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Social Media and the Targeting of Influentials in Drug Marketing
--Guest post by Yuwen Yang, American University graduate student.
In January 2009, new voluntary pharmaceutical industry guidelines on marketing to physicians went into effect (David 2010), which emphasize disclosure and transparency regarding the relationship between physicians and pharmaceutical companies. They also require changes in how pharmaceutical companies market products to physicians.
New marketing strategies enabled by social media, however, are raising additional issues regarding guidelines and government oversight. In today’s technology driven age, pharmaceutical companies are finding themselves in an era of seismic change. Power is shifting from the advertiser’s voice to the voice of the empowered consumer. Social networking offers an effective -- if not also potentially uncertain -- two-way communication opportunity for pharmaceutical companies, physicians, and patients.
Opinion-Leaders: A Traditional Influence Strategy
Pharmaceutical representatives play a crucial role in helping companies promote their products. Part of a representative’s strategy involves token gift giving. Many physicians receive pens, notepads, and coffee mugs, all items kept close at hand, ensuring that a marketed drug's brand name stays top of mind for a physician. Additionally, if drug reps and physicians have a strong relationship, physicians may receive gifts such as travel tickets or silk ties.
Company representatives often develop working relationships with key opinion leaders among physicians, influentials who are especially effective at shaping the judgments of their peers. Pharmaceutical companies hire opinion-leading physicians to consult for them, to give lectures, and occasionally to make presentations on their behalf at regulatory meetings or hearings. The concept of an "opinion leader" was first introduced by sociologists Paul Lazarsfeld and Elihu Katz in their 1955 book, Personal Influence. They coined the term to explain the way that media messages were spread by way of opinion-leaders, who paid closer attention to the news and who via their personality strength and many social ties, then spread information among others.
Though critics argue that recruiting opinion-leaders among physicians is only about benefiting a drug company’s bottom line, others argue that opinion-leading doctors provide their peers with accurate and balanced information about the use, safety, benefits and risks of medicines, information that aids doctors in making decisions about prescriptions. Ultimately this benefits patients.
Social Media Strategies
Social networks like Facebook, LinkedIn and Twitter -- and hundreds of smaller niche websites--allow pharmaceutical companies to organize online communities aimed at u supporting and influencing physicians’ decision making. Platforms provide forums for physicians to discuss medical cases, treatment problems, clinical trials, malpractice issues and other popular topics. Within these forums, physicians with strong opinion-leading traits are likely to be the most participatory and vocal.
Many pharmaceutical companies have chosen to create their own websites to target physicians. For example, British pharmaceutical giant AstraZeneca established a digital department in 2009 and began formal operations in 2010. A website called "AZ Touchpoints" was designed and operated by its digital department. On the website, physicians can ask questions or order free drug samples. If physicians’ questions have not been resolved online, Touchpoints will offer counseling services by phone. In addition, physicians can also download self-training materials from the website.
According to medical reporter Kathlyn Stone, physicians have been considered the earliest adopters of mobile technology, beginning with beepers and pagers, telephones, smart phones, tablets and other digital tools that make patient case data and reference materials portable. Apps for the iPad and smartphones seem a ripe niche for pharmaceutical companies with so many physicians using electronic devices. Tablet PCs are shaping up to be game changers in the pharmaceutical field, they provide an excellent opportunity to develop new apps that appeal to physicians.
However, pharmaceutical companies are now hesitant to expand their use of social media. The Federal Drug Administration (FDA) recently drafted guidelines for using mobile health applications. Current regulations don’t specify what topics can or cannot be disscussed on social networks. Due to the popularity of social networks, a series of questions come to mind. For example, how do doctors avoid ethical or legal missteps in using social media? Who is responsible for the security of patient information?
The main goal is to protect consumers from being misled by emerging social media strategies. The FDA is concerned people will misread or misinterpret pharmaceutical information. The guidelines also mentioned that application developers should be required to strictly protect user's health information.
Within this uncertain and quickly changing regulatory environment, pharmaceutical companies are still trying to find the right way to use and track social media interactions. For example, a company that offers a "Brand Bodyguard" service monitors conversations about its clients on blogs, discussion boards and websites. The service also pro-actively creates positive content on the Web to edge out negative content. It is yet to be decided if this is an appropriate usage of social media by the pharmacetical industry.
--Yuwen Yang is a graduate student in the MA program in Public Communication at American University in Washington, D.C. Read other posts from her course on Public Communication Theory.
