Healthcare PR Blog

Healthcare PR in a Cost-contained World

With healthcare reform legislation signed by President Obama on March 23 2010, there's no doubt that along with changes to the US health insurance system, there will be a much greater focus on healthcare cost-containment in the years to come. Predictions on whether the impact of this legislation on the US pharmaceutical industry will be positive or negative are mixed.

What does this mean for healthcare public relations? Actually, on this issue, I'm bullish. I think there are a number of reasons why public relations has a major role to play in the changing healthcare environment, and I discuss them in a recent article I published in Communique Volume 16.

Most importantly, challenges such as communicating the very real differences between cost effectiveness as opposed to price when talking about a drug, biologic, device or procedure require the development of multifaceted, nuanced arguments. And public relations, more than any other marketing discipline, is best at framing complex issues, creating and mobilizing advocates and engaging in conversations with multiple stakeholders.

For these reasons, healthcare PR is alive and well in countries where healthcare cost containment has been in place for decades. As an American who lived and worked for eight years in the United Kingdom, you need only look at the vibrant, continuously evolving and highly creative UK healthcare communications agency business to see proof of that. 

There is no doubt that changes in the US healthcare system will place new pressures on the life sciences industry to communicate in different ways. I believe that as a result, healthcare public relations will become a tool that these companies will rely on more than ever before.

For a PDF of the article I published recently in Communique 16, click here.

--David Avitabile

FDA Practicing Stealth Comparative Effectiveness? What's So Stealth About it?

The In Vivo Blog has a very interesting discussion about a recent Pink Sheet/CMS Summit Panel discussion that suggested that the FDA may be  practicing "stealth" comparative effectiveness through an increasingly greater focus on superiority data (rather than, I presume, non-inferiority data). Read it here at In Vivo.

 The blog raises a number of interesting points, not the least of which is the question that is on many people's minds, including physicians, patients and industry: "is the FDA becoming too conservative?"

I believe that this question needs to be considered as part of the overall discussion, debate and analysis of issues such as the decline in new molecular entities, fewer first action FDA approvals, and fewer treatment options available for patients who need them.

A decline in R&D productivity has contributed to these issues to be sure, but I don't believe that industry is to blame for all of it. Open and honest discussion and debate is in the best interests of everybody, especially patients. 

--David Avitabile

Will Media Report how Ted Kennedy’s Life was Extended through Improved Technology to Fight Brain Cancer? Probably Not

Ok, I am backlogged on my reading, so what else is new?  If you are a healthcare public relations professional you are, by definition, behind on your reading!  If I can scan my newspapers, multiple news aggregators, and Twitter messages each day I’m ahead of the game.

 

However, I did take the opportunity to review PharmaceuticalExecutive’s Fifth Annual Press Audit.  While this appeared earlier this year, its findings are very relevant today, and will be valid until they field and report the 2010 press audit results. For those involved in healthcare communications and pharmaceutical and biotechnology public relations, these data are profound.

 

The PharmExec audit reveals that while articles covering pharma’s marketing, sales and other promotional practices have fallen, they have been replaced with articles about drug safety issues.  During 2008, Approximately 83% of articles focusing on pharmaceuticals and biotech were about drug safety concerns.  Negative articles about drug safety issues are at a five year high.  And, while overall media coverage of pharma is down, the majority of this coverage is negative, with only a small percentage considered positive (12%).

 

Considering these data, along with the ever increasing regulatory and political headwinds facing the pharma industry, we believe strongly that we need to restore confidence in the industry.  As leaders in healthcare PR and pharma marketing, we are proud of the work we do each day to raise awareness of new ground-breaking medicines and medical technologies.  We are passionate that pharma technology and R&D will contribute to cost savings in this era of healthcare reform and increased rationing. 

 

Many of our clients serve cancer patients and their families.  And, as we have witnessed today with the loss of Senator Ted Kennedy to cancer, the victory over this global scourge is still somewhere in the future. Senator Kennedy’s death is a terrible loss. However, we know that his life was extended months longer than it would have been just ten years ago because of the great strides we have made in the fight against brain cancer.

 

As healthcare communications professionals, I believe it is our responsibility to support a balanced portrayal of the pharmaceutical industry, and communicate with patients, legislators, the business community and the general public about its valuable contributions to extending and enhancing human life.

Town Hall Chaos, or Democracy at Work?

As a healthcare communications professional, it has been very interesting to witness the continuous clashes over healthcare reform between concerned citizens and our nation’s political leaders taking place at Town Hall meetings throughout the country.

