Packaging – people do care!

A couple of days ago I came across a very interesting question posted on Twitter. A patient had posted an image of their medication package and reached out to @novonordisk to ask why the new packaging was so big compared to the old packaging.

I noticed this post for a couple of reasons. Firstly I am always intrigued to see how pharma companies respond to direct questions from patients via social media. Will they respond, and if so how quickly and how appropriately, or will they ignore the question? I saw a great example of a tweet that Pfizer should have just ignored but instead they sent a totally inappropriate automated response – clearly no one had bothered to read the tweet!

Secondly this question made total sense and resonated with me. Like many consumers I am so fed up with excessive packaging that has become endemic in our society. I get so frustrated trying to grapple with DVD packaging or double packaging for food products. A pet hate is also large boxes for tiny products, for example my Fuelband came in a huge box which was mostly empty – why? I am aware of the damage we are doing to the environment and I hate contributing to this, especially by excessive use of packaging. This was then a great question that @martinzwart1 posted and I was intrigued to see what the response would be.

I was very happy to see a prompt response from @novonordisk, stating that they would get back as soon as possible with more information. This is a great example of how to respond when you are not able to respond immediately – far better than not responding and just waiting until you have the information to respond. @novonordisk then came back a day later with an answer – again very prompt – and also invited @martinzwart1 and me (by now I had of course jumped on the bandwagon) to get back to them with further questions. A great example of how to respond to a patient via Twitter.

Sadly the actual response was very disappointing. The reason Novo Nordisk has had to increase the size of their packaging is not through choice but rather as a result of new regulations from European authorities. This to me is so absurd. We have various EU and national directives aimed at reducing packaging and packaging waste and yet here is an EU authority demanding that packaging is made bigger!

I personally find this rather disgraceful and irritating. In a day when more and more people get their information online why on earth is there a need to increase package size? If patients require additional printed material could this not be requested at the pharmacy when they pick up their medication? Those, like me, that prefer to read the information electronically (or just ignore it) can then be served with our smaller, more environmentally friendly packaging. Why must we, and our environment, suffer as a result of over-zealous, backwards looking regulatory authorities?

So … who is Doctor XXXX?


I had the great pleasure today to be chatting with @Boehringer, and it was politely pointed out to me that there was a typo in my last blog post “Boehringer still chatting away”. I presumed that in my hurry to type up my post & then post I had got a where / were wrong or perhps some other typo. @Boehringer however then asked whom did I mean by Dr.X.   I took a deep breath … this was not the typo I was expecting – this was a blatant error! In actual fact it was Dr XXXX – it was one of the doctors taking part in the tweet chat and I had meant to double check the name before committing some error on my blog. Well that failed spectacularly because I forgot to amened and now my blog talks about some Dr. XXXXX!

Had it been Dr X I would have been annoyed but mildly amused too. Dr XXXX however brings up all sorts of connotations and my blog is meant to be vaguely professional! If I were new to social media, or a pharma company, I would have rushed online, made the change and prayed that no one had spotted the error. As it was somebody very kindly parted me with my smartphone in Barcelona over the weekend so I had no way of getting online quickly. Panic you may think.

However I am now starting to be bit of an old hand at social media so actually I was not overly concerned. I maintained that mild amusement – of a slightly different ilk but still mildly amused. And I was in no rush to try desperately to find wifi and get online with my laptop. In fact I started mulling over writing this blog post … and wondering what sort of traffic I will get with XXXX in my title!

The reason for this mild nonchalance is because I know and I trust social media. I know for starters that the intent of my article was serious and well-intended so any comments I get will either be relevant to the rest of the post or humorous (at least I hope so). But perhaps more to the point I also feel that now that the mistake is made it is better to point it out, have a laugh and live with it rather than furiously, desperately try to correct it and pretend it never happened. This is what my experience in social media tells me.

Sadly many companies when they make a mistake in do exactly this – they try to very quickly cover up the mistake and hope no one noticed, and potentially get very defensive if anyone is so “rude” as to point the mistake out. This can back fire and there have been some spectacular examples of this in social media (Google this and you will find plenty of entertaining examples). They essentially dig that proverbial hole – which I am sure most of know from experience makes matter worse (and often even more entertaining for the bystander).

