Is Pharma Branding at Odds with Patient Engagement?
Regular columist Katrina Firlik, MD, looks at the negative impact pharma branding can have on patient adherence programs.
A few years ago my company ran a six-month digital medication adherence pilot sponsored by RealAge (now a part of Sharecare). It was branded as “RealAge Rewards.” It was a relatively small pilot, about 300 patients, all with asthma or COPD.
Our engagement metrics well surpassed our hopes. The mean number of logins per user per week was above 7. The weekly quiz and survey completion rates were nearly 70%. Only about 17% of the patients stopped engaging with the program altogether. When we presented our data to potential customers, some thought we must be padding the numbers somehow. We weren’t.
For one of the weekly survey questions, I decided to ask the following of this patient cohort: “How would you feel if RealAge Rewards were sponsored not by RealAge, but instead by a pharmaceutical brand or company?” Here were the responses:
- 31% “Fine, I would be just as happy to participate”
- 30% “I would still participate, but I would not be as enthusiastic”
- 27% “Not sure if I would still participate”
- 8% “I would not participate”
Now that we are running programs overtly sponsored by pharmaceutical brands, I sometimes question to what degree enrollment and engagement are potentially compromised by pharmaceutical branding.
I wonder if “fun” and “pharma” are dissonant in people’s minds, and whether or not that poses a challenge.
On the flip side, I have to assume that pharmaceutical branding is actually a plus for many patients, rather than a neutral or a negative. I’m sure it can help to convey credibility, gravitas, and seriousness of intent.
However, given that a primary purpose of our platform and others like it is to bring a sense of enjoyment—even fun—to the chore of staying adherent to a chronic medication, I wonder if “fun” and “pharma” are dissonant in people’s minds, and whether or not that poses a challenge.
We don't have clear answers yet, but to hedge our bets we do mention the following in our Implementation Guide for brands:
“There are a number of considerations regarding how a HealthPrize program should be branded, depending upon the sponsor’s goals. Please determine which of the two is the primary goal of the program:
- Maximizing consumer engagement and adherence (in which case the sponsor might consider minimizing pharma branding) or
- Enhancing consumer exposure to the brand or company name (in which case pharma branding would be more prominent)”
Branding affects a number of elements, including which entity is listed in the “From” line in emails, to the name and logo of the program, to whether or not Important Safety Information (ISI) is required, hogging precious space on computer and smartphone screens.
I’m not suggesting that we unduly obfuscate sponsorship (in the setting where pharma branding is kept to a minimum). A patient should know exactly who is paying for programs they chose to engage with, and they shouldn’t accept attempts to conceal this information. Instead, it’s simply an issue of degree. Is the name of the company and the medication pervasive across the site and its educational content, or is there simply a logo at the bottom of the page and in the footer of all emails?
A nice way to attempt to answer the question would be to run an adherence or engagement pilot with two cohorts of patients: one arm would be exposed to minimal pharma branding, the other would see more aggressive branding. You could then gauge enrollment and engagement differences between the two groups.
Given that digital programs in pharma—with dynamic content, multiple pages, and often a mobile app—require a significant amount of work to get approved through the medical-legal-regulatory processes (in many cases, requiring a hard-copy print-out of every possible screen shot displaying each day’s planned content, and every permutation of each screen shot, including separate copies of the accompanying mobile screens), this would be a tall and expensive order, but probably worth it.
Thinking about my own personal experience, I signed up for a digital pharma-sponsored diabetes wellness program a while ago, to see what the user experience was like. I don’t have diabetes but regardless, much of the general wellness advice targeting people with diabetes applies quite nicely to general public wishing to avoid diabetes as well, so therefore is widely applicable.
I opened the emails for a while but then stopped. One thing in particular that struck me as slightly off kilter was the pharmaceutical branding in close combination with recipes and photos of healthy entrees. Activities like visiting farmer’s markets, cooking at home with fine, fresh ingredients, and enjoying a healthy meal are more personal activities that I was somewhat averse to linking to pharmaceutical branding. I naturally and logically link pharmaceutical branding to pharmaceutical products, but I’d prefer to keep the “medical” separate from the “culinary” (even if I were a diabetic). Eating well is certainly key to a healthy lifestyle, but I feel that the “medicalization” of food is not healthy, and sometimes even counterproductive.
In other words, if I’m looking for enticing recipes, I’m seeking out a trusted culinary source, not a pharmaceutical source.
This is only one example of where branding may be a bit out of sync with a program’s intent (others may not share this sentiment regarding recipes, in particular), but I think it’s worthwhile keeping top of mind, when creating a new patient engagement program, how consumers feel about different brands. Another example: would you seek out a pharma brand or Nike in order to get motivated about exercise?
Programs with a focus on medication adherence specifically—as opposed to some form of all-encompassing lifestyle program—are perhaps less tricky, given that the branding refers directly to the products, but I would still argue for a careful consideration of degree of branding, and whether prominent pharma branding enhances vs. erodes engagement and the “fun factor.”
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