First of all, I think a bit of perspective is in order. The United States has a long and colorful history of vigorous debate, ideological clashes and differences of opinion. Just read about the presidential election of 1800 between John Adams and Thomas Jefferson. Or read about the Whiskey Rebellion of 1794, where President George Washington decided to declare martial law and send troops to Pennsylvania to put down a rebellion of farmers opposed to federal taxes on whiskey. The new taxes were introduced as a way to pay down the national deficit, which was a real concern following years of war with Britain and massive borrowing from France, Spain and Holland to finance the American Revolution.

The current debate over healthcare reform, and the scenes taking place at Town Hall meetings throughout the US, is tame by comparison to these early struggles. Viewed in historical context, one could even argue that the current national scene is an example of democracy at work.

However, as the debate continues, neither side is communicating effectively. Supporters of reform seem unable to define clear, effective key messages. Political leaders are falling into classic traps by allowing themselves to be provoked and driven off message, and few if any seem to be prepared to handle the hostility that they are facing. On the other side, hyperbole, misinformation and shrillness don’t seem to be working either. The work goes on in Washington, and displays of hysteria at Town Halls could have the undesirable effect of marginalizing opponents of healthcare reform at a time when different views should be heard and considered.

Most rational people agree that the current US healthcare system is badly in need of reform. There are legitimate concerns over what shape healthcare reform should take, how much it will cost, and how it will impact the lives of ordinary citizens. Whether we succeed or fail hinges upon how well we as a nation can define the critical issues, engage all the stakeholders in this debate, listen to differences of opinion and create a shared understanding of the way forward.

In other words, we need to communicate.

Tort Reform Anyone?

Unless you missed it, on Friday, July 31, 2009, the Energy and Commerce Committee of the House of Representatives approved H.R. 3200 “America’s Affordable Health Choices Act.” This bill, which will require much more work, has successfully found more consensus than opposition.  It rests on a variety of reforms, most evident are underwriting practices of health insurers.

 

The devil is always in the details, so we can expect major debate over healthcare reform when legislators return from their August recess.  Based on current healthcare spending growth rates, most reasonable Americans understand that some form of healthcare reform will be required to stem the tide of rising healthcare costs. 

 

Healthcare communications professionals, the media and others who are following this debate are asking a number of critical questions. Will a new healthcare law reduce costs or raise costs?  How will such an extensive overhaul be funded? How will the insurance industry compete against a public healthcare insurance option?  Will healthcare reform harm the biomedical industry by hampering investment and innovation?  How will cost containment translate into rationing, and how will Americans react to government-mandated rationing?  Will the quality of physicians and care improve or deteriorate if there is a government-run system?

 

I have seen all of these questions raised by both sides, however, the major question I have not heard much about from either side (and perhaps I’m not listening hard enough) has to do with tort reform.  There just doesn’t seem to be much rhetoric or debate around allowing doctors to practice more preventive medicine and less defensive medicine. 

 

The point of healthcare reform is to reduce cost and improve access to quality healthcare for all Americans. An abundance of lawsuits against doctors, hospitals and insurance companies has had a massive impact on the rising cost of healthcare in this country. Yet the amount of media coverage on the issue of tort reform specifically as it relates to healthcare reform has been minimal at best.

 

A number of op eds have been published on the issue of healthcare reform, both for and against, and many of these have been pretty inflammatory depending upon the political stance of the writer. One of the very few op ed writers who has made a strong case for tort reform as part of healthcare reform is Charles Krauthammer in the Washington Post. Now let me be clear: I don’t necessarily agree with all of Krauthammer’s opinions on the issue of healthcare reform. However, he does raise the issue of tort reform, and the need for it, in order to reduce healthcare costs. On that issue, I believe he has a point.

 

There does need to be legal recourse for patients in legitimate cases of medical malpractice. However, for our leaders to focus on cutting out the waste and fraud in our current healthcare system while ignoring the very real need for tort reform as part of the overall healthcare reform package is disappointing.

 

Why haven’t we heard more about malpractice tort reform and capping malpractice awards?

 

Any healthcare reform will be a hollow victory without malpractice tort reform.

The Rhetoric of Healthcare Reform and Healthcare Communications

Last week, National Public Radio’s show “On the Media” discussed the language being used in the healthcare debate. Frank Luntz, communications consultant for the Republican party, shared tips from “The Language of Healthcare 2009: 10 rules for Stopping the ‘Washington Takeover’ of Healthcare,” a 28-page memo instructing the GOP on the best language to sway public opinion.

Both sides of the debate are utilizing highly potent words: “government takeover,” “rationed medicine,” and “ticking time bomb.”  Now, with little chance of movement until after the recess, politicians and stakeholders on both sides of the aisle have the month of August to continue stoking the heat on the healthcare reform debate.