The correct way to handle this is of course not to try desperately to brush it under the carpet, bring lawyers in, close down your page, etc. The best way is to accept it, admit that you made a boo boo, and perhaps like me, have a strong drink and laugh at your mistake. Some would argue this is different from companies but I always point them back to that rather old example of the Red Cross getting slizzard post (and yes alcohol again).

The original Red Cross post

The original Red Cross post

I love this example. Here is a very reputable organisation, with a very serious subject matter, mistakenly tweeting about getting drunk! Shock horror! If ever there was a time to desperately back pedal here is a great example. The problem of course was that this one mistaken tweet had gone viral. Again shock horror! What to do?! A knee jerk reaction might be to temporarily close the account. A better reaction was however for the Red Cross to tweet a light hearted, but genuine apology.

The Red Cross response

The Red Cross response

The result shows why this was the right thing to do. The tweet went even more viral, along with the response, and people started using the # used in the drunken account as a drive for people to give blood. One drunken tweet turned into a charitable drive to get people to donate blood. That to me is a result – born not of planning but of being human and transparent.

It is therefore along this vein that I am now tweeting about Dr.XXXX – to show that even potentially rather embarrassing social media mistakes are not the end of the world. In fact they can reinforce your credibility and your social media appeal. You cannot plan for these things (that is just creepy and wrong) but you can show your true metal but how you respond to your mistakes online, in public. It takes guts but we will love you all the more if you can show that you too are only human. We are forgiving when you admit your mistakes and damning when you try to hide them.


Addendum: Stealing from the Red Cross mistake I wanted to also follow this with a fundraising drive for my charity Hope for Romanian Strays. If you laughed at my mistake or appreciated this blog post and think that you would like to make a difference to a life then please make a donation via paypal to @hopeforstrays Dr XXXX campaign. We need funds to feed, vaccinate, neuter and treat puppies and strays in the shelter (hence the loose connection to a doctor and the number 4). You can donate via paypal at, mentioning DrXXXX – for €10 you can vaccinate a puppy or buy a bag of food, €21 neuters a puppy and for €40 you can vaccinate, neuter and feed a puppy. Donations for treatment will go to pay off our never-ending debts with the vets for treating all our emergency cases. So essentially for the price of 4 drinks you can save the life of a puppy or a stray, and bring hope where there is so much despair. Now that would be a great result from a social media mistake! For more information on the charity visit


Ursa - when she was so emaciated she could no longer stand we picked her up and gave her the care she needed.  Will you help her and others like her?

Ursa – when she was so emaciated she could no longer stand we picked her up and gave her the care she needed. Will you help her and others like her?


Left to die in a field - rescued by Hope for Romanian Strays

Left to die in a field – rescued by Hope for Romanian Strays


@Boehringer still chatting away

This week Boehringer Ingelheim held another tweet chat around Afib, which IMHO was a great success, like their other previous tweet chats. Using the #CHATafib, @Boehringer led the engagement, along with a few physicians who had been invited to join, such as DrXXXX.

Quoting @lenstarnes: “Have to congratulate @boehringer for staging the 2nd #CHATafib, not many pharmas have the courage or vision to do similar”. I think this sums up my point of view too – I genuinely congratulate Boehringer for their forward thinking and bravery in organising these tweet chats and continuing to use social media as an engagement channel, rather than just a PR channel.

I thought it was also great to see the @Boeringer handle being handed over to Dr Sona Tvrdonova, Global Medical Advisor, for the tweet chat. I have been telling pharma for years to get their medical teams involved in social media and this is a fantastic example of how that would work, and why it is a good idea.

The tweet chat itself was as always interesting and engaging. For me tweet chats provide value in a number of ways. The first has to be as a great way to introduce newcomers to twitter – give a live feeling of how twitter works and the dynamics of the platform. I also think it is a great tool for students. These conversations often include real experts and some great insights – which may be less interesting to people who know the content really well, but great for those trying to learn it can provide fantastic insights, and for free.

