Case Studies in Social Media Listening

Case Studies in Social Media Listening Major companies are improving performance through what they hear

By Greg Cohen, Associate Director, Global Marketing, UCB and Siva Nadarajah, GM Social Media, IMS Health

The rapid spread of social media has created rich opportunities for pharmaceutical companies to access unfiltered, organic insights into how patients and other stakeholders perceive and interact with brands, or experience and manage associated diseases. It also provides a new channel for engagement with the industry’s fast-expanding customer base. While some social media dialogue may appear to privilege a vocal minority, companies can ill afford to ignore inputs that may have rapid and far-reaching consequences for brand and corporate integrity, targeted investment, and competitive advantage.

Social listening is increasingly recognized as a viable research tool. It is rarely applied, though, as a continuous and fully-integrated strategic function. Typically, social listening involves seeking answers to predetermined questions by tapping into online conversation. Companies need to progress beyond project listening on an ad-hoc basis, and to engage more openly and consistently in a dynamic environment that can fill in critical business-knowledge gaps as well as uncovering potential avenues for traditional market research. In doing so, they can draw on specialized software that employs advanced-analytics techniques to track and contextualize online dialogue around diseases, brands, and companies. These findings can then be linked to anonymous, longitudinal patient-level data to ensure the statistical validity of leading indicators and trends seen in social listening. Ultimately, these findings serve as a platform for concerted action, including constructive engagement with stakeholders through the company’s own social media channels. Concerns about the burden of additional pharmacovigilance obligations through exposure to social media tend to be overstated. The benefits—both descriptive and predictive—of continuous and integrated social listening extend throughout the product lifecycle, from shaping R&D and recruiting patients for clinical trials to informing sales and marketing or communications strategies. Ongoing listening enables companies to identify and track trends over time, while illuminating the issues that really matter to patients, healthcare professionals, the general public, and a whole online community of established and emerging key opinion leaders. WHY SOCIAL MEDIA MATTERS Listening to patients or other key stakeholders talk freely about their experiences, preferences and needs around disease management and product usage is a window into a fluid and fast-moving world. Some of that dialogue may be trivial, ill-informed or malicious. It may reflect the experiences or opinions of a vocal minority, which some may consider unrepresentative of the patient body at large. However, if that vocal minority is discussing your brand online, then someone will be listening…and opinions can be highly contagious! Rather than dismissing this dialogue as empty chatter or worrying about the implications of hearing something that might be more trouble than it is worth, industry needs to adopt practices from more consumer-oriented sectors and embrace social media intelligence on a continuous-listening basis. Doing so will bring pharmaceutical companies into alignment with a critical mass of patients, prescribers, and advocates who are already taking the conversation around diseases and treatments outside the conference hall, the doctor’s office, or the focus group, and into a space far more candid, intuitive, open-minded, and continually invested in the issue of health. CURRENT TRENDS IN INTELLIGENCE-GATHERING A recent study by Best Practices, LLC 1 drew on interviews with 15 digital and social-marketing, and market-research leaders at 15 large global healthcare organizations, including six of the top 10 pharmaceutical companies, to determine how they were using social media listening programs.

It found that 85% of the companies participating in the study were currently engaged in some form of social media listening. All of these companies were monitoring patient forums while most of them were also keeping tabs on the major social media channels such as Facebook (91% of those listening) and Twitter (82%).

All of the surveyed companies engaged in social media listening were looking to capture brandspecific market or patient insights, such as: • patient adherence to treatment; • brand awareness, reputation and loyalty, including misinformation perpetrated in online discussions; and • physician discussions around specific brands and markets.

