering-Plough collects, including patients' E-mail addresses, is stored securely on the company's Web-platform database server. Other drugmakers with similar concerns have turned to third-party service companies that manage databases of patient information (see story, "Data Flow: Tracking Consumers").

Pfizer is one of the leaders in the consumer-information movement. It manages its own patient information, zealously guarding who has access to it, inside and outside the company. Consumers opt in to programs for specific medications via phone, mail, or on the Pfizer for Living site. They supply personal information, E-mail addresses, and identify their medical conditions--including sensitive ones such as depression and overactive bladder--in order to get notices about medications, answers to questions, and other information. A shared IT infrastructure, with reusable software components and standardized Web templates, underlies most of these operations, and IT staff are part of the marketing teams for the various drug programs.

Much of Pfizer's IT spending is closely aligned with specific marketing programs. But consumer information isn't shared across drug programs or marketing teams, even if a person's profile reveals that he or she has opted in for multiple Pfizer programs. Pfizer won't say how many subscribers it has in its Pfizer for Living program. The company makes more than 30 drugs and offers online support programs for most of them. Data onsubscribers is maintained in a small number of databases that are segmented with firewalls according to diseases and corresponding drugs. The only other people with access to customer-data profiles are call-center workers at a third-party service company Pfizer uses as another way to provide consumers with information. "We have an architecture which is consistent across programs and products and that drives the ability to really manage data in a cost-effective and secure way," Cassese says.

Pfizer is migrating all of its Web sites to a component-based architecture, says Ramon Vega, who as business-technology director and team leader at Pfizer is responsible for the IT and business processes that support communication with consumers. That "plug-and-play" architecture, utilizing .Net and Java technologies, will help Pfizer add content and capabilities to its Web site more quickly as market needs change, he says.

Pfizer manages Web-site content with software from BEA Systems Inc. and EMC Corp.'s Documentum unit, but the new framework means internal content managers don't need to be exposed to the complexities of those systems. The goal is to reduce the time to market for Web programs by half, Vega says. "Our goal is to simplify those processes as much as possible," he says. He cites a case in which after Pfizer research determined that people tend to live with overactive bladder problems rather than treat them, the company was able to quickly redesign the relevant Web pages to include information about treatments and increase the visibility of that information. That has made a difference in how Pfizer's product for the condition, Detrol LA, is being received, Vega says.

When it comes to using the Internet to develop and inform customer relationships, there's nowhere to go but up for most pharmaceutical companies. Only about 5% of seniors age 65 and older, a key constituency, use the Internet for drug information, according to Manhattan Research. In a study of Web sites earlier this year by the Customer Respect Group, a research and consulting company that assesses how businesses treat customers online, pharmaceutical makers scored 5.8 out of 10, below scores of travel, retail, and financial-services industries. The customer respect index measures Web-site attributes such as responsiveness to inquiries, privacy protection and respect for customer data, ease of navigation, site "attitude" or customer focus, and the transparency of Web-site policies, Customer Respect Group says.

While drugmakers' Web sites generally scored high on privacy and personal data protection, they scored low on interactivity. "The Web puts some control in the hands of the consumer, [and] the consumer is looking for a dialogue now," says Terry Golesworthy, Customer Respect Group's president. "That's a fundamental business problem."

Most pharmaceutical companies use customer-relationship-management applications from vendors such as SAP and Siebel Systems Inc. to manage their relationships with health-care professionals, but few have applied that experience to their consumer audience. Some of the biggest CRM deals in the industry remain focused on the traditional customers: Last month Germany's Boehringer Ingelheim GmbH, one of the industry's 20 largest companies, said it's implementing Siebel CRM applications to 6,000 sales and marketing staffers in 24 countries to provide comprehensive views of 1.5 million physicians and hospital professionals.

Pfizer has taken the next step, using CRM applications from Siebel to manage its consumer marketing campaigns, including sending materials on diseases and Pfizer products to consumers based on their opt-in profiles. "CRM in the pharmaceutical industry is still pretty young. But I think we're getting better at it," Vega says.

Generally, pharmaceutical companies still are experimenting with what kinds of technology and processes they require to meet patients' needs. "Along with that will come an evolution in the IT infrastructure in data management, campaign management, and predictive analytics," says Elizabeth Boehm, a Forrester Research health-care and life-sciences senior analyst. "The marketing proposition is still evolving, so it's hard to justify the IT infrastructure spending to support it."

To some extent, the pharmaceutical industry is a Johnny-come-lately to the Internet in terms of developing its business model, acknowledges John Fish Sr., global E-business director at AstraZeneca plc. Like nearly all drug manufacturers, AstraZeneca uses its Web site to back up advertising by offering information about diseases and treatments. The company is in the early stages of developing a CRM strategy for the consumer market and plans to make its Web site more interactive. That includes developing standard processes for collecting, managing, and using customer data to get a single view of a consumer across its product lines. AstraZeneca also is considering having patients report "adverse events," or side effects of using the company's drugs, and improving patient-to-patient communications through newsgroups and Weblogs, Fish says.

Schering-Plough already has increased its online dialogue with patients. It offers services and information about hepatitis C through its Be In Charge site for users of its Peg-Intron drug, including health-diary forms patients can download, fill out, and take to their physicians. Schering-Plough expanded the site's interactive capabilities earlier this month to let patients sign up for E-mail reminders for taking the daily pills and weekly injections, as well as for therapy, laboratory tests, and other appointments. "Using the Web site more is a big change from the past," director Zonca says. "What we're trying to do now is offer other ways [for patients] to learn about the disease state."

Schering-Plough's Be In Charge services are more extensive than those the company offers for its other pharmaceutical products. Hepatitis C patients generally need more support because of the social and psychological issues around the disease. But the company, which develops most of the applications that run on its site in-house, would consider providing similar online capabilities for other drugs, such as an HIV product now in development, that require long-term therapy and patient support, Zonca says.

It's clear the pharmaceutical industry is evolving its relationship with consumers even as consumers evolve in their expectations. "The Internet is just another medium for providing information," Pfizer's Cassese says. And getting it back, too, which the pharmaceutical industry will increasingly find as it further opens up a direct dialogue with the people who use its products.