4 Practical uses for a Wiki in Pharma

You’ve lived and experienced the nightmares associated with document management and collaboration in an enterprise environment. E-mails follow multi-branched and reply all paths. Spreadsheets and Word documents get passed around and everyone asks – “do I have the latest version?” Or what about the times when you need a new job posting on your corporate site or to perform an urgent update to content. Do these problems sound like your organizations? Even worse do you have a over burdened process that governs what you need to do to make simple changes?

Enter the wiki: collaboration software that solves all these problems yet, unlike many traditional content management systems, remains simple enough for non-technical employees to use.
Although wikis have been around for a decade, they're just starting to take off in business. Like the Web did when it first caught hold in the corporate world, wikis will likely go through a period of wild growth, fierce competition, and inappropriate usage. Proceed with caution. Any “crazy” technology will cause undue distress amongst your management team. Baby steps are usually best for “crazy” technologies. Likewise as you all know making the business case is just as important. That said, I’ve outlined 4 practical (or crazy) uses for Wiki’s below that will help align a powerful collaboration tool with emerging business needs for the pharmaceutical industry.

• Create an internal communication portal: Prior to wikis, an expensive enterprise application would have been required for sophisticated information management. But because most wikis are based on open-source code, they're free for companies who opt for an open-source distribution, or relatively cheap for companies willing to pay for their implementation and support. That said portals are implemented very often in pharma companies. For example marketing teams are asked to develop a communication website specific to a particular brand that will help align all internal messages regarding one or multiple indications. Typically when marketing types are asked to create web sites, they have to rely on the chance that someone in a group knows how to make a web site, or that some sort of training is available or even worse spend several thousand dollars to get a static website from an interactive agency. The wiki eliminates all three obstacles, because it provides a ready to use site with a simple user interface, ability to easily add pages, and simple navigation structure. Imagine a wiki that would allow the marketing people to concentrate more on strategy and content development, instead of trying to learn how to put font tags around a section of text. The simplicity of the wiki syntax, or language for formatting text, inserting images and creating links, means your employees spend less time trying to figure out how to make the site do what they want. Easy and empowering
  
• Develop a peer reviewed paper: Publish or perish. That’s the tenant that many researchers live by. Publishing is the main vehicle to advertise the positive (and negative) effects of a particular drug, however often times the peer review process is tainted with inefficiencies and lack of a true peer review. A wiki makes it easy for researchers to write, revise and submit a manuscript, since all three activities can take place in the wiki. Imagine a researcher that is provided access to a wiki page to develop an outline. First the researcher will begin by tracking their background research and bibliography. This allows the fellow researchers, to see what they’re using, help them if they’re off track, suggest other resources/searches, or even get ideas based on what others find useful. Next, the researcher can draft the paper in the wiki, taking advantage of the wiki’s automatic revision history that saves a before & after version of the document each time s/he makes changes (sound like EDMS). This allows the peers to see the evolution of the paper over time, and continually comment on it providing transparency. When the researcher completes the final draft, admins and/or agencies can ready all elements of the manuscript for submission to a journal and/or congress. Efficient and transparent.
  
• Simplify the maintenance of processes: Just about every pharma/biotech company I’ve worked with has an emphasis on process, however they face 2 challenges in their change management efforts of a process: a) getting buy-in from all who use the process and b) effectively implementing changes and distributing a consistent communication stream to all involved. Imagine a wiki where processes are published for the entire organization. Say the process for reporting expenses is slightly inaccurate and Judy from accounting makes a recommended correction. The process excellence folks see the error and republish the change. Now the challenge, disseminating the change effectively. Imagine then all users who have been trained on the process are distributed an alert and notified to refresh themselves on the revision. This collaboration happens automatically without any human intervention. Impactful and lean.
  
• Track emerging regulatory trends: The need to track emerging pharmaceutical trends, especially regulatory ones is a need that pharma companies pay millions for in subscription based services every year, while their most important resource – their people – already have this information in small doses. Built together in a collaborative workspace such as a wiki, a pharma company can be nimble in addressing emerging trends. For example in the news as of late was a re-hash of the PHRMA ethical guidelines. Imagine an internal wiki where a researcher places a notice about the amendment that he/she read on a blog. A medical writer who recently attended a conference posts a slide kit that was posted by a leading opinion leader in the regulatory space. All this in a centralized location where users can sign of real time alerts to get the data. Powerful communication without having to pay for it.
  
