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2013 planning thought starters

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2013 planning thought starters

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Introducing Help with 2013 Planning

00 Re-imagining the Website 00 Planning the Extended Total Office Call 00 Marketing Insights of the Grateful Dead 00 Marketing Drivers Are Changing, How About Your Metrics? 00 The Illuminating Power of Compassion 00 Shifting into the Service Gear 00 Design Inspirations 00 Local Leverage 00 New Habits for 2013 00 Doctors Are from Mars and Patients Are from Venus


Introducing help with 2013 planning While summer is the vacation season for most people, for healthcare marketers around the world it means the start of planning season. So while friends and family may be: • c arrying a paperback beach novel, you’re lugging PowerPoint presentations in your overflowing beach bag •h  eading to pool parties, you’re diving into decks of data and financial forecasts • t hinking about where to splurge on a summer weekend escape, you’re wondering about new creative ways to do more with less Extrovertic can lighten your load. This summer, we’re devoting these Wednesday posts to sharing crisp, juicy ways to give you food for thought about your business. We’ll be serving up different perspectives gathered from our Extro-Analog process, which is where we: •e  xplore non-pharma solutions and strategically apply them to the realitiesof pharma marketing • s trip down the problem to its bare essentials • s earch outside of healthcare for companies or brands that’ve faced similar challenges And we never know where inspiration can strike. For example, we came up with a new way for a client to help patients by studying addiction counseling. We even developed an idea for a new video series based on the Heidi Klum Summer Run. We’ve found that the further out you go, the better the ideas. So this summer we’ll offer up refreshing pitchers of ideas that’re focused on: • strategies • tactics • measurements These will include short- and long-term thought starters for your consideration.

Sometimes there are ideas that can be directly applied, while other times these out-of-industry examples provide the root of a new idea that can be harvested or further cultivated. We’ll also point out particularly interesting examples from around our industry. So, starting tomorrow (June 20th), check out our Intro to Extro blog. Then, every Wednesday for the next 14 weeks, you’ll see some bright, sunny ways to approach your 2013 marketing plan. We hope you find them useful and thought provoking. Either way, we’d love to hear from you. Thanks for letting us share.


Dorothy


Re-imagining the Website “What are we going to do with our website next year?” and “How are we evolving our digital strategy?” are inevitable questions that come up during planning season. One of our creative tenets at extrovertic is that marketers need to think more like magazine editors or television-station managers by answering: •W  hat are the regularly scheduled features that are going to keep patients coming back for more? • What does your fall lineup look like? • What is your editorial calendar? It’s a real challenge in healthcare—particularly pharmaceutical marketing—when just getting the branded patient education brochure or core visual aid approved seems to require an act of God.

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I recently stumbled upon an article by Ken Gordon entitled, “Why You Should Run Your Website Like A Magazine,” which offered some good, practical advice that can be easily applied to or tweaked for pharma. Here are the top 4 ideas I gleaned from the article:

1. Use your customer’s media habits for inspiration. Marketers have reams of data on what magazines your customers read. Pull some of the titles and look at the: • style • types of regular features • columnists • types of articles You’ll see what keeps them returning to Time Magazine week after week. Ask your favorite magazine rep for some time with their editorial or research department to get more insight into the ideas that captivate your mutual customers. 2. Keep it short, sweet, and useful. People are drawn to articles that list “the top 3 things to do/not to do/to try.” According to the author, people are always looking for ” short, useful pieces that improve their lives or solve a particular issue.” As an added bonus, shorter is also

easier to get through the review committee. 3. Think contrast. This piece of advice is a little harder to apply in a highly regulated environment, but still has relevance. The author suggests that “if your site offers different voices that complement or contrast with each other, you’ll have done something special.” As an example, consider a point/counterpoint article about obesity with one physician saying lifestyle changes alone are enough as a remedy and another doctor (maybe a company physician) explaining how medication can be an important adjunct to diet and exercise. Die-hard lifestylers aren’t going to change, but people on the fence may take your willingness to present both sides of the story as proof of your belief in the product. 4. Exclusivity is authority. Provide content no one else is providing. Pharmaceutical companies have access to experts of all kinds, inside and outside the company. A KOL (key opinion leader) from a major medical center would provide a new perspective for a consumer living in a town of 15,000 people. Do you use celebrities in your marketing? What about a short articles or series of article by them? One way to get started would be a quick two-hour brainstorming session—pull out the magazines, put on your editor’s hat, or even better invite an editor (from a magazine that you spend millions in) for an outside perspective. While not exactly a day at the beach, it would sure beat a regular day in the office.Thanks for letting us share.


