Securing Doctors’ Trust – Has Indian Pharma Lost The Plot?
Doctors and pharma are the pillars of a solid healthcare system, sharing a common goal of curing disease and saving human lives through the best possible treatments. However, their relationship seems to be in the doldrums of late. Physicians do not trust the information provided by Indian pharma companies and most believe that the industry’s loyalty rests with its investors rather than patients. To restore doctors’ faith, pharma needs to make some radical changes in its practices. Apart from taking a firm stance on ethical and quality issues, it must revisit the way it connects to and communicates with healthcare professionals.
Why Don’t Doctors Trust Pharma Anymore?
- Ethical and quality issues – Recent news states that 200 Indian pharma firms have broken the government cap on prices of life-saving drugs. Negative media reports at the international level have added fuel to the fire. Stories abound of pharma-sponsored research resulting in an epidemic of misinformed physicians. Drug manufacturers have been accused of tampering with results of clinical studies at every stage of the trial, be it design, analysis or publication. There have been reports of companies hiring ghost writers for their clinical studies and playing down harmful effects of drugs. Some have even been accused of planting doubts about rivals’ products. These acts have led many physicians to dismiss industry-funded clinical trials and research. Bribing investigators and selling unapproved drugs are some of the other pharma practices that have created distrust.
Nomura Research reported that 27 Indian drug manufacturing plants received warning letters from the USFDA between 2011 and 2016. One of the latest instances is the warning letter sent to USV Ltd. in March, accusing the company of violating data integrity and sterility testing norms. These cases are making doctors question pharma’s commitment towards improving healthcare outcomes.
- Incentivizing prescribers – It is highly ironic for pharma to expect the trust of a community whose loyalty it has always incentivized, monetarily or otherwise. Doctors have always received messages from pharma on how prescribing a particular brand will benefit them rather than their patients. It is a well-known fact that the grandeur of major Indian medical conferences is facilitated by pharma industry’s sponsorship. Pharma marketers are known to hire services of eminent medical personalities to influence other doctors with respect to their products. Such practices eliminate all possibility of trust in pharma’s relationship with clinicians.
- Lack of trust-building content – Traditional ways of engagement like field force visits to doctors’ offices and third-party surveys fail to lend pharma marketers deep insights into the concerns and queries that arise in doctors’ minds while making a prescription decision. Therefore, their marketing content falls short of addressing all skepticism. Doctors have no time or inclination to interpret the long, statistical content presented in clinical study reports that are given out to them. It becomes very difficult to secure the trust of someone not fully convinced of the safety and efficacy of a new product.
- Ineffective communication – A survey conducted to understand the online behavior of Indian doctors reveals that 76% believe the internet to be a great source of information. Online media has made possible the instant dissemination of all negative news around a drug or its manufacturer to the doctors. However, pharma’s lackadaisical approach towards adopting a digital engagement model restricts it from presenting its side of the story to the medical community. By not dousing out the fire in time, pharma helps the distrust to grow to such a level that it gets deeply ingrained in the doctors’ psyche.
Pharma needs to take immediate steps to reinvent its relationship with doctors and reestablish itself as an equal partner in improving patient outcomes. This can be achieved only through real, systemic and cultural changes in the way it functions and interacts with physicians.
How Can Pharma Win Doctors Back?
- A zero-tolerance policy on ethics and quality –A culture of ethics and quality that has so far been grossly neglected by the Indian pharma sector should now be taken up on a priority. Top level executives need to take onus for this and work towards making ethics a part of their organization’s DNA. Pharma companies often project a lopsided image of their products, leaving doctors with no choice but to look for other, more balanced sources of information. However, there is a possibility that these sources cause more harm, and in fact, perpetuate the doubt in doctors’ minds further.
A wiser move would be for drug makers to provide full disclosure of the clinical trials themselves and also score some points over competitors in the process. Indian firms should follow the example of GSK, which, a few years back, made a bold move by opening its clinical trials data to scrutiny by external scientists. Pfizer also made news when it began declaring all payments made to physicians for clinical trials. To ensure quality, pharma can devise early-warning systems that catch all cases of data transgressions, accurately identify the root cause and ensure fool-proof remedial actions for fixing the issue.
- Educate, not sell – Pharma needs to let go of the ‘salesy’, molecule-focused messages that have, till recently, been the hallmark of its communication strategy. A better approach would be to initiate discussions around the disease characteristics, therapeutic areas and treatment approaches.
The industry should focus on educating its audience through its expertise and scientific data and reposition itself as an enabler of the best prescription decision. This will ensure a far deeper engagement and a longer relationship that is based on shared goals rather than incentives. Pharma companies could also partner with professional associations such as physician bodies to execute mutually beneficial activities that improve medical outcomes by creating a more informed healthcare professional.
- Establish continuous engagement – Traditional communication models focus on connecting with doctors only at seminars and conferences or via field force visits. On the other hand, digitization facilitates multiple touchpoints that enable pharma to occupy physicians’ mind space like never before. Using digital tools, pharma can work more closely with all healthcare stakeholders and efficiently disclose outcomes of clinical trials to the parties concerned. Data-driven insights can even help pharma customize its communication as per the needs of specific audience groups.
Through careful evaluation, pharma should pick the most effective digital channels (websites, mobile apps, social networks, etc.) and leverage them to engage with physicians at every stage of the product’s lifecycle viz. disease awareness, product launch, product maturity, etc. An engagement which is consistent and based on a dialogue (not monologue) will help marketers pinpoint the exact reasons for the distrust and resolve them in no time. A sound content marketing strategy thus holds the key to rebuilding trust.
- Deliver real value – Pharma needs to wake up to the fact that today’s digitally-connected doctors have other means to update themselves on drugs. In fact, the medical community is now empowered to choose the type of content it wants to consume, when it wants to consume the content and from where. Pharma’s relevance now depends on whether it can offer real value to doctors. It is a fact that most doctors do not possess statistical savvy to interpret complex clinical data. Herein lies the opportunity for pharma to add value by providing simplified yet balanced analyses of clinical trials and the effectiveness of various molecules.
Pharma should strive to fulfill doctors’ information needs. It is observed that medical professionals wish to be informed about industry developments, research and educational opportunities and patient education materials. Such value add is possible only when pharma accurately understands its target audience, specifically its opinions, perceptions and pain points. This is rarely possible in the brief interactions that sales reps have with physicians or the surveys that they conduct through traditional channels. A digital connect can supplement these physical meetings and help pharma conduct a mindset analysis on its audience.
- Use 3rd party aggregator platforms – A 2015 survey conducted by Ipsos MORI in Europe, revealed that up to 40% of doctors do not trust disease management apps and other online resources developed by pharma companies. This perception seems to hold true closer home as well, with proprietary resources (Ciplamed, Knowledge Genie) gaining only moderate success. Also, there is a limit to the number of individual apps that clinicians can have on their mobiles. 3rd party aggregator platforms like Docplexus remove the element of bias and bring together a large number of medical practitioners belonging to different specialties on a single platform.
To conclude, Pharma’s ethical misdoings and an outdated communications approach have cost it the trust of its most important consumer group – the prescribers. While undoing the damage is not easy, it is not impossible either. A serious commitment to ethics coupled with a new engagement model can turn the tides in pharma’s favor and help it regain its lost glory.