David, G. (2010). Limiting the Influence of Pharmaceutical Industry Gifts on Physicians: Self-Regulation or Government Intervention? 25(1): 79–83.
Fugh-Berman A, Ahari S (2007) Following the Script: How Drug Reps Make Friends and Influence Doctors. PLoS Med 4(4): e150. doi:10.1371/journal.pmed.0040150.
Emotional intelligence is a skill sought by many employers. Here's how to raise yours.
- Daniel Goleman's 1995 book Emotional Intelligence catapulted the term into widespread use in the business world.
- One study found that EQ (emotional intelligence) is the top predictor of performance and accounts for 58% of success across all job types.
- EQ has been found to increase annual pay by around $29,000 and be present in 90% of top performers.
Researchers hope the technology will further our understanding of the brain, but lawmakers may not be ready for the ethical challenges.
- Researchers at the Yale School of Medicine successfully restored some functions to pig brains that had been dead for hours.
- They hope the technology will advance our understanding of the brain, potentially developing new treatments for debilitating diseases and disorders.
- The research raises many ethical questions and puts to the test our current understanding of death.
What's dead may never die, it seems<p>The researchers did not hail from House Greyjoy — "What is dead may never die" — but came largely from the Yale School of Medicine. They connected 32 pig brains to a system called Brain<em>Ex</em>. Brain<em>Ex </em>is an artificial perfusion system — that is, a system that takes over the functions normally regulated by the organ. The pigs had been killed four hours earlier at a U.S. Department of Agriculture slaughterhouse; their brains completely removed from the skulls.</p><p>Brain<em>Ex</em> pumped an experiment solution into the brain that essentially mimic blood flow. It brought oxygen and nutrients to the tissues, giving brain cells the resources to begin many normal functions. The cells began consuming and metabolizing sugars. The brains' immune systems kicked in. Neuron samples could carry an electrical signal. Some brain cells even responded to drugs.</p><p>The researchers have managed to keep some brains alive for up to 36 hours, and currently do not know if Brain<em>Ex</em> can have sustained the brains longer. "It is conceivable we are just preventing the inevitable, and the brain won't be able to recover," said Nenad Sestan, Yale neuroscientist and the lead researcher.</p><p>As a control, other brains received either a fake solution or no solution at all. None revived brain activity and deteriorated as normal.</p><p>The researchers hope the technology can enhance our ability to study the brain and its cellular functions. One of the main avenues of such studies would be brain disorders and diseases. This could point the way to developing new of treatments for the likes of brain injuries, Alzheimer's, Huntington's, and neurodegenerative conditions.</p><p>"This is an extraordinary and very promising breakthrough for neuroscience. It immediately offers a much better model for studying the human brain, which is extraordinarily important, given the vast amount of human suffering from diseases of the mind [and] brain," Nita Farahany, the bioethicists at the Duke University School of Law who wrote the study's commentary, told <em><a href="https://www.nationalgeographic.com/science/2019/04/pig-brains-partially-revived-what-it-means-for-medicine-death-ethics/" target="_blank">National Geographic</a>.</em></p>
An ethical gray matter<p>Before anyone gets an <em>Island of Dr. Moreau</em> vibe, it's worth noting that the brains did not approach neural activity anywhere near consciousness.</p><p>The Brain<em>Ex</em> solution contained chemicals that prevented neurons from firing. To be extra cautious, the researchers also monitored the brains for any such activity and were prepared to administer an anesthetic should they have seen signs of consciousness. </p><p>Even so, the research signals a massive debate to come regarding medical ethics and our definition of death. </p><p>Most countries define death, clinically speaking, as the irreversible loss of brain or circulatory function. This definition was already at odds with some folk- and value-centric understandings, but where do we go if it becomes possible to reverse clinical death with artificial perfusion?</p><p>"This is wild," Jonathan Moreno, a bioethicist at the University of Pennsylvania, told <a href="https://www.nytimes.com/2019/04/17/science/brain-dead-pigs.html" target="_blank">the <em>New York Times</em></a>. "If ever there was an issue that merited big public deliberation on the ethics of science and medicine, this is one."</p><p>One possible consequence involves organ donations. Some European countries require emergency responders to use a process that preserves organs when they cannot resuscitate a person. They continue to pump blood throughout the body, but use a "thoracic aortic occlusion balloon" to prevent that blood from reaching the brain.