Planning the Extended Total Office Call A few years ago, the idea of the Total Office Call was in vogue in pharma marketing. A comment I heard at a recent conference, however, gave me an idea about how to morph this concept into a new way of thinking about an age-old issue—the doctor/ patient relationship.Firstly, let’s briefly revisit the idea of the Total Office Call.The goal of the Total Office Call is to build a deeper relationship during the office visit by providing services and support to the complete healthcare provider staff, including: • the physician • nurses • billing department The point is to help all of them better deliver healthcare. Planning strategies and tactics typically include

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•p  roviding information for nurses on how to manage specific patient types • formulary status, insurance coverage, and patient support options

A comment by Dr. Frank Spinelli at the Pharma Summit Conference in May got Thought Starters me thinking about amplifying this concept into the Extended Total Office Call. Dr. Spinelli challenged the audience of pharmaceutical marketers toextend the doctor/patient interaction prior to and following the actual office visit by helping merge the online and off-line experiences. The need for extending the doctor/ patient connection—before and after the office visit—has never been more acute. Three reasons drive this demand: • The Affordable Care Act is coming into play in 2014. • Physician payments are going to be increasingly linked to the quality of care they provide. • Healthcare providers will be compensated based on the outcomes they achieve. The pharmaceutical companies that help healthcare providers meet these new challenges will be more welcomed in doctors’ offices.How can you plan for the Extended Total Office Call in 2013?Well, start by using the Extended Total Office Call as an organizing principle, both in how you go about planning and in the tactics you consider. First, think about having your teams start off as one integrated unit with the mission to: • help prepare both the physician and patient to have a productive office visit

• enable the patient to easily obtain any required medicine • support and monitor the patient afterwards Traditionally, the three customer teams (and possibly a separate digital team) start the planning cycle by going off separately to optimize their promotional mix, based on their particular customer needs. Then, towards the end of the planning cycle, they meet to check for synergies and disconnects. This results in siloed thinking, which is the antithesis of the Extended Total Office Call.Next, think about some new tactics. One execution of an Extended Total Office Call tactic could be an app that collects important data about critical patient habits or one that helps the patient develop new, more productive habits. The solid data provided by an easy-to-use tracker app could potentially eliminate a lot of wasted time and patient frustration. An app, of course, is an obvious solution.To dig a little deeper, I’d suggest gathering an integrated group to consider the following questions at the beginning of the planning season: • What are the critical activities and information exchanges that must take place during the office visit? • What can the physician uniquely contribute to the visit? Is it knowledge? Providing a sense of caring or peace of mind? Providing a solution? • Would any activities or information exchanges before the appointment help improve the quality or efficiency of the experience? • What are the barriers for different patient types to actually paying for and obtaining the prescribed medicine? • What follow-up or activities would help ensure the physician treatment plan is monitored and adhered to? • Are there any other healthcare stakeholders—such as nurses, pharma reps, support groups, or associations—who could play a role before, during, or after the office visit? • Is there a different sort of in-the-field support people that could be provided? For example, clinical nurse educators or lay health workers? It is hard to meet the continual planning challenges of thinkingoutside-of-the-box and doing-more-with-less, when we try to answer the same questions year after year. Considering the Extended Total Office Call provides a new set of questions. Give it a try and let us know how it works for you. Thanks for letting us share.


Marketing Insights of the Grateful Dead One of the more beachable business books I’ve read is “Marketing Lessons from the Grateful Dead. What every business can learn from the most iconic brand in history” by David Meerman Scott and Brian Halligan. It’s a fast, 156page read of the Dead’s marketing breakthroughs, coupled with examples from other industries. It includes helpful application tips (labeled “Rock On”) for your own business situation. Here are my top 3 takeaways:1. Be on the lookout for new business models. The Grateful Dead pioneered a multitude of new business practices. Unlike other bands that relied heavily on selling records, the Grateful Dead made their money primarily from concerts and merchandise. The Dead eliminated the middleman 2013 Planning by selling tickets directly to fans rather than going through major ticket sellers. And finally, they pioneered relationship marketing by including the following on one of their record sleeves:

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Thought Starters

DEAD FREAKS UNITE: Who are you? Where are you? How are you? Send us your name and address and we’ll keep you informed. Deadheads, P.O. Box 1065, San Rafael, California 94901 New business models are even starting to emerge in the traditionally risk-adverse pharmaceutical industry with Pfizer’s new approach to the Lipitor patient expiration being a prime example. Rather than let brand sales plummet into the sunset, they extended Lipitor sales by selling directly to patients—at a generic price—by enlisting help from specialty pharmacies. With all the upcoming changes in the healthcare industry, it pays to invest some thinking time into how medicines can get into the hands of patients more quickly and cheaply. 2. Experiment and continually adapt. No two Grateful Dead concerts are alike. The Dead experimented continually as a group, and individually, both on and off the concert stage. This uniqueness increased the value of their concerts and concert tapes.