  Stay tuned for my next post – Why a Wiki wouldn’t work for you…
  
  About the author –Hassan Mahmud is a Principal of WEKGroup, LLC a project and management consultancy specializing in forward thinking and technology adoption within the pharmaceutical industry. He is an early adopter of lean process management and has implemented Wikis at leading pharmaceutical and professional service organizations. For more information on Mahmud and WEKGroup’s services, you can visit them online.

Internet Killed the Pharma Sales Star

Well it doesn’t exactly roll off your tongue like the iconic hit, Video Killed the Radio Star by the Buggles, but the title is perhaps foreshadowing to the inevitable…the reduction of pharmaceutical sales rep and their role in the drug marketing process.

The infamous Accell report (“Through Our Customers Eyes”) find many revelations in regards to pharmaceutical sales and marketing. There is lots of data in the report, but my key takeaways include –

• Between 1995 and 2000 the number of pharmaceutical sales reps almost doubled, yet the sales generated were not nearly proportional to the increase in reps


• About 10 years ago, adding a rep to the sales force yielded 750,000 visits per year. By 2000, the number dropped to just 17 visits per year. Today, more than 90,000 drug reps compete for the attention of 768,500 doctors.


• For every 100 visits, only 8 reps succeed in speaking to a physician and being remembered.
  

What gives? Did drug companies loose sight of the value that solid pharma reps provide to the physicians? Is the proportion of reps to physicians at its saturation point? Do the physicians simply no longer trust a typical rep? I believe it to be a combination of the later and the three major reasons why eDetailing is on the forefront of many product manager’s minds and also of execs with companies such as Pfizer, Seprocor and GSK who have slashed their sales forces. Bob Dylan said it best…Times are a Changing.

Against the backdrop of the Accell report, electronic detailing (eDetailing) has emerged as an increasingly popular alternative, with 31% of physicians participating in eDetailing according to Forrester Research. For more on eDetailing see (en.wikipedia.org/wiki/E-Detailing).

So will eDetailing kill the pharma star? In my opinion most likely - in due time of course. Like many industries, methodologies and processes, the internet and technology have revolutionized how people do things. Traditional drug detailing is no different. Today’s physicians have less time, are embracing technology and want to talk science. Studies indicate that physicians do not listen or care for pharmaceutical reps. The most impactful value proposition that a rep provides is samples.

There are research firms out there that walk a fine line on this issue suggesting that both eDetailing and traditional detailing can co-exist in harmony by allowing the reps to focus on details for “willing” physicians and leave eDetailing for the hard to reach folks. That doesn’t make a whole lot of sense to me. Why not use the eDetailing machine to detail all physicians in a consistent, ethical and regulated manner yielding better educated physicians who can make the right therapeutic decisions. There’s also the potential of adding eSampling to this whole mix! On the flipside there is something to be said about relationship building between the rep and a physician for the pharma company, but as a consumer that’s exactly what I’d like to not happen.

Let’s face it, regardless of how unbiased a rep is, it’s in his/her best interest to spin the data and facts in favor of the company that they work for. If Joe Rep is counting on a huge bonus around the holidays to pay for his wife’s new Tag watch, Joe Rep is going to say and do what he has to, to establish credibility with the physician to net more prescriptions. You may want to take a look at a recent New York Time article (Dr. Drug Rep). The article is an example of the types of behavior that has shed severe scrutiny on pharma sales reps and the traditional marketing process.

Pharma companies are smart…really smart and are facing other promotional issues such as ghost writing, CME, and patent expiration for small molecules. Add the pressure of cost cutting and mergers and you get a perfect storm begging for a clearing. Enter eDetailing. It’s not the answer to all of pharma’s problems, but just may help them sing a different tune and revolutionize medical promotion by enhancing reach and message quality, while performing details with the highest integrity. Perhaps that tune would be Honesty (Billy Joel), or I could be completely wrong and we’ll all be singing Dream On (Aerosmith).