As public relations professionals, we understand the importance of using language to drive awareness, change perceptions and influence behavior.  Words – beyond their denotations – are the most basic of the tools we use.  

Many in life sciences community will rely on the thorough review process of legal, medical and regulatory representatives to tone down or strengthen language as appropriate.  However, with the knowledge that comes from being a healthcare public relations professional, I believe we have a duty to communicate with honesty in all writing, before it even gets to our clients’ desks. 

Words carry weight. Acknowledge your influence, and use them responsibly.

--Maureen Miller

Telling the Human Story of Healthcare Reform

I read an excellent essay in The New York Times on Monday, written by a doctor about the shortcomings of our current healthcare system. In the Times essay, the doctor argued that the current system whereby doctors are paid based on how much they treat patients, rather than how well they treat patients, has created a battle for the soul of medicine. Why do doctors get into medicine in the first place? Is it really just about money? What about building relationships with and caring for patients?

What touched me most about this essay was its humanity. As the battle rages in Washington over healthcare reform, regular people caught up in the current system—doctors, patients, and yes, healthcare executives—are struggling with fundamental questions about why we’re all here in the first place, and how we might be able to make things better.

Call me an idealist, but I really do believe that there are good people on all sides of the debate, including the clients I deal with every day at pharmaceutical, biotechnology and medical technology companies. I would say that most of them have chosen to do the work that they do because they want to help people.

My greatest hope for healthcare communications professionals in this environment is that we can work with our clients to tell these human stories, and that the work we do can help remind everybody that the most important thing to remember is why we all got into this in the first place—to help people.

If we can remember that, I'm confident that we will succeed in creating a system that allows doctors to practice medicine with a focus on what is best for the patient, not how many tests and procedures they perform.

I want to thank Dr. Sandeep Jauhar, the cardiologist who wrote that New York Times essay, for sharing his story with us.

Diagnostics Companies Will Ride the Wave of Change

As US citizens hold their breath and speculate about how healthcare reform, personalized medicine and the shift toward prevention will impact them, I am certain that diagnostics companies are going to benefit more than most from the changes taking place.

Personalized medicine is increasing demand for molecular diagnostics that can accurately predict which patients will respond to a particular drug. Biomarker tests that can ensure a product will show some efficacy in the patients for which it is prescribed are therefore going to be in high demand. Drugs matched with biomarker tests can also translate into more rapid regulatory approval, albeit, possibly more narrow market potential.  It is also no coincidence that three Big Pharma players doing relatively better than their competitors are those with a major presence in diagnostics—Abbott, Johnson & Johnson and Roche.

G. Steven Burrill had a fascinating interview in the June issue of Life Science Leader magazine in which he talked about the future of healthcare, personalized medicine, changes in the pharmaceutical industry and the rise of diagnostics. In the article, Mr. Burrill predicts that the rise in personalized, predictive and preventative medicine as a result of healthcare reform is going to lead to a shift in diagnostics from being a high volume, low margin business to a high value, high margin business. Personalized medicine seems inevitable when you consider that according to some estimates, about 55% of the drugs consumed in America don’t work for the patients that they were prescribed for, and 80% of all approved cancer therapies fail to provide positive outcomes for many cancer patients.

What has been very interesting to see is how the evolution of our client base is keeping pace with the increasing importance of diagnostics companies in the healthcare marketplace. While JFK Communications has been providing public relations services to diagnostics companies since our inception, today approximately half of our client base includes diagnostics companies.

Diagnostic product public relations is every bit as challenging and engaging as pharmaceutical, biotechnology and patient advocacy communications. It requires an understanding of different regulatory pathways, complex commercial development, licensing and distribution environments, and a unique media universe that is changing and growing at the same pace as other media segments.  It also demands that we interpret and position our clients’ interests and messages in anticipation of looming healthcare reform in the U.S.

Double-digit Sales Growth, Robust Pipelines and Multiple New Launches Planned

I knew that headline would get your attention. And while it might look like fantasyland in light of current economic trends affecting the pharmaceutical and biotechnology industries, it isn’t. The oncology market is forecast to grow at a compound annual rate of 12% to 15% between now and 2012, according to the IMS Global Oncology Forecast. The growth of the oncology market will be nearly double the forecasted growth rate of the overall pharmaceutical market over the next few years, reaching $75 to $80 billion in sales by 2012.

There are nearly 2,000 individual molecules currently in development for the treatment of cancer. Our industry has clearly identified oncology as a major opportunity, and demographics suggest that this market will continue to grow in spite of economic fluctuations. Global populations are aging, and cancer is an age-related disease. Looking at the US, President Obama vowed to seek a “cure for cancer in our time” in his February 2009 speech to congress, and followed that up by announcing a plan to double cancer research spending by 2017.