In applying this relentlessly innovative mindset to the practicalities of business, the authors advise that “marketers should shorten their planning cycles to monthly—versus six to twelve months out—in order to become more agile in response to changing marketplace dynamics, new product developments, changing competitive landscapes, and new marketing technologies.” While a monthly planning cycle might be impractical, it does make sense to plan for regular quarterly reviews to evaluate the current direction and environment. At the annual planning session, it would make sense to: • highlight how the environment could change • note how you will monitor the potential change • identify some alternative ways to address any environmental shif Ask your team: What if a competitor comes out with better than expected data? What if your brand suddenly has a shorter or longer expected life? Identify and plan for these potential pivot points.3. Get some fresh perspectives. One of the reasons why the Grateful Dead was so innovative was that the band members came from diverse musical backgrounds. For example, Jerry Garcia was also a bluegrass banjo player in addition to rock guitar. To think more expansively about your team, the authors suggest searching for employees using very broad criteria, such as finding someone who is good with numbers and someone who is good at getting found. A more practical approach for the upcoming 2013 planning season would be to locate a few people from different industries and brainstorm around a key issue; say, retention. Or encourage each team member to take a course outside of healthcare. That’s how we encourage our extroverts to expand their thinking. For example, one of our extroverts will be taking an online course with Berklee School of Music on Online Music Marketing. Just thinking about how you would develop a fan base is sure to result in some new acquisition and retention strategies. The book is full of lots of other practical business advice engagingly served up with tales of the Grateful Dead and their loyal Deadheads. So put Marketing Lessons from the Grateful Dead on your summer reading list. Try bringing the book to work and reading it at lunch; it’s sure to start a new conversation and that’s what you want. Thanks for letting us share.



Marketing Drivers Are Changing, How About Your Metrics? Good planning focuses resources on the key elements that drive product choice. If sales are dependent on patient requests, then we like to say Brand X is a patient-driven brand.We can measure patient requests for a brand.Then we drill down a little deeper and consider: What is getting in the way of patient requests? Is it: • awareness of the condition? • awareness of a potential solution? We can measure awareness issues.But because we don’t know how to measure the effect of the family and friends phenomenon, 2013 Planning often called word of mouth marketing (WOMM), we tend to ignore it. WOMM is, however, quickly becoming an important source of information for patients who will ask their doctor for a drug by name.Patients are increasingly: Thought Starters looking for, relying on, and trusting commentary about medicines that they get from their friends and family. So how a patient feels about—and what they say about—your brand and company can be a real sales driver. Consider these three facts:

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•6  8% of all adults ask a friend or family member when they need information about dealing with health or medical issues •3  4% of Internet users—or 25% of adults—have read someone else’s commentary or experience about health or medical issues on an online news group, website, or blog •1  8% of Internet users say they have gone online to find others who might have similar health concerns. For adults living with a chronic condition such as high blood pressure, that figure rises to 23%

But don’t worry, we can measure that too.The Net Promoter Score (NPS) measures the sentiment people have about a brand in one, single number that correlates to sales and profit growth. Marketing masters General Electric and American Express use NPS to help measure the quality of their relationships with their customers. NPS relies on one question: “Would you recommend this brand to a friend/family?” For a more complete overview, the 2008 Harvard Business Review article, How the Net Promoter Score (NPS) Can Drive Growth by Fred Reichheld does a great job.The economic benefit of a high NPS score is derived from what Reichheld calls the Loyalty Effect. Basically, patient brandpromoters are more likely to: • use more of the product for a longer period of time • cost less per person to serve • say positive things about your brand An NPS might have been helpful to Sanofi-Aventis in determining the effect on sales of the highly publicized Taxotere issue, where a woman flooded the media about the product’s side effects. If Sanofi-Aventis had understood the impact of the woman’s complaints, their marketing department may have considered investing in monitoring and responding to patient comments online. Conversely, if we understood how one positive interaction with a nurse educator impacted NPS, we might invest more in nurse educators and less in direct-to-consumer advertising. It’s about matching investments to business drivers.If NPS has captured your imagination, consider putting one of the courses offered by Satmetrix on your 2013 agenda. You should know that using NPS correctly is a significant undertaking. Instead, you may want to start smaller by adding the NPS question to an ongoing tracker, or conducting a quick online study. With customer commentary and relationships controlling business more than ever before, doesn’t it make sense to start measuring the impact that customer word-of-mouth communication has on your business? Maybe even plan for a few customer-care initiatives in 2013 (see our next Thought Starters post)? Thanks for letting us share.


The Illuminating Power of Compassion “He who knows the customer best, wins.” That’s what one of the best planners in the business, Nat Puccio, once told me when I started in DTC. Now, years later, I feel that knowing the customer is necessary, but is insufficient to win the hearts and minds of healthcare consumers. Instead, I now believe that, “He who has the most compassion for the customer, wins.” My view evolved because the most valuable insights I have seen generated came from a client who developed true compassion for the patient. And they are these shifting, tectonic insights that result in creative executions that truly connect and motivate. When patients are moved to tears by the self-awareness they feel from a headline, you know you have made a 2013 Planning deep connection.

