Sunday, August 5, 2007

Winning trust and the era of Clinical trial 2.0

Trust is a very delicate word. It is about believing in the honesty and reliability of others. And trust is the very foundation of business relationships. When a doctor prescribes a product, no doubt it is efficacy, safety, purity, and availability of a product that matters; however, his decision to commit a prescription to a brand depends on the trust factor. When a doctor endorses, prescribes or orally recommends a product he believes in the reliability of the medicine or the healthcare product in the clinical situation. Trust is the greatest motivator of brand prescribing habits.

Today if something ails Pharma; it is a dip in the trust factor ratings. In fact, if World Bank can measure the Physical and Material Quality of Life and rate countries or states on this scale it will not be difficult for image building agencies, consulting companies, and soft skill specialist companies to come out with a measure for trust. Consider the recent happenings, Vioxx (rofecoxib) debacle and the Avandia (rosiglitazone) controversy; add to this pot pourii Pfizer’s la-affaire clinical trial at Nigeria - what does it all point to? A deep erosion of trust.


It is said people do business with people. It is relationships that count in the market. Trust is the cornerstone of successful marketing campaigns and relationships. All marketing endeavors work when bridges of trust are with prospects and customers. Marketing campaigns trigger of emotions and strengthen trust to forge purchasing or prescribing habits. Hence, it is said, brands are the covenants of trust.

Now after the Nigeria Pfizer's meningitis pediatric clinical trial fiasco, what is the level of trust that the corporate brand name Pfizer inspires? It is a question to introspect on. Western medicine is gaining taboo levels in Nigeria, with groups of people neglecting to administer even polio vaccine drops in the fear that it causes infertility.


The emotion called trust is exactly why the outbreak of social media is succeeding. A concerned prospect for a healthcare product would be interested in reading about a fellow obese individual’s experience with Alli or addiction potential of Corex the cough syrup, rather than the view put forth by the website of Alli or Corex, Pfizer’s premier Indian brand. In fact, vested interests, hidden agendas, and prejudices (of companies and executives) are responsible for the erosion of trust in certain modern medicines. Probably, if the marketing effort was subtle, and Vioxx was not positioned for chronic pain and its use was limited to acute pain (less than 3 weeks) – may be - Vioxx would have still been around. It is said FEAR AND GREED are the most potent motivators of human behavior. Vested interests and prejudices have their root in these emotions. It is the message boards, blogs, vlogs, and other web 2.0 appendages that have virally marketed or demarketed products. Rosiglitazone’s epitaph was written with web 2.0 technologies. Web 2.0 is helping create a leveling field for market operators. Messages are passed around at the speed of light.

REMEDIAL APPROACHES FOR TRUST BUILDING – social media assisted clinical documentation, Clinical trials 2.0, and other approaches:

a) One of the most important approaches for trust building is having a collaborative and two-way communicative approach with peer companies and other market entities as opposed to operating in silos.
b) Next, put information in to open domains.
c) Take clinical documentation, clinical experience records, case studies, clinical trials, Phase 4 post marketing surveillance studies to the web 2.0 level. Call it CLINICAL TRIALS 2.0. Create software tools and web portals where doctors, healthcare professionals, patients, and others can share their clinical experiences on the web and measure them using statistical tools, moderate them; build dialogues with the stake holders of healthcare and work out judicious solutions with a participative approach. This will insulate Pharma companies from Pfizer-Nigeria type fiascos. Particularly herbal companies will benefit from such a web 2.0 enabled clinical documentation approach. This will lead to better appreciation of folk based and traditional medicines by Big Pharma and the spin off will be a collaborative approach paving the way for better healthcare approaches. This type of a dynamic approach will lead Chinese Traditional Medicines, Ayurveda, Tibetan medicines to a new higher platform. And such a web 2.0 enabled clinical documentation approach may even lead to a new phenomenon called social media enabled clinical documentation. In fact, the recent meta-analysis clinical study that harrassed rosiglitazone was an example of an IT enabled clinical study. In a meta-analysis an actual clinical trial is not done. Clinical trial data is mined and studied using IT tools. And see the power of such an analysis. Avandia is shuddering. Now imagine if Google 2.0 offers a clinical documentation and analysis service. Pharma companies - better get savvy. It is a wired and interactive world.
d) Move away from a long patent life of products to a very short patent life. The bane of healthcare is that companies focus on gaining patents and evergreening patented healthcare products to protect huge profits and maintain monopoly markets. A shorter patent life will enhance innovation and marketing of products at a fair price. Companies will move away from a high cost R & D model to a collaborative R & D model, where R & D costs will be spread between various participants.
e) Create a global delivery model for sourcing raw materials from the most economical areas of the world; manufacture the products at locations where costs can be minimized, and pass on the benefits to customers by way of reduced prices of medicines. By this approach try and make drugs available at pennies to the end customer, and Pharma companies should continue to make dollar profits.
f) Pharma companies better get web 2.0 savvy, as social media is here to stay. Using the medium for building trust with prospects and customers is sagacious. Ignorance of the social media will not sweep the importance of social media under the carpet. Social media is here to stay, either wise up to it or get swamped by it. Google 2.0 will be the future of healthcare counseling, clinical trial documentation and clinical experience sharing. Remember, Google is one of the parents of web 2.0.

This is the 39th blogpost put up from my sister’s house, on Sunday, 5.8.2007. I invite readers to read all the posts including older posts. Today is World Closefriendship day, trust is the theme of this post, and I dedicate this post to my close friends I need their continued bestwishes and blessings.


Shankar said...

Good article

Sunil S Chiplunkar said...

Thanks for your viewpoint. Is your profile online? I can't access it.