Another 91% of the companies were gathering data on disease states, such as mapping the patient journey through a disease. About one third of those engaged in social listening were using it as a source of competitive intelligence. OWNERSHIP AND USES OF SOCIAL LISTENING While the regulatory framework for social media clearly influences the degree of social media listening geographically, the precise nature and objectives of social media listening strategy also vary according to which business function is entrusted with this responsibility (see Table 1). In the Best Practices study, the social media listening program was part of market research at 58% of the organizations surveyed and belonged to a digital/informationtechnology group at 42% of organizations. Large pharmaceutical companies were far more likely to entrust social media listening management to market research, while in midcap pharmaceutical, biotechnology or medical-device organizations responsibility tended to sit with the digital/IT group. Brand managers involved in social media listening tend to be interested in factors influencing share of voice compared with rival brands, trends in patients switching from one brand or product to another, identifying key opinion leaders or online patient advocates, and tracking general sentiment around a brand asset. This is usually real-time listening, whereas market-research departments are concerned with much broader trends, and from a lon-

ger term perspective. This might involve looking at unmet needs in a particular disease, typically through a six- or 12-month retrospective analysis. There are also areas of common interest overlapping brand management and market research, such as digitallandscape analysis: comparing brands to determine which sites or activities produce the best returns from online investment. These signals are then used as the basis for targeted social surveys run online, sometimes with numbers of patients far beyond the capability of conventional market research. The survey results lend statistical validity to the signals picked up from social listening. The goal here is to pinpoint any correlations between what patients say about a medicine online, and how patients generally behave with a product in a real-world setting by examining anonymous patient level data. In this way, social listening can help companies to deepen their understanding of real-world trends, predict where those trends are going, and use the findings as a genuine call for action. ADVANTAGES OF SOCIAL MEDIA LISTENING Social media intelligence should not be seen as a separate entity from market research. It can • fill in critical business-knowledge gaps, whether around brand awareness, patient adherence, physician preferences, or product misinformation • suggest avenues for more conventional market-research initiatives

• expand significantly the available patient population for market research • provide further insights into what the general public think about diseases, treatments, brands and their corporate guardians • take the conversation beyond the restricted framework of a market-research survey • tap into conversations around brands, diseases and companies while they are still loose and organic • bring to the surface day-to-day issues that are actually important to patients, rather than projecting potential concerns a company may have previously established as important to patients • identify and track trends over time, through continuous listening • help make predictions about how brands might perform over time NEW TOOLS FOR LISTENING There are now more sophisticated tools for the identification and quantitative analysis of trends in online conversation. This is about more than just tracking the volume of mentions for a particular brand, company or issue on leading social media sites such as Facebook or Twitter. A key starting point for listening is actually where nothing is being said at all—search engines. Search interest is a proxy for gaps in user knowledge and can highlight areas of potential conversation to look for online. Text and semantic analytics can then delve more deeply into the numbers of people talking about a particular disease, using a broad dictionary of disease terminology. This enables researchers to capture the maximum possible number of mentions while providing insights into different terms used by realworld patients to describe their condition—for example, “high blood sugar” as opposed to diabetes. These can then be fed back into marketing, labeling or clinical-trial materials. Too often, pharmaceutical companies rely on the disease descriptions they expect patients to use on the basis of previous research or marketing programs— or, worse, the technical or medical terms that companies use internally rather than finding out which words and phrases really mean something to patients. Text analytics also allow companies to track social media conversations purely on the basis of the words being used, and in isolation from any underlying sentiments. Those sentiments may in themselves be of interest, especially if they point to a serious misperception that will need to be addressed actively through marketing or public relations. But they can also cloud objective judgments of how conversations around a disease or a brand are evolving, in particular where sentiment is measured in basic degrees of positivity or negativity. The next stage in quantitative analytics is using the identified trends and numbers as a platform for more structured social surveys conducted online. By validating