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So how do you get to the point of having true compassion for your patients? To go beyond the point of knowing, you have to spend real time Thought Starters with them, not just observe them from behind a computer screen or two-way mirror. You have to interact with them continuously over time. You might not have a breathtaking insight with every interaction, but if you keep at it long enough, you will uncover some rich nuggets that change your view about your patients. It is often the small, seemingly inconsequential interactions that resonate most powerfully: •T  he panicked call from a patient at 6:30 am when she reads the hotel invoice slipped under her door and is worried about fronting the expense •T  he jaw-dropping respect you feel in the presence of someone who has overcome addiction •T  he anguish of the soft-spoken, dignified p atient who “fell off the wagon” due to grief at the death of his two beloved chihuahuas Deep insights have the power to change a negative sales trajectory, even in the most mundane categories. P&G’s

legendary sales turnaround in 2006 was driven in part by a consumer immersion program that resulted in more tailored products and better communication campaigns. This program included sending marketers to the rural village in the Shaanxi province of China to do laundry, and to small shops in low-income areas of Mexico to see how customers shopped. According to interviews with P&G’s CMO at the time, Jim Stengel, the benefits to marketers are multiple. First, interacting with customers gives marketers a larger perspective, “one in which Pampers is not about diapers, it’s about helping a mother with her baby’s development.” And secondly, it changes their attitudes about their jobs. People come back from fieldwork “more pumped up” because they “understand the product has a role in someone’s life.” They are these changes in perspective and attitude that I think make the critical difference. When you develop a more compassionate attitude towards patients, you begin to have more of a sense of urgency to solve their problems. You give it an extra oomph by fighting for a more generous support program or spending an afternoon running around the company to get a product shipped to a patient. It’s part of a larger concept that I call compassion marketing. So in thinking about your research needs for 2013, consider adding some potential compassion builders— opportunities to interact directly with patients—into your plan. These interactions can happen in multiple ways: • Research companies that organize weekends where marketers closely interact with patients • Invite a patient to your office for a set of meetings • Work one-on-one with a patient to develop materials • Use patient ambassadors and field “ride-alongs” to hear patient stories If you listen long and hard enough, a patient will say something that will change your view about your product, your therapeutic area, or about healthcare in general. And this tiny, brightly burning insight could change you and your business in unexpected, positive ways.Thanks for letting us share.


Shifting into the Service Gear My friend and colleague, Ellen Brett, forwarded me a great Forbes article, “IBM’s Reinvention Should Inspire Flat Pharma Businesses,” by David Chase. In the article, Chase posits that pharma has 2 options: either fade into the sunset like the railroad industry in the early 20th century or forge ahead like IBM under Lou Gerstner in the ‘90s. The key to IBM’s reinvention was a shift from a product to a service orientation. As Chase says, “Remarkably, IBM demonstrated how it’s possible for a large company to shift from a product-centric culture to a customer- and servicecentered company.” While transformation on the scale of IBM is more of an enterprise versus a brand initiative, there are ways to infuse a service approach into your 2013 tactical planning. 2013 Planning

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Below are 2 exercises that can be conducted to create a more serviceoriented mindset. These exercises are based on a series of articles, written for MarketingProfs by Jeanne Bliss, entitled, “Customer Experience Leadership Survival Guide.”

•T  ouchpoint planning: Identify all the “touchpoints” where a patient or physician can come into contact with your company or brand. Then, prioritize the points by where you can make a difference, or as Bliss says, “begin improving reliability and weaving in those differentiating ‘wow’ moments.” For example, if you have a support center, identify the best representative or nurse and find out what they do and how they do it. Figure out how this technique can be applied across all the representatives in a consistent fashion.

• Customer room: Create a customer room where, on the wall, you show all the stages of the customer experience, complete with any physical materials the customer might receive. This room should represent a multimedia experience, complete with customer calls and field representative role-play videos. It is also important to portray areas seemingly out of your control, such as articles in the New York Times or comments in patient communities where customers might be exposed to your brand. This room should be action-oriented. Bliss suggests including KPIs for each stage on the wall and convening regular management meetings in the room to focus the organization on the customer experience. In both exercises, it is important that you have enthusiastic, cross-functional participation. Many times, it is in the uncoordinated, cross-functional touch points where the customer experience falls apart. Based on these exercises, new, more customer-focused initiatives should arise. These could include everything from incremental “brand-experience” training for your telephone reps to streamlining patient education materials (do you know how many different departments in your organization have produced disease-state materials?). Who knows; your customer efforts just might jump-start your company on the path to reinvention, à la IBM. Thanks for letting us share.