</p><p>The system is already controversial because it raises concerns about what caused the patient's death. But what happens when brain death becomes readily reversible? Stuart Younger, a bioethicist at Case Western Reserve University, <a href="https://www.nature.com/articles/d41586-019-01216-4#ref-CR2" target="_blank">told <em>Nature</em></a> that if Brain<em>Ex</em> were to become widely available, it could shrink the pool of eligible donors.</p><p>"There's a potential conflict here between the interests of potential donors — who might not even be donors — and people who are waiting for organs," he said.</p><p>It will be a while before such experiments go anywhere near human subjects. A more immediate ethical question relates to how such experiments harm animal subjects.</p><p>Ethical review boards evaluate research protocols and can reject any that causes undue pain, suffering, or distress. Since dead animals feel no pain, suffer no trauma, they are typically approved as subjects. But how do such boards make a judgement regarding the suffering of a "cellularly active" brain? <a href="https://bigthink.com/philip-perry/after-death-youre-aware-that-youve-died-scientists-claim" target="_blank">The distress of a partially alive brain</a>? </p><p>The dilemma is unprecedented.</p>
Setting new boundaries<p>Another science fiction story that comes to mind when discussing this story is, of course, <em>Frankenstein</em>. As Farahany told <em>National Geographic</em>: "It is definitely has [sic] a good science-fiction element to it, and it is restoring cellular function where we previously thought impossible. But to have <em>Frankenstein</em>, you need some degree of consciousness, some 'there' there. [The researchers] did not recover any form of consciousness in this study, and it is still unclear if we ever could. But we are one step closer to that possibility."</p><p>She's right. The researchers undertook their research for the betterment of humanity, and we may one day reap some unimaginable medical benefits from it. The ethical questions, however, remain as unsettling as the stories they remind us of.</p>
Starting and running a business takes more than a good idea and the desire to not have a boss.
- Anyone can start a business and be an entrepreneur, but the reality is that most businesses will fail. Building something successful from the ground up takes hard work, passion, intelligence, and a network of people who are equally as smart and passionate as you are. It also requires the ability to accept and learn from your failures.
- In this video, entrepreneurs in various industries including 3D printing, fashion, hygiene, capital investments, aerospace, and biotechnology share what they've learned over the years about relationships, setting and attaining goals, growth, and what happens when things don't go according to plan.
- "People who start businesses for the exit, most of them will fail because there's just no true passion behind it," says Miki Agrawal, co-founder of THINX and TUSHY. A key point of Agrawal's advice is that if you can't see yourself in something for 10 years, you shouldn't do it.
After a decade of failed attempts, scientists successfully bounced photons off of a reflector aboard the Lunar Reconnaissance Orbiter, some 240,000 miles from Earth.
- Laser experiments can reveal precisely how far away an object is from Earth.
- For years scientists have been bouncing light off of reflectors on the lunar surface that were installed during the Apollo era, but these reflectors have become less efficient over time.
- The recent success could reveal the cause of the degradation, and also lead to new discoveries about the Moon's evolution.
A close-up photograph of the laser reflecting panel deployed by Apollo 14 astronauts on the Moon in 1971.
NASA<p>The technology isn't quite new. During the Apollo era, astronauts installed on the lunar surface five reflecting panels, each containing at least 100 mirrors that reflect back to whichever direction it's coming from. By bouncing light off these panels, scientists have been able to learn, for example, that the Moon is drifting away from Earth at a rate of about 1.5 inches per year.<br></p><p style="margin-left: 20px;">"Now that we've been collecting data for 50 years, we can see trends that we wouldn't have been able to see otherwise," Erwan Mazarico, a planetary scientist from NASA's Goddard Space Flight Center in Greenbelt, Maryland, <a href="https://www.nasa.gov/feature/goddard/2020/laser-beams-reflected-between-earth-and-moon-boost-science" target="_blank" rel="dofollow">said</a>. "Laser-ranging science is a long game."</p>
NASA's Lunar Reconnaissance Orbiter (LRO)
NASA<p>But the long game poses a problem: Over time, the panels on the Moon have become less efficient at bouncing light back to Earth. Some scientists suspect it's because dust, kicked up by micrometeorites, has settled on the surface of the panels, causing them to overheat. And if that's the case, scientists need to know for sure.</p><p>That's where the recent LRO laser experiment comes in. If scientists find discrepancies between the data sent back by the LRO reflector and those on the lunar surface, it could reveal what's causing the lunar reflectors to become less efficient. They could then account for these discrepancies in their models.</p>