Stuck in a Moment – Web 2.0 Practical Uses, Edition 1.0 - Star Search

First in a series of 4 Editions.

Enough already…I’m tired of reading and hearing about Web 2.0. Now they’ve even got the Web 3.0 thing. Why doesn’t someone actually tell me how to apply Web 2.0 methodologies that aren’t going to make me look like an idiot in front of my colleagues? I’ve had consultants come and lay out a grand plan, but it’s not practical in my business. HELP! It’s on the way, this is the first in a series of 4 editions that will provide real world practical examples of how to use Web 2.0 methodologies within you enterprise.

Before we start…the reason you know so much and have heard so much about Web 2.0 is because of Web 2.0. In one word it’s about community. If you want more background from every crime fighter in the world, Google ‘Web 2.0’. Also want to state if you and your team(s) are ever going to evolve then there will be a time where you have to leave your comfort zone. Generally smaller corporations are more successful in implementing Web 2.0 techniques because they have little or no money have to be creative. When you’re a multi-million dollar enterprise, it’s hard to go against the grain to think that you will do better because of a new methodology…change is slow, so baby steps are key. There are so many experts that could go on and on for days on this topics, but let’s get to Edition 1.0.

Edition 1.0 – “Star Search”

I loved Star Search – the Ed McMahon version. Ed had a tendency to be able to find the best of the best and the worst of the worst (for entertainment value of course). Ed was way ahead of his time – only if he had found William Hung as a youth (she bang). Even back in the Mid 80’s Ed knew for his show to be successful he had to showcase and develop real “stars” - whether they could tap dance, sing or my personal favorite juggle bowling pins a-fire.

The industries I’ve worked within, at times have felt like Star Search because their success was heavily contingent on the “stars” that they found and promoted. With broader adoption of technology and a trend to move things off shore, getting the right people and the right mix is not an easy task, not to mention the cost of fees associated with procuring the people or setting up an in-house recruiting department. If you’ve done this, ask yourself how much return are you getting on the later resources? I mentioned earlier, in my opinion the core concept of Web 2.0 is community. Why not turn to the community that surrounds you. YOUR EMPLOYEES!

Heck your employees are already recommending folks on sites such as LinkedIn and Plaxo. Imagine if you set up a simple database or utilized one of your existing technologies to track potential “stars” – if you’re small enough I’m sure email could be used as well.

Let’s play this theory out in an example. Let's say Ed is looking for a Bear Trainer for an upcoming special that has experience with training bears on how to fire juggle. Ed has been searching for months for this position and either all the great bear trainers are happy in their current jobs or the ones available lack that pizzazz. Running out of ideas, Ed posts on the Star Search blog (just pretend there were blogs in the 80s) that he desperately needs assistance in finding a Bear Trainer for tomorrow’s show. Anatoly one of the gaffers sends Ed the name of two Russian bear trainers that he worked with on the Russian equivalent of Star Search. It works and Ed gets his bear trainer for the upcoming special. Fewwww…..Ed ponders for a moment, “I didn’t even know this Anatoly existed”. Realizing the potential on internal networking, Ed starts a corporate campaign to reward (not just financially) employees that help acquire talent for his shows. In fact he starts gathering “LinkedIn” type information internally providing a sustained stream of talent for the show. This internal networking then spawns an opportunity to begin syndicating Star Search in Germany where it become wildly popular due to the special host David Hasselhoff….on and on and on…

You get my point, talent is paramount for an organization and can be found sometimes in non-traditional formats. Why do I cite such a silly example? 1) for the obvious humor factor and 2) this example works, regardless of how specialized or obscure the skill sets you are looking for.

End of the day Ed’s paid out little or no money for a referral service, which probably provides candidates that are just as qualified, if not more than the ones brought in by 3rd parties or service oriented departments, because the people doing the recommending know what it’s like in the trenches. One thing Ed will need to be mindful of is “group think”. Innately his employees will recommend people like themselves, which breaks the diversity needed within an organization...regardless, if Ed adds this tactic to Star Search’s recruiting strategy, it just may save the studio money and get better talent more efficiently…your opinions welcome.

Look for Edition 2.0 coming soon.