Design Inspirations Last winter, we extroverts embarked on a quest to identify how the principles of good design could add value to the typical healthcare agency model. If you are interested in our full exploratory, start with our post, “Designing the Service Business Model,” and follow the trail. But if you are short on time, here are 3 “design inspirations” we came up with that can enhance your 2013 planning process: 1. Find a renewed purpose in the mundane: Most of us have used some sort of “laddering up to higher order benefits” exercise for our brands. This exercise helps brands go beyond just a functional offering to a more “higher order” type of benefit that makes a powerful connection with 2013 Planning patients. For example, the higher order benefit of “personal happiness” for the prescription allergy brand, ZYRTEC, was identified using a laddering up exercise.The power of this exercise can extend beyond Thought Starters brands to even the most mundane piece of collateral. Consider how the Foreign Policy Design Group reinvented the conventional in-room directory for the Wanderlust Hotel.

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The in-room hotel directory went from a mere listing of hotel services to an engaging, interactive, and exciting itinerary full of useful local maps, transit schedules, cool shops, and restaurants. This itinerary/directory even contained blank pages for notes and sketches, turning it into a personalized memento of the consumer’s hotel stay. In essence, it went above and beyond the typical level of customer service, and offered guests something that really catered to them. How cool is that?! (For more information, see our blog post, “Wander into the Wanderlust Hotel”). So why not spend an extra 2 hours in a room digging deeper into the higher purpose of your patient or physician collateral?

2. Employ the power of the unrelated: In our quest to design extrovertic, we went on 2 field trips—one to AIGA’s NYC branch exhibit, “365/Design Effectiveness,” and the other to FIT’s Daphne Guinness fashion exhibit. While we got some great ideas from the AIGA exhibit, the more breakthrough ideas came from looking at 6-inch heels and chain-mail dresses. So this year, have your brainstorms in an unexpected place. To keep costs under control, look at your company’s philanthropy list to see if you support any local museums or musical venues. Often times, these packages come with free room privileges that go unused. 3. Embellish with details that wow: Healthcare product packaging and collateral generally don’t elicit feelings of surprise or wonder. We usually assume that all “user experience” stuff is for technology products. But when I unwrapped a cherry-flavored Halls Defense drop last winter, I realized the bar has been set too low for healthcare. On the wrapper, rather than a listing of ingredients, I got “A pep talk in every drop.” Each wrapper contained a brief aspirational message, such as “Be unstoppable,” or “You’ve survived tougher.” Why not spend a few extra hours with your product collateral and see how little pick-me-ups can be added to your patient education, websites, and packaging? So with these few ideas to get you started, how can design inspire a re-design of your 2013 planning? Let us know what you come up with. Thanks for letting us share.


Local Leverage “There’s just no scale in local programs!” “Local won’t make a dent in my sales numbers!” Those are the objections that start flying when live, local programing is proposed as a tactic in the annual marketing plan, whether it is a patient education, community support, or physician seminar. The appeal of local programs is that they offer the opportunities to personally interact and provide value (information, services, etc) directly to your customers. Even successful online brands, such as Amazon’s BeautyBar.com, have begun using physical outposts in order to have more direct interaction with customers.

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However, local programs usually get discounted because they are expensive on a per person basis and are often hard to scale. But these objections can be overcome by purposefully l everaging the local investment for national impact. One of the best forms I have seen of leveraging local programming is Levi’s support for the town of Braddock, PA.

Braddock is a town with an activist mayor, John Fetterman, who is innovating his way out of a recession with unique ways to put people back to work. Fetterman is a modern pioneer, fighting urban blight rather than taming the Wild West. Braddock’s slogan is, “Reinvention is the only option.” Levi’s committed $1.5 million to funding the refurbishment of Braddock’s community center, urban farm, library, and community gardens. Levi’s leveraged their involvement in the “comeback kid” Braddock story into a compelling national advertising campaign—the latest installment in their “Go Forth” advertising campaign. Here’s what I think makes this local leverage great: • The local programing is a strategically relevant expression of Levi’s positioning and heritage as pioneering work brand, in this case, a “back-to-work”

brand • The Braddock effort increases Levi’s brand relevancy by addressing pressing and important issues to their customers. Relevancy is a key concern for a brand dating back to 1853 • Levi’s amplified the impact of their local investment with national advertising, both in terms of reach and performance. $1.5 million is a relatively small investment that turbocharges their estimated $60–80 million investment in US commercial production and media So how can you use this example to spur a new approach to local programing in 2013? Here are a few thought starters: • Brainstorm local “manifestations” of your brand’s essence, personality, and/or positioning. What are the local support programs you could create that exemplify your brand? If your brand stands for progress, what sort of progress on a local level could you activate for customers? • Examine your brand and company’s local support programs. Can any of these be amplified, expanded, or tweaked to become a plank in your brand’s communications platform? • Advertising is only one way to amplify the effects of your local programing. Is there anyway to increase on- or offline word of mouth? Can a local program be part of a learning agenda for your approach to the upcoming changes in healthcare? Can you use your advanced marketing practices in one market to signal to your customers across the nation that you have a new approach? That’s what IBM accomplished with their Smarter City/Plant initiative. IBM highlighted their innovative practices in local markets to exemplify their evolution from a hardware manufacturer to a tech visionary company If social media has taught us anything, it’s that one idea, one person, one video can become an overnight sensation and have national, even world, impact. The same principle applies to local marketing; actions in one market can have national impact, if properly leveraged. Thanks for letting us share.