The other value I see in tweet chats, and again a favourite topic of mine, is how they can be used to develop relationships with people. One of the reasons this is one of my favourite topics is that it was through the #hcsmeu tweet chats that I really got into twitter and start to “meet” people via twitter, many of whom I have now met in person. People who do not use twitter do not always grasp how this is possible. The reality is there is a degree of trust and openness that is, IMHO, unique to social media. This comes from sharing and discussing common interests from the start, unlike a face to face meeting, where you have to first find out what people are interested in. The people I met through #hcsmeu all shared my passion for healthcare and social media – we had an automatic shared interest, and in the end this is the foundation that relationships are built of.

I know other pharma will start to follow @boehringer’s lead, but Boehringer holds that pioneer crown. It is well deserved and I look forward to many more successful and interesting tweet chats with @boehringer.


The value of virtual conference attendance

We recently went through that ASCO time of year again. In terms of social media this is a big event and ASCO was one of the early adopters in terms of twitter and conference #.   I have been preaching for years about the value of using social media at conferences but it is only now really becoming more mainstream within the pharma and pharma conference industry.

Social media around these conferences has value in a number ways. Firstly there is increased in reach and impact of messages and information from the content. We are approaching a time when there will be more virtual attendees than physical attendees, in part driven by cost cutting measures and restrictions on paying for physicians to attend, but also driven by the increased use of digital channels to extend the conferences virtually.

Doctors who in the past were too junior or not perceived as a “key” stakeholder would not have been able to attend congress and would have to wait for the publication of reports from the conference. Now they can have real-time access to what is being presented and the latest news being presented many miles away at a conference like ASCO.

The other aspect of extended reach is to a whole stakeholder group who would, for the most part, not traditionally been able to attend – patients and caregivers. Patients are becoming increasingly engaged and active in their own healthcare, and going online to find information and following disease related #. Increasingly Patient KOI are actively following conferences and sharing the most pertinent information with their followers. This way, patients are able to find out the latest news and information that related to their disease – information that they would not traditionally have had access to outside of their doctor’s office.

A further benefit that social media at conference brings is the possibility to gain insights, identify KOI and build relationships with these KOI.   Conferences are a great opportunity to identify KOI or KOL who are active on social media and to start engaging with them. Social media can be used to reach out to them directly if they are at the conference and ask for a meeting, for example. Or, alternatively, identify them at congress and then follow up later online.

Despite all these benefits many pharma companies are still not fully optimising this opportunity. Some are starting to be very active at conference but then do not optimise the on-going opportunities that can come out of these events. Fortunately though each year I am seeing more and more activity around these conference so there is definitely a light at the end of the tunnel.

Patient centric – this year’s buzzword?

The term “patient centric” seems to be cropping up more and more but is it just another buzzword,  like Multi-Channel Marketing was last year?  And what exactly does “patient centric” mean?

Looking first at the meaning of “patient centric” – it essentially is what it says!  It is about putting the patient at the center. Sounds simple – especially if you do not work in the pharmaceutical industry.  In most industries it is a no-brainer that you center your marketing, strategy and indeed whole business, around the end user of your product and service.  After all if your customers are not happy with your product or service you will potentially go out of business.  In healthcare, and in particular from the pharmaceutical industry perspective, things are not quite so simple.

To start with the industry still sees physicians as their customer, not the patients.  This is in part as a result of regulations but also in part historical.  Until recently patients had little say or voice in their healthcare and relied almost entirely on healthcare providers for information and, to an extent, decision making.  This, coupled with regulations forbidding most direct contact between industry and patients in most countries, meant that the patient rarely came into the equation.  As far as the industry was concerned the key decision maker, and therefore customer, was the physician.  Now as to how customer centric the industry is towards these customers is another story – and warrants a separate blog piece!

The advent of the internet and social media has led to a change in the dynamics between patients and their healthcare.  Increasingly physicians are not the only, or indeed in some cases the main, source of information.  Increasingly it is other patients who provide the answers and the information.  And increasingly other sources online provide information to patients – not always accurate or appropriate but there none-the-less.

A recent example I saw was of a diabetes patient who reached out to a closed group of online friends.  She had recently been prescribed a product by her physician but as a result of some of the things she had read online around side effects she was very scared of starting the treatment, despite her physician’s advice.  She was delaying starting the treatment out of fear, which her physician had not allayed (and indeed had probably not covered in the brief appointment).  She therefore turned to this Facebook group to express her concerns – not so much asking for advice as just wishing to share her feelings.  Fortunately for her a couple of people in the group had experience with this product and told her not to be afraid and that it really was not that bad.  They provided her with the more accurate, personal information she required but they also calmed her fears and provided the emotional support she needed.  As a result of this she started her prescription as her physician instructed.