Unprecedented progress in genomics, the growth of targeted therapies and the promise of personalized medicine are all playing a critical role in winning the battle against cancer. A greater focus on screening, earlier diagnosis and prevention is also going to contribute to continued growth in the cancer diagnostics sector.

JFK Communications has a strong legacy of oncology public relations and cancer communications experience.  From ground-breaking disease awareness initiatives with Lance Armstrong to global launches of blockbuster cancer medicines, JFK has been there.  And we remain stalwarts in supporting companies large and small working to bring and end to this global scourge.  We help our clients with difficult oncology clinical trial recruitment, as well as even more difficult preparation for Oncology Drugs Advisory Committee meetings.  We know the cancer advocates, oncology KOLs and the PR folks at the major oncology professional societies.  JFK team members have spent much of our careers working at leading oncology companies and supporting global cancer initiatives.  We also provide pro bono support to key patient advocacy clients. 

Healthcare reform will bring a number of seismic changes. These include the emergence of a comparative effectiveness model, and for cancer patients, an increased focus on personalized medicine, improved screening and earlier diagnosis. Throw into this mix a highly motivated patient advocacy community committed to making sure that patients get the best treatments for their cancer, and you have a very challenging communications environment.

This is an exciting time to be involved in the cancer market. Considerable progress is being made in understanding the disease, governments are making major commitments to eradicate cancer, and healthcare reform is changing the model for delivery of care.

As Abraham Lincoln once said:

As our case is new, we must think and act anew.

--David Avitabile

Healthcare Public Relations in the Age of Healthcare Reform

Whether you like it or not, healthcare reform has arrived in the United States.

The widespread opposition that characterized attempts to get the Clinton healthcare plan off the ground in 1993 will not be repeated in 2009 as the Obama administration tackles healthcare reform. In fact, industry representatives have pledged their support for healthcare reform, as seen by the recent meeting of industry leaders with President Obama where they by outlined $2 trillion in spending reductions to help cover the cost of universal healthcare.

The debate over what form universal healthcare in the US will take, and the new business environment that will be created by implementing those changes, creates opportunities for public relations to do the things that it does best. Communicating complex, nuanced messages, rallying disparate interest groups to achieve a  common goal, fostering debate and dialogue over challenging issues, and leveraging advocacy groups to influence critical decisions—these are all areas where public relations excels compared to other marketing disciplines.

How will our industry fare as reform begins to happen? Rather than doom mongering, let's look at some positives. Major changes in healthcare infrastructure and delivery will force industry leaders to innovate and adapt. I have great confidence in pharmaceutical, biotechnology and medical technology companies’ ability to innovate in order to respond to the changes that are coming. Increases in funding for basic research and finding new treatments that address unmet medical needs will remain important national priorities. Stem cell research is a relatively new area of biotechnology and is likely to become one of the fastest growing R&D sectors moving forward. This is all good news for industry in the long run.

I spent eight very rewarding years of my career living and working in the United Kingdom, so I have first hand experience of nationalized healthcare, its benefits and shortcomings. I also know from personal experience how important public relations is to companies competing to communicate comparative effectiveness, fighting for a share of limited healthcare resources, and trying to motivate patient groups and the media to push for rational funding decisions. Politicians, patient advocacy groups, industry and the media all have a very strong interest in these issues. Skilled healthcare public relations professionals can play an essential role in making sure that these different interest groups are heard, and that they engage on these issues with articulate, clear and effective messages.

Some companies operating in the UK have shown great initiative and creativity in dealing with the National Institute of Clinical Excellence (NICE) regarding funding decisions for their treatments. For example, Johnson & Johnson has agreed to refund the cost of treatment with Velcade(R) in multiple myeloma patients who don’t respond.  Celgene has received a positive appraisal from NICE for its multiple myeloma treatment Revlimid(R), including Celgene’s proposal that the National Health Service (NHS) pay for the drug for 26 treatment cycles in those patients with previously-treated disease. Celgene would fund the drug (used in combination with dexamethasone) in patients benefiting from it thereafter.

These two examples, I think, show our industry at its finest. These companies are not afraid to be creative in how they approach difficult business challenges. They are also sending a very clear message that they believe in the value of their products.

If comparative effectiveness becomes a component of healthcare reform in the US, I wouldn’t be surprised to see industry leaders using similar approaches in the US to cooperate with government health authorities and to demonstrate the same belief in the value of their products.

--David Avitabile