signals from semantic and text analytics, the quantitative findings of these surveys reach the threshold for recommendations. These recommendations may involve, for example, adjusting an existing marketing campaign, launching a new campaign, stimulating further social media interest, or developing an unbranded educational program to raise disease awareness. Observations gleaned more organically from social listening might serve as a prompt for tactical adjustments, such as a brand manager launching a counter-campaign or stepping up a brand’s social media presence in response to a dwindling share of voice online. AN INTEGRATED STRATEGY Multiple stakeholders within pharmaceutical companies, including brand managers, clinical-research departments and real-world evidence groups, are already tapping into social media on their own initiative—albeit non-systematically—to help inform specific activities or to solidify relationships with their customer base. One advantage to a formal program is that it is website-agnostic, looking for every conversation and aggregating. If a brand manager is conducting her own search, she may spend time on a few key forums/ sites with which she is familiar or which she finds first as opposed to looking at the aggregate of data across all sites. This goes beyond listening to patients or the general public. For example, sales representatives, key account managers or medical science liaisons are better prepared for interactions with customers if they know about issues physicians have been raising in social media or other forums. This boosts the representative’s credibility with the client, breaks the conversational ice and can lead to longer meetings with time-pressed professionals. Increasing numbers of key opinion leaders now actively use Twitter. The more active KOLs are on social media, the more followers they accumulate, and the more likely they are to be recognized as a leader in their respective space. Other physicians may also have a dynamic presence online, whether through tweets, blogs or video presentations.

Medical conferences are a prime opportunity to discover what a large cohort of physicians and specialists is talking about both onand offline. Conference organizers encourage real-time discussion of speaker presentations through allocated social media channels, while levels of interest in posters or new molecules can be gauged through the quantity and content of online dialogue among attendees.

Ongoing social listening can get at what patients, healthcare professionals, or anyone else closely involved in taking medicines, really feel about the whole experience. It drills right down to the impact that a product’s efficacy (or lack thereof), ease of use, or side-effects have on key aspects of patients’ lives, most notably the need for stability, predictability or relief from pain and discomfort. Moreover, it illuminates what patients have to undergo or forego if those needs are not addressed by existing therapeutic options. In a marketplace dominated by concerns about drug costs and associated outcomes, listening to what patients in uninhibited dialogue through social media want from medicines is not so much a useful contribution as a basic strategic imperative. CASE STUDY 1: WHAT SOCIAL-INTELLIGENCE ANALYSIS SAYS ABOUT PRODUCT SWITCHING A multinational pharmaceutical company looked at whether social media listening might help it to identify the drivers behind variations in treatment-switching patterns for recently launched oral multiple sclerosis (MS) therapies observed in real-world claims and pharmacy databases in the US. The retrospective database analysis involved monitoring social media conversations among self-identified MS patients through publicly available channels such as Facebook, Twitter, blogs and online forums between October 1, 2013 and October 31, 2014.

The study combined automated listening and processing with manual analysis of social media data by qualified analysts and physicians. Lexical entities referring to switching between oral, injectable and iv therapies for MS, identified by brand name, were captured from extracts of relevant online conversations.

In total, 25,073 data points were extracted from social media conversations around oral MS therapies in the target population, subsequently filtered to 22,887 relevant data points. Of these, 10,260 were identified as relevant to the study objectives and 1,684 data points were collected for treatment switches, which were most prevalent among patients in injectable MS therapies and least prevalent among those on iv therapies.