New Habits for 2013 One of the best business books I have read lately is The Power of Habit: Why We Do What We Do in Life and Business by Charles Duhigg, a New York Times reporter. The fundamental premise is that habits drive our day-today behaviors. To adopt a different habit—say for example, daily exercise—we have to first understand how habits are formed. Here are a few of the key concepts from the book that can serve as inspiration for new thinking in 2013: •T  he first step to changing a habit is by understanding its makeup. Duhigg deconstructs habits into cues, routines, and rewards: Cue: The signal that triggers the habit or behavior. Cues usually take the form of a specific time, location, emotional state, and/or activity immediately preceding the routine. For example, 3 pm is Duhigg’s cue to go to the cafeteria to get a cookie 2013 Planning Routine: The typical set of activities that surrounds the habit. In Duhigg’s case, at 3 pm each day, he gets up, goes to the cafeteria, speaks to friends, and then takes a cookie back to his desk Thought Starters Reward: The positive reinforcement that keeps you coming back to the habit. It’s key to identify the real reward. In Duhigg’s example, the reward could be the renewed energy, the social interaction, or the cookie. Once this is understood, a new, healthier reward can be substituted for the unhealthy one. For example, if it is energy Duhigg seeks, then a cup of coffee will suffice •O  nce the habit has been deconstructed, it is important to understand what creates the successful adoption of a new habit: The power of a crisis: Crises make people more willing to change. Duhigg provides a wealth of examples, including how a crisis enabled a hospital to overthrow the familiar, and sometimes detrimental, routine of never questioning the doctor’s authority Familiarity breeds openness: If you are trying to get someone to do or open themselves to something new,

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then fold it into something familiar. For example, radio stations often introduce new songs sandwiched between established hits Planning for obstacles: Make a plan for how you are going to deal with obstacles. For example, Starbucks trains its employees to maintain their friendly demeanors when faced with cranky customers Habit has a lot of applicability for healthcare marketing, both in developing communication programs and dealing with organizational issues. Here are some topline thoughts to pursue for 2013: • Framework for adherence: Adherence programs help patients create new habits so they can stick to their treatment regimes the way their doctors prescribed. Perhaps the cue–routine–reward framework could be worked into the design of an adherence program. For example, can you find new ways to help patients plan for the inevitable difficulties of adhering to a complex medicine schedule? • Leveraging a crisis: How can you transform a sales downturn into a rallying cry for innovation? Do the upcoming changes to the healthcare system present an opportunity to reinvent your go-to market approach? Could your organization adopt a new habit of allocating a percentage of marketing spending for innovative pilots? • Selling a new idea: Can you “Velcro” a new idea onto an existing program? For example, can responding to customer complaints through online boards be positioned as an extension of the medical information call center mission? I found the practices in The Power of Habit to be habitforming. They’ve helped me rethink everything from my approach to exercising to how to spur innovation at extrovertic. I’m looking forward to applying these insights to some thorny compliance issues. So what (good) habits can you start applying? Thanks for letting us share.


Doctors Are from Mars and Patients Are from Venus Every year, the doctor–patient relationship is an issue that comes up at marketing planning time. What can marketers do to improve this seminal relationship? What new approaches can we try? This year I found inspiration on my bookshelf, in two seemingly unrelated books: How Doctors Think by Dr. Jerome Groopman and Men Are from Mars, Women Are from Venus (MFMWFV) by Dr. John Gray. Both books posit that the key to more productive r elationships is understanding the way spouses/doctors think and their emotional state. I was aware of medical school courses helping doctors understand patients. However, 2013 Planning helping the patient understand the doctor’s emotional state was a new concept for me.

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Groopman asserts that understanding Thought Starters the doctor’s emotional state could mean the difference between life and death. As he says,“ Typically, it is the doctor who assesses our emotional state. But few of us realize how strongly a physician’s mood and temperament influence his medical judgment.” Groopman urges patients to actively question the doctor in a non-threatening way. MFMWFV also contends that understanding the way the different genders process information and their emotional responses leads to more productive relationships. There are a lot of similarities between the two books. Consider the following two quotes from each book on how men and doctors deal with failure. MFMWFV How Doctors Think “A man’s deepest fear is that he is not good enough or that he is incompetent.” “Many doctors have deep feelings of failure when dealing with diseases that resist even the best therapy.”

