Guest Feature - The European eMarketing Scene: Desperately Seeking Strategy

Prior to the Berlin conference, Starnes and several of his European colleagues participated in a Pharma Marketing News Roundtable conference call on the subject of physician eMarketing in Europe.

By Editor on May 15, 2006

Prior to the Berlin conference, Starnes and several of his European colleagues participated in a Pharma Marketing News Roundtable conference call on the subject of physician eMarketing in Europe. Other experts on the call included: Pascal Vancoppenolle, CEO and co-founder, MediQuality; Kay Wesley, Global Director eMarketing, AstraZeneca; Vincent DeChellis, Principal at NHHS, an independent healthcare consultant; and Mark Millar, Director, PraeMedica, a technology-based physician communications agency.

Ten years ago we had great expectations, said Starnes. Some people made a lot of wild predictions such as we can forget the rep because now, with the Internet, we have reps 24/7. Since then, we'sve been through the trough of despair in 2000 and now we are coming into a much more realistic phase.

Strategically Challenged

In Europe, not all pharmaceutical companies are using the Internet strategically, said Pascal Vancoppenolle, CEO and co-founder, MediQuality, an online sales & marketing application provider and consultancy based in Belgium. There is a tendency for some companies to employ eMarketing on a project by project basis. They have an idea and then implement it, followed by another idea, etc. There is no coherent strategic vision. Consequently, Europe, unlike the US, has not yet moved away from eDetailing because eDetailing has not been widely implemented.

I agree, said Kay Wesley, Global Director eMarketing, AstraZeneca. The industry up to now has been tinkering about with pilots and not doing a great deal of strategic work in the online channel.

Commercial vs. Educational eDetailing

Yet in some ways, European pharmaceutical eMarketers are ahead of the curve and more forward thinking than their US counterparts, at least when it comes to commercialized vs. educational eDetailing.

As recently as two years ago, pharmaceutical companies in the US routinely gave cash-equivalent incentives to physicians for completing commercial product eDetails. Recent OIG and PhRMA guidelines, however, has led to the demise of the practice in the US.

Incentives are what drove a lot of the curiosity in eDetailing by physicians in the US initially, said Vincent DeChellis, Principal at NHHS, an independent healthcare consultant based in the US. The good thing about the OIG and other guidelines on incentives is that the content must now be more compelling in order to attract physicians. The companies providing eDetailing in the US now realize that they cannot simply repurpose sales aids or vis aids and that's why they are heading more into eLearning. The likelihood of physicians coming back is dependent on how valuable they find the information and whether it was time well spent.

Some markets in Europe do permit the offering of honoraria for participation in eDetails, said Wesley. Nevertheless, there is less acceptance of a highly-commercial eDetailing approach in Europe. Many European physicians value interactive product education,'s so eDetails in Europe may be positioned slightly differently and have a more educational tone.'s As a matter of fact, we'sve observed that doctors who are interested in eCME are also interested in eDetailing. We should encourage this educational's positioning of product information and help all prescribers find it when they need to, rather than restricting its use to specific campaigns with incentives.

Implementation Issues Abound

Europe has its own unique problems in terms of deploying eMarketing solutions. Although the EU may be likened to the US federation of states, Europe is still comprised of separate countries with significant cultural and language differences.

Unlike the US, Europe is not a single homogeneous market, said Mark Millar, Director, PraeMedica, a technology-based physician communications agency based in Ireland. There are many variations in regulations as well as licensed indications for phrama products.

Starnes agrees and sees a north-south divide in how countries interpret directives. Member countries adapt European directives for their local needs. We tend to see some of the north European countries (eg, Netherlands, Scandinavia) being more liberal in their interpretations of the directives. The further south you go, especially the Mediterranean countries, interpretations are stricter.

This difference seems to align with the cultural differences relating to freedom of access to information. These differences are quite deeply rooted and apply not only to consumer-directed information but also to physician-directed information.

The cultural differences not only apply to regulators in different countries but also to product managers within the pharmaceutical companies themselves. Most agreed that it comes down to what is an acceptable level of risk.

Changing Regulatory Landscape

The situation is dynamic rather than static as well, said Starnes. We are seeing quite a change in what regulators will allow us to do from year to year as new concepts are explored. For example, compliance programs for patients are not addressed at all in the EU directives and if we actually have the chance to talk to regulators, in some markets they often will change their views and allow us to do things we couldn'st do before.

An example would be regulations relating to physician access to medical information on the Web provided by pharmaceutical companies. There are some markets Sweden, for example where passwords are absolutely not necessary. In other markets it's really up to the product manager to determine the degree of security necessary to access Web sites, said Starnes. In some markets, such as France, pharmaceutical companies must really limit access to bona fide physicians.

Not only are there different regulations to contend with, but cultural differences also call for different delivery approaches. We have seen different models of eDetailing work in different markets, said Wesley. In some Scandinavian markets we'sve had success with shared-screen eDetailing in which a rep talks the doctor through the detail on the phone. In most other markets, however, the virtual, self-directed eDetail model is prevalent.

Organizational Issues

In the US, most pharmaceutical companies have disbanded their e departments and disbursed Internet-savvy personnel to brand teams. This has not happened yet in Europe. Why is that?

The experts agreed that US marketing teams have much bigger budgets and more people with Internet expertise than do local European markets. In Europe, they contend, it is impossible to place an eBusiness expert in each product team. Resources are so limited in some small markets that some product managers are responsible for more than one product! What's needed is at least one specialist per country that can work with all the product managers to guide them and help them to put the right marketing mix and campaigns together.

We'sve actually just changed our eMarketing structure, said Wesley. All our global eManagers are now in the brand teams so that each brand has an eMarketing manager, who we see as having a strategic role in getting the brand as a whole to leverage the channel from global congresses through to e-selling on the ground and patient disease awareness. These global eManagers still work together on global capabilities.

Although I have an eBusiness title, said Starnes, I spend 50% of my time in customer and patient relationship management. I am actually part of the CRM team. The positive thing about that is I can to talk about the e-channel in a completely different way that is more relevant to the CRM folks.

The Future

The day will come when marketing is not e or online and offline, it will be just marketing, said DeChellis. As it stands right now, the complexity of online marketing is still somewhat daunting to marketers and their agencies. Specialists are still required to deal with things that marketers don'st fully understand or don'st want to deal with. Consequently, we still have a siloed online/offline approach when we should have integrated marketing of a brand.

The end goal should be for all marketers to be eMarketers,'s said Wesley. But in Europe that is still very far from the case, so the eMarketing role is about getting the channel embedded into the mix. I anticipate this role will be around in Europe for a few years yet. The people we have in AZ with the eMarketing job title are all-round marketers with broad experience of all marketing channels but particular expertise in innovative marketing. Since the pace of change is continuing to accelerate and new channels emerge all the time, maybe there will continue to be a role in future called Innovation Marketing Manager's?

If you believe that your business model is going to change fundamentally -- and we do then it's a strategic imperative to build the capability to handle that change, said Wesley.

The summary above is abstracted from an article originally published in Pharma Marketing News. To access the original article, which includes a European case study and survey data, please go to www.pharma-mkting.com/news/special/pmn53-article01.pdf .