1. Digital Pharma: Evolution and Revolution in Marketing and Sales

2. l A decade of digital pharma l Targeting doctors l Targeting consumers & patients l Healthcare social networking Agenda

3. A decade of digital pharma

4. 19962007 Hype Raising expectations Disillusionment Trough of despair Enlightenment Productivity Realistic expectations Evolution vs revolution Evolution 2006 Revolution

5. Expectations ’96: The 24 x 7 rep – how wrong! Branded websites will be more effective than a rep visit Sales forces will be cut Revenues will soar Doctors will flock to our sites One-size fits-all portal will suffice

6. HCPs ’ media consumption shifting from off to online 85% of EU HCPs say the internet is critical for success of their practice* 16% of EU HCPs use a PDA for professional purposes* Professional use of digital media by European HCPs* % European HCPs *Taking the Pulse Europe v6.0; sample of 1024 doctors from D/F/It/Sp/UK; Manhattan Research, 4Q06

7. Quality content yes, but in an appropriate context Credibility and trust will be crucial Expectations ’96: Health information seeker – right! Internet will become the most preferred source of health and medical information Internet will become a powerful medium for patient acquisition and retention Patients will be empowered

8. Consumers’ favoured sources of health information moving online 143 million EU consumers have accessed health information or health services online during the last 12 months* Most frequently used sources of health information in Europe* % European consumers *Cybercitizen Health Europe; sample of 4302 consumers from 10 EU countries; Manhattan Research, 2Q07

9. Low digital marketing spend 1- 5% Digital pharma status 07/08 Industry remains a late adopter But solid experience and realistic expectations Too few digital-visionaries at senior level Moving slowly towards integrated solutions

10. Targeting doctors

11. Doctors generally prefer authoritative sources - medical societies, universities, hospitals A major challenge Doctors ambivalent towards pharma Doctors’ prime information needs focus on new research, clinical studies, case studies, continuing medical educational, networking with colleagues, cost constraints, running a surgery as a business,…

12. The sales force arms race

13. Result: ever decreasing detailing time USA: 1:30 mins Europe: 2 - 4 mins Number of sales representatives Detailing time 1980 - 2007

14. E-detailing is becoming a viable alternative l Convenient – access after hours and at weekends l Complements sales force l Average session times 8 -12 mins l Greater reach & better message retention l Documented +ve ROI

15. Live detail with tablet-PC Web-based e-detail Multi-channel CRM application Electronic details, interactions tracked and logged by CRM application Closed-loop marketing is next Interactive details customized to meet doctor’s needs Iterative detailing process

16. Engaging doctors can only be successful if… l Real needs and expectations are met l Focus is on integrated multi- channel services *Taking the Pulse Europe v6.0; sample of 1024 doctors from D/ F/ I/ E/ UK; Manhattan Research, 4Q06 Over half of EU HCPs expect online service today*

17. 30 – 50% of medicines prescribed for long-term illnesses are not taken as directed* Compliance is a major issue *Adherence to Long-Term Therapies: Evidence for Action, WHO 2003

18. Isolated compliance channels Patient SMS & mobile Pack & devices Contact centre Case manager VAT Internet & email Direct mail

19. Patient Integrated compliance channels Patient signs-up for ‘daily tips’ on coping with SEs Patient calls asking for advice about a severe SE Patient downloads a PDF on SEs management Application software accessed by a case manager All patient interactions and interventions logged Case manager alerted to SEs issue and makes appropriate interventions Secure patient database

20. Multi-channel integration plus behavioural modelling Smarter systems through incorporation of constructs from behavioural models Identify a patient ’ s risk level and propose appropriate interventions

21. Healthcare social networking

22. ‘An expert moderated repository of the knowledge base, in the form of a medical wiki, may be the answer to the world’s inequalities of information access in medicine…’* Web 2.0 is radically changing medicine and healthcare Dean Giustini, How web 2.0 is changing medicine, BMJ, 23 December 2006

23. ‘Is pharma ready for social networking?’ ‘… it appears that the forces of change would come from the consumers’ ‘Are social media dulling pharma’s marketing knife?’ ‘…it won’t be long before pharma realizes that it isn’t in control anymore…’ But pharma is still debating Source: www.forums.pharma-mkting.com

24. Web 2.0 is a disruptive technology Adapted from: Web 2.0 in Healthcare, John Sharp, Cleveland Clinic, USA Pharma values Web 2.0 values Risk averse Information from authoritative sources Privacy & security are regulated Long lead times Controlling access to data and information Intellectual property closely guarded Risk taking Crowd wisdom Anyone can join Rapid deployment Information contributed by and distributed to all Open Source

25. Pharma web 2.0 Public relations Consumers & patients Sales forces Internally: Enterprise 2.0 HCPs Disruption at all levels

26. Paradigm shift The doctor-industry relationship has the opportunity to become a true partnership based on mutual respect and collaboration Doctors can now dictate the terms of engagement to the pharma industry

27. 1/3 of consumers in USA consult a health SN site before visiting a doctor* UGC from health mavens can profoundly influence consumer and patient preferences Conversations are raging: patients are learning from one another www.revolutionhealth.com *Manhattan Research, 2007

28. Health warning to pharma marketeers Don’t fake it

29. Paradigm shift The industry must decide whether it wants to actively participate in the conversations or remain an outsider Consumers and patients are taking ownership of brands, diseases and conditions

30. Pharma corporate blogs are emerging J&J BTW blog J&J blogger Marc Monseau ‘Everyone else is talking about our company, so why can’t we?’

31. Pharma sales reps are the most visible active bloggers 5,000 threads 60,000 posts Rants & raves, corporate grapevines, jobs

32. The pharma marketing and sales revolution has begun