To a certain extent, this is because the majority of doctors, particularly specialists, are men. But I believe that many women doctors would have the same thought patterns, developed during the notoriously hardcore medical training. Reading MFMWFV, I went through the book, looking for ways to apply the advice for communicating with men to improving the doctor–patient conversation. Here’s one of the ideas I came up with: So my advice is that if you are looking for a fresh way to approach an intractable marketing problem in 2013, look no further than your bookshelf (you might skip “Shades of Grey,” however). There is a myriad of books about starting a new life, sticking to a diet, and other relationship-building topics. Many of these can provide inspiration for helping patients with their health challenges in new and engaging ways. Thanks for letting us share. Dorothy


Who do you want your customers to become The phrase, “Who do you want your customers to become?” jumped out at me one day while flipping mindlessly through my e-mail. These words pointed me in a whole new direction in thinking about customers— both my own and those of my clients. So it hit me that the phrase might serve as a great thought-starter for 2013 planning. Who Do You Want Your Customers to Become? is the title of an e-book by Michael Schrage being offered by the Harvard Business Review. The basic premise of Schrage’s book is that new products and services transform customers. Each new product and service asks a customer to become someone different. One example Schrage gives is Facebook: 2013 Planning “Facebook asks its users to become more open and sharing with their personal information,” says Schrage. Another example is how the Prius brand asks customers “to evolve from Thought Starters merely being drivers to becoming ‘ environmentally responsible.’”

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Businesses can keep growing by asking, “Who do our customers want to become?” and helping them get there by strategically investing in customer capabilities. Invest in customers because, as Schrage puts it, “Your future depends on their future.” So it’s essential that marketers/innovators understand and support what their product/service asks their customers to become. This concept seems to have special relevance to pharmaceutical marketing because, after all, don’t our medicines transform patients into healthier people? Don’t our relationship marketing programs foster education and adherence? It seems to me that the question of “Who do you want your customers to become?” has a lot of application in our 2013 plans.

So I ask you; what does a good pharma customer look like now and in the future? Patients: Someone good at self-advocacy? One who can effectively conduct research online? One who knows how to build a support network, on- and offline? Physicians: A physician who can effectively navigate the transition to electronic medical records? One who can effectively communicate with patients? One who can convince managed care organizations to authorize the use of a Tier 3 medication only when medically necessary? Emerging customers: What does a pharmafriendly Patient-Centered Medical Home (PCMH) or and Accountable Care Organization (ACO) look like? Once you have a vision of what a good customer looks like, both now and in the future, you can start to think about investments that your brand can make to help these customers along the way. Perhaps a program that teaches patients how to be better online researchers is one example. The question also provides a useful way to consider the effectiveness of planned innovations. For example, do you have an app scheduled to launch next year? Schrage would urge you to consider how the app will make the customer more valuable. Do patients and physicians become more valuable because you can reduce the amount of paper-based education you provide? Can physicians offer a higher level of patient care? If the answer is yes to any of these questions, what can you do to accelerate the proper use of the app to achieve these benefits? There are lots of great questions and exercises in the book that broaden one’s approach to meeting customer needs. So I am asking you to become more of a change agent in your organization: ask yourself what new questions you can ask your team in your 2013 planning sessions. Thanks for letting us share.


What’s your brand’s sound? What does your brand sound like? Like me, you may not have an answer to this question. However, after chatting with CORD, a music planning and buying agency that specializes in sonic branding, I realized that I was missing out on a critical branding and marketing element. Consider the following uses of sound: Sound as confirmation of functionality: Think of the camera click that occurs when you take a screenshot on an Apple computer or the swoosh sound that confirms your e-mail has been sent Sound as a product experience: You know that satisfying crunching sound you get when you’re eating potato chips? 2013 Planning According to my friends at CORD, 80% of a person’s perception of that crunchiness is the result of sound rather than mouth feel

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Sound as a reinforcement of brand attributes: Consider the sound of an electric toothbrush. When one manufacturer redesigned the buzzing sound of its toothbrushes to more closely communicate “clean, gentle, and white,” sales jumped Sound may become a more critical branding element as more of the physical world goes digital. One of my favorite examples is Barclaycard, which utilizes sonic branding to compensate for lost branding opportunities as people have started to pay for goods using their smartphones instead of their credit cards. This started me thinking of the branding opportunities that may be declining in the pharmaceutical arena. How about the sound of a rep’s voice? According to industry figures, the number of pharmaceutical representatives in the US has declined 30% in the last 5 years. So perhaps sonic branding is something to consider in 2013 planning and beyond in order to fill the void.

It is surprising that music/sound has been such a missing link in the healthcare marketer’s toolkit. Consider music therapy, which is defined by the American Music Therapy Association as “an established health profession in which music is used within a therapeutic relationship to address physical, emotional, cognitive, and social needs of individuals.” Included among music therapy’s uses are alleviating pain, counteracting depression, inducing sleep, and promoting movement for physical rehabilitation. Clearly, sound has a relevant place in healthcare. So how can sonic branding be used in 2013 plans? Here are some thought-starters: Incorporate music into your relationship marketing programs. What if your e-mails came with different sound elements corresponding to the different time-points in the patient journey? For example, you could embed an encouraging 4-note tune in e-mails that are meant to encourage patients at tough points in their treatment. Or, use a song that helps convey a “You did it!” message once they’ve successfully completed treatment Use sound to brand a video series, whether it’s product- or condition-related. Video is an increasingly important venue for healthcare communication. Think about having a consistent look, feel, and sound for your videos Think about the sounds associated with a disease state, say coughing or heartbeats: What could be a sonic signal of improvement? Can certain sounds be associated with progress? Even if you don’t engage in sonic branding per se, thinking about what your brand sounds like and having everyone on the team bring a song or artist that represents your brand, could help people get on the same page as to what the brand stands for. You could at least start to answer the question, “What does my brand sound like?” So, when it comes to incorporating sonic branding into your 2013 planning, does anything ring a bell? Thanks for letting us share.