Disclaimer: The examples in this series are for illustrative purposes only and much rigor would have to be applied to actually implement a Web 2.0 based Star Search application within your enterprise. You are correct Sir!

The Ghosts in the Machine

In my opinion ghost writing is one of the most pressing issues that pharmaceutical and biotechnology firms face today. What better topic for Halloween….

What is ghost writing? According to CBC News: The practice of drug companies procuring professional medical writers to draft articles endorsing new medicines and presenting them to prominent doctors and scientists to put their names to, in exchange for financial (or other) compensation. So what? Who cares?

Let’s put this into context.

Fast forward…
Your father has severe plaque psoriasis and has had it for years. He faces issues with depression, discomfort and unsightly scaly skin. He’s taken every conventional therapy available. He’s sat under UV lights. He’s worn long sleeve shirts as long as you can remember. Essentially he has let psoriasis run his life and accepted there is not cure for the auto immune disease. Now imagine that there are 3 drugs at the disposal of your father’s dermatologist which could potentially help your father’s conditions. Your father’s dermatologist prescribes a biologic, “intolumab”, that has been proven to be very effective in treating psoriasis. The reason: Your father’s dermatologist read of the positive impact of intolumab in a prominent medical journal that was written by a prominent dermatological researcher Dr. Frankenstein. Your father begins treatment and finds out after 2 years of very costly treatment, his psoriasis is no better than it began. He’s had to pay approximately $4K out of his own pocket and his morale is lower than ever. I can hear him rumbling something about ghosts…

Rewind…
6-8 years where research is being conducted in phase II clinical trials for intolumab, the future biologic therapy that will be used to treat your father. intolumab is meeting all safety and efficacy endpoints. Intolumab evolves through the clinical development process and right around Phase III or Phase IV of the process, intolumab’s manufacturer “Bio Odyssey” begin dreaming of the impact their emerging product will have on psoriasis patients. Bio Odyssey begins a “publication planning” campaign; bringing together a cross-functional team consisting of medical affairs and marketing to prove to the world intolumab is the best therapy for treating psoriasis. A communication strategy is developed outlining how Bio Odyssey will promote the effectiveness of intolumab to the world. (Let’s face it everyone reading…the purpose of this “strategy” is to increase prescriptions. I hope we can all agree on this point)! As a part of the communication strategy the cross-functional team develops marketing messages or “key clinical findings” as some may refer to them.

The team hires a medical communications (aka ghost writing) firm to help them draft the publications. The accepted role of the firm is to do research, work with the authors in an iterative manner to more efficiently produce the article. By the way this is absolutely legal and practical to garner the assistance of a medical writing company to help craft a manuscript, review article etc since many researchers lack the ability to draft professionally written articles.
The breakdown…
Along the process, all parties realize the publication will have significant impact on the dermatology community and the positive impact for intoumab. Bio Odyssey asks the medical writing firm to identify a prominent dermatologist to include as an author in the late stages of developing a manuscript. You guessed it…Dr. Frankenstein. Dr. Frankenstein does contribute in periodic reviews and posting comments for the “ghosts” to incorporate, however Dr. Frankenstein has not analyzed any of the data. The medical writing firm has accidentally forgotten to include important subset of data that shows intolumab being not as effective in patients who are 50 and older. Uh Oh Casper, what’s that you say your father is 62?

Do you see the dilemma here? It’s not my intent to make you think that all pharma/biotech companies and medical communications firms are real monsters that don’t adhere to ethical publishing practices. It’s my intent for readers to recognize that this does occur. Even if the occurrence of inaccurate information posed by ghost writers is minimal, it should be none since the core publishing principal is “publish only your own work”.

I’m scared are you? Who’s to blame? It’s complicated since there are competing principles all which have merit. Many observers tend to point the finger at pharma/biotech and the medical writing firms. Regardless of where the blame falls, I think we can agree that a solution is needed so my hypothetical father can live a better life with psoriasis. I think the question we should all be asking is how do we solve this problem and make sure all the ghosts in the machine are friendly. Interested? Stay tuned.

Disclaimer on “intolumab” and “Bio Odyssey” are completely fictitious. Any accidental match of current drugs or organizations is simply coincidence.