So how does this story help a pharma company looking to be more customer centric?  Outside of the US the first response would probably be “oh we can’t talk about our products with patients so we are powerless in this situation”.  Poppycock I say to that!  Whilst in Europe companies are severely restricted in what they can communicate directly to patients they are able to communicate directly to physicians.  In the example above had the physician been more aware of the conversations that his patients are reading online he may have been better prepared to allay his patient’s fears.  Some appropriate patient support materials speaking to these fears may also have been useful for the physician to share.  In the US the same rings true but there is the added element that pharma marketeers need to be aware of the dangers of DTC advertising.  Due to regulations they have to document the long list of possible adverse events – which to many patients is far more scary than the disease!  Again being aware of how patients feel, are communicating and thinking, can help counter some of this – for example by moving away from being so promotional to being more supportive in the messaging.

In essence being patient centric is about bringing some of this customer centric thinking into the work practice.  It involves making sure you really understand your patients. How are they using your products?  What are their fears and concerns?  What support do they need?  What issues do they have taking your products compliantly?  How do you use this information in your daily work?  This is even easier to do today – just as patients have access to more information so do companies.  Using social media listening for example companies can identify what the key pain points are and look to provide support accordingly (either directly or via physicians).

This brings me back to my first point – is this really happening or is “patient centric” just another buzz word?  Judging by pharma companies websites it is real – many of them promote their patient focus on their homepages suggesting that this is indeed of strategic importance.  Sadly digging a little deeper shows that in many cases this is indeed just another buzz word.  In many pharmaceutical companies there is talk of being more patient centric but too little action to support this talk.  The regulatory burden puts many off.  The lack of innovative thinking hampers others.  But perhaps the biggest issue is the lack of realisation of just how import patient centricity really is.  Whilst the example above is of just one patient – mulitply this by thousands and you start to see an impact on revenues.  With patent cliffs, more specialised pipelines and tightening budgets every patient starts to count.  What good is it convincing doctors to prescribe your products if the patients are getting information online that then dissuades them from using the product?

Patient centricity must move beyond being a buzzword for the industry.  It needs to be embraced and incorporated fully by the industry today.  Without patients there would be no industry so it is time the industry started acknowledging patients and taking their needs, but also their potential power, more seriously.  Because if not who knows what the future holds for the industry – but I doubt it will be that profitable.


Patient's increasingly have a choice. What's your choice?

Patient’s increasingly have a choice. What’s your choice?

How digital and social media is impacting pharmaceutical marketing

The world as we know it is changing. Our stakeholder’s way of thinking, and behaving, is changing due to 24/7 access to global information. So how does this impact our industry and what are the opportunities for pharma marketers?

Patients are engaging online around their health, and they expect to be able to engage online with other people and companies in this space. They do not understand why big pharma companies does not engage and this exacerbates the industry’s poor reputation. From a corporate marketing point of view this is an easy win. By accepting social media, rather than avoiding it, companies can start to have a positive impact on their reputation, and build corporate brand value.

This new dynamic is also impacting physicians, who face patients coming to appointments well informed, and with different questions than they used to, for example “is there an app for that”. Here again is a nice win for marketers. Rather than focusing on providing the information that they want physicians to hear, i.e. all about their product, why not look at also providing value by helping physicians with some of these real-world issues? Why not sponsor an assessment of disease apps, or ensure that the physician is kept up to date with what patients are Googling?

Another impact that the digital environment has led to is an increased pressure on people’s time. Marketing now means that you are no longer just competing with another pharma company. You now compete with a whole array of different parties to get a slice of a physician’s time. Give a person the choice to access information when they want and how they want, or to physically sit through a sales call at a specified time and it is a no-brainer which option people will increasingly choose. That is not to say that people will stop choosing the physical meeting altogether but they want a mix of options – and a choice.