The Multicultural Tipping Point Last May when the 2011 census results were released, a historic milestone was reached in American demographics: For the first time, the US had more minority or mixed-race newborns than non-Hispanic whites. In a recent Time article, William Frey, a demographer and senior fellow at the Brookings Institution, said, “This is a fundamental tipping point signaling a change in our demographic structure for decades to come.” So the question for 2013 marketing plans is, does this represent a tipping point for how multicultural marketing is incorporated into the planning process? Most pharmaceutical companies have dabbled in multicultural marketing for many years, including setting up separate multicultural marketing teams. However, these multicultural 2013 Planning teams were often underfunded and needed to sell their programs to the brand teams. Even when the multicultural teams could provide successful pilot program data, the Thought Starters brand teams often hesitated to commit funds outside of their span of control. And when multicultural marketing programs did make it through the budgeting process, those programs were always first on the chopping block at budget-cut time.

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But those were fatter and happier days for pharma. When your billion-dollar brand grew 10% or more year after year, why bother with an incremental $50 million business opportunity? The pharmaceutical marketplace has changed in the last 5 years to the point that no possible business opportunity can afford to be wasted. Witness the phenomenon of “Mature Brand” or “Established Business” departments that are breathing new life into old brands and building the bottom line. Could multicultural marketing be the next wave for unrealized brand growth?

To fully leverage the opportunity in a cost-effective way, you have to be able to answer the question, “How much should be invested in multicultural marketing against what target with what messages and what channels?” Here are some questions that can become part of a 2013 learning plan to guide your investment decisions: 1. B  usiness Opportunity—What is the size of the business opportunity? 2. T  arget—Do multicultural patients approach health issues differently than the general market patients in their disease state? 3. M  essage—Do the current messages in your communications resonate with the multicultural patient? 4. C  hannel/Tactic—Does your current media and tactical plan reach the multicultural patient? 5. P  artnerships—Are there organizations that could help accelerate access and the impact of your efforts? The road to effective multicultural marketing is full of pitfalls. As you attack these questions, don’t forget to bring the rest of the organization along with you. Because when you think multicultural, you should think multifaceted, too—the way these patients are portrayed is often an emotionally charged and personal issue, both inside as well as outside of your organization. Thanks for letting us share.


Ready for 2014? Part of what any marketing plan should do is lay the groundwork for successfully addressing upcoming challenges and opportunities. In 2014, The Patient Protection and Affordable Care Act will take effect. What is in your 2013 plan that is going to get your business ready for the changes that will take place in 2014 and beyond? There is no way to cover the entirety of the act and its implications on pharmaceutical marketing in a 500-word blog post. However, here are some topline thoughts: First, it is important to understand the purpose of the act, which is to expand coverage and improve the quality and affordability of healthcare. Some of the key mechanisms in the act for doing this are: • Linking physician compensation to patient outcomes and quality-ofcare measures • Broadening the base of venues that provide care (for example, the act provides for a $50 million grant Thought Starters program that will support nurse-managed health clinics) • Expanding health insurance coverage to an additional 30 million people, one-third of whom will receive it through an expansion of Medicaid • Providing information that enables patients to make better healthcare decisions • Encouraging and enabling physicians to track and report healthcare data 2013 Planning

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Some of the implications of these changes that spring to mind are: 1. How can you help PCPs manage their increased patient load? This increase is happening at the same time we are experiencing a dramatic shortage of PCPs!

2. What HCP targets and venues should you add to your promotional plan? Pharmaceutical companies have only dabbled in reaching out to nurses, NPs, and PAs. Given the shortage of PCPs, it seems inevitable that these groups will become more influential. 3. How can you retool your patient adherence programs to show real patient outcome data? Consider the WellDoc diabetes app, which has been clinically shown to improve A1c levels. If a small company can invest in a clinical trial to prove their program works, why can’t a pharmaceutical company do the same? 4. Looking at the requirements for the meaningful use of electronic medical records, how can you help a physician show how his or her efforts are helping patients to engage in their own care? Although there are many more implications of the act, the important thing is to, well, act! Start thinking about what the new law could mean for your business and how your brand can leverage the opportunities into a competitive advantage and start piloting. Thanks for letting us share.


Planning 2014