Patient Empowerment: Consequences for Pharmaceutical Marketing and for the Patient–Physician Relationship - Innovation and Marketing in the Pharmaceutical Industry - page 435

external users the rules and expectations for social media interaction, and (3) clearly
connecting the social media strategy with the right organizational objectives. 10
Hence, following a few initial success cases, it is time for other pharmaceutical
firms to boldly and clearly delineate the social media strategy for their different
brands, which needs to consider the new role of the patient in the patient-physician
relationship and the relationship with other stakeholders, such as payers and regula-
tors. It is also important for academic research to develop better methods and algo-
rithms to efficiently monitor patient-generated content on social media and web 2.0
(e.g., via sentiment analysis).

14.4.2.3 Firm-to-Patient Communication via Mass Media

Despite the emergence of new channels for communicating with patients, firms also
need to devise strategies for communication management via traditional channels,
such as mass media, namely, DTCA strategies. 11 DTCA is still by far the most used
channel for firms to communicate directly with patients, especially in the United
States. In fact, branded drug slogans, themes, and imagery are now considered part
of American popular culture (Myers et al. 2011 ). However, outside the United States
and New Zealand, a key impediment to direct-to-patient communication is regula-
tions forbidding DTCA. In Europe, for instance, public opinion typically rejects
DTCA, which has led the European Commission to maintain the ban on the supply
of any form of information destined to “promote the prescription, supply, sale or
consumption of medicinal products” (Article 86, Title VIII on Advertising of
Directive 2001/83/EC, as amended by Directive 2004/27/EC 12 ). Hence, all commu-
nication efforts need to deal with the regulatory constraints in place in each region.
Even when DTCA is not allowed, there are often possibilities to fruitfully inter-
act with patients. Despite regulation, it is possible for firms in Europe to interact
with patients to provide information that is beneficial for patients and not aimed to
promote a specific brand. Excluded from the ban imposed by Directive 2001/83/EC
are, for instance, (1) information relating to human health diseases without refer-
ence to branded drugs (i.e., non-branded disease awareness campaigns), (2) labeling
and package leaflets (which are regulated by Title V of the same directive), and (3)
correspondence, perhaps accompanied by non-promotional material needed to answer
specific questions about a specific drug (which opens the door for firms to explore
legal possibilities for interaction with patients and possibly adherence programs).

10 See http://engagementstrategy.com/articles/astrazeneca-healthcare-engagement-strategy-
2012-open-dialogue-award/ .
11 The academic literature on DTCA is extensive, and my goal here is to complement this literature
with an overview of the effects of patient empowerment on DTCA, especially given the regulatory
limitations of such communication. I refer the reader to excellent papers providing in-depth sum-
maries of the literature on DTCA, such as Iizuka and Jin ( 2005 ), Kolsarici and Vakratsas ( 2010 ),
Narayanan et al. (2004) and Osinga et al. ( 2011 ).
12 Available at http://www.ema.europa.eu .