Here again that word “value” comes in. As a marketer the way to grab a piece of someone’s time is to deliver value, both in terms of channel preference but also in terms of content. Digital enables us to understand individual’s areas of interest – why not then deliver your marketing information tailored to their preferences?

Of course this costs money, which is an age old problem. Again digital can help. Traditionally pharma marketing has been very siloed, by brand, function and geography. Digital provides the means to break down these siloes and generate cost efficiencies. By working in a more collaborative way, digitally facilitated, companies can reduce waste, for example in asset development and in time. Why should each brand, in each country, produce their own app? Often they have a similar end use and the backbone could be developed jointly and then adapted for local end use.

And this brings me onto the final massive change that digital, and in particular social media, has led to – namely access to information. The amount of information available on our stakeholders online is huge. Despite this I still see teams basing the bulk of their marketing plans on traditional market research with very little social media listening included. Now social media listening is not the be-all-end-all but it should be included. It provides key insights that need to be part of a modern marketing plan, for example where do your customers go for information, what topics are they talking about (and here is a hint – it is probably not about you) and what are their needs. Social media enables pharma marketers to get a better understanding of stakeholder’s emotions and behaviours, and at the end of the day it is emotions and behaviours that impact pharma sales.

Digital is no longer new and it is an integral part of daily life. Companies today should be optimising their marketing to reflect this digital impact and to start offering their stakeholder’s real value.

Social Media in Pharma Conference

Last week I had the immense pleasure of chairing the SMI conference on social media in the pharmaceutical industry.  I have to admit that I really enjoyed chairing, despite some minor hiccup with some of the name pronunciations (for which I do apologise!).

On the whole I enjoyed it and found the vast majority of presentations really interesting.  Not surprisingly Boehringer dominated the event. There was  Müge Gizem Bıçakçı Akalın from Boehringer Ingelheim Turkey who presented some great slides on what they have been doing in social media.  The first thing, that got lots of raised eyebrows, was their Facebook page targeting women with period pains for their product Buscopan.  The page is a profile page for a “retro” female character called … Buce Kopan!  To many of us this just seemed so blatantly DTC but apparently this is not seen as such in Turkey and both Buce and Kopan are well known Turkish names.  Doing a bit of research I can confirm that there are in fact numerous people called Buce Kopan so perhaps it is not quite as bad – just a tad a risky in my opinion!


 The other thing that I thought was fantastic to hear from Boehringer Turkey was that they are integrating their social media into their sales efforts – so they are encouraging sales reps to support the social media campaigns and are rewarding them for their involvement.  This to me is taking social media to the next level and it is great to see Boehringer again being a pioneer in this space. 

Another Boehringer presentation was made by John Pugh who showed some really interesting research, which I believe Silja Chouquet did for Boehringer, comparing the various pharma social media accounts.  There were some interesting points about how number of followers correlates to a degree with company size.  Reach however does not – so Novartis has far more followers that Boehringer on twitter but the same reach as Boehringer. 

Boehringer is also known for trying things out, and John talked through another example of this with the hypertension Facebook page for HCPs.  They had chosen an area where products are soon going off patent – so not a priority brand area – to test how relevant and effective a Facebook page for HCPs would be.  So far it looks like this has been a success – with some interesting learnings such as to advertise on the platform you are using rather than on other platforms (i.e. Facebook advert to a Facebook page). 

That was not the end to the Boehringer mentions though!  I myself used them as a case example when I talked about building relationships with KOL and KOI online.  My main points were that there is value in doing this and that there is a clear process to follow.  You can see my presentation here:

Gary Monk also spoke about how human Boehringer’s approach to social media is, citing their Facebook disclaimer as a great example,  contrasting markedly with Novartis’ very legal and formal disclaimer.  Gary also made a great point that Novartis, a company based in Switzerland, a country with four official languages (none of them English) has called out in their disclaimer that they community is English language only.  Boehringer of course manages very nicely to deal with multiple languages!  You can see Gary’s presentation here.

There were also some great examples from companies other than Boehringer.  Sherri Matis-Mitchell from Astra Zeneca presented some really interesting information on how they are using social media listening in R&D.  This actually seemed to complement a theme than ran through the event – namely the move of social media from marketing and communicaitons into R&D.  There were a few other mentions of the use of social media in clinical trial recruitment.  