The highest proportions of reported switches were to oral therapies from iv (98%) or injectable (83%) products, followed by switches away from oral medication to other oral drugs for MS (46%), injectable therapies (29%) or iv therapies (25%). Side-effects, lack of efficacy and physician advice were the most common reasons given for a change of medication, while around 14.5% of the MS patients switched from injectables to oral therapies due to ease of use. The researchers concluded that social media intelligence was a powerful tool for outcomes research, providing insights into specific aspects of health-seeking behaviour that might not be available through other research channels, and in a population that appeared to be representative of patients engaged in real-world medication switching. The study demonstrated that social media analytics, based on observations from real-world healthcare utilization and claims databases, could be used to quantify treatment-switching patterns and identify factors underlying switching behaviour in a defined patient population. CASE STUDY 2: HOW ONLINE LONGITUDINAL PATIENT STUDIES CAN DRAW REALLIFE JOURNEY MAPS A multinational pharmaceutical company conducting ongoing analysis of patient conversations was looking for insights into how long patients went misdiagnosed before being accurately diagnosed with Crohn’s disease. It then wanted to see how long patients tried different treatments before finding the right medication for their needs. The analysis centered largely on blog and forum discussions. This highly qualitative study started with 34,133 data points then focused on the 500+ points with enough data to construct these longitudinal journey maps. Ultimately, the team built three comprehensive, archetypal maps, showing the five- to 15-year journeys undertaken by different types of patients who discussed their experiences online. The maps demonstrated that expectations of how quickly patients move through the patient journey may have been understated. Rather, it showed that patients spend much more time circling the symptoms-diagnosis-treatment paradigm before they make reasonable progress towards something the patient would consider an acceptable outcome. CASE STUDY 3: HELPING A PATIENT GET BACK ON A SUCCESSFUL REGIMEN One multinational company identified a patient through a social media forum who had been successfully managing her condition for years on one of the company’s products. They found that once the Affordable Care Act came into force, the patient’s healthcare plan insisted she switch back to a product on which she had already failed. However, thanks to social media listening, the company was made aware of the situation early and was able to intervene for the patient by alerting a market-access colleague in the state concerned (luckily, the patient had indicated in her post which state and which plan she was using). The company was able to escalate the situation

to the point where, a few days later, the patient came back onto the online forum and reported that a company rep had spoken to her physician and she was now back on her original regimen. In that way, the company managed to add value to the patient experience and enhance its own reputation by responding to an immediate customer concern.

CONCLUSIONS Social media listening can no longer be sidelined as an optional supplement to mainstream market research or as a siloed activity pursued by different business units on an ad-hoc, project-by-project basis. With access to specialized software employing advanced-analytics techniques to track, grade and contextualize dialogue around diseases, brands and companies online, then find, validate and substantiate those findings through linkage to real-world data assets, pharmaceutical companies are well equipped to embrace social listening on a continuous-listening basis, integrated across internal departments and with benefits extending throughout the product lifecycle. •

1 Pharma Social Media Listening: Benchmarking Innovative Practices in the Healthcare Industry. Best Practices, LLC. Available at: http:// www. slideshare.net/bestpracticesllc/ psm-303-a-report-summary-pharma-social-media-listening-benchmark (accessed February 16, 2016). Greg Cohen Associate Director, Global Marketing, UCB Greg Cohen is an Associate Director for Global Marketing specializing in Multichannel Engagement working for UCB. Greg is part of a team tasked with accelerating the marketing maturity of UCB in order to build a world-class marketing organization. Greg is passionate about evolving how companies think of interacting with patients in order to provide a better paradigm for care. Prior to joining UCB, Greg worked in consulting and advertising, developing go-to-market strategies for B2B and B2C Fortune 500 companies interested in accelerating their activities through embracing digital and social.

gcohen@us.imshealth.com

Siva Nadarajah GM Social Media, IMS Health Siva Nadarajah is General Manager, Social Media at IMS Health and joined the organization through the acquisition of Semantelli, which he co-founded and grew to be an industry recognized leader in social analytics for pharma. Prior to founding Semantelli, Siva was responsible for global CRM and compliance solutions with Cegedim. Siva is a voting member of the Wikimedia Foundation and has spoken worldwide about adverse events management in social media and the impact of Wikipedia in healthcare. He was recognized for uncovering two major security holes in Microsoft Hotmail in the early days of the Internet, which forever changed the security design of internet based email systems.

snadarajah@us.imshealth.com

IMS Health is a leading global information and technology services company providing clients in the healthcare industry with endto-end solutions to measure and improve their performance. Our 7,500 services experts connect configurable SaaS applications to 10+ petabytes of complex healthcare data in the IMS One™ cloud platform, delivering unique insights into diseases, treatments, costs and outcomes. The company’s 15,000 employees blend global consistency and local market knowledge across 100 countries to help clients run their operations more efficiently. Customers include pharmaceutical, consumer health and medical device manufacturers and distributors, providers, payors, government agencies, policymakers, researchers and the financial community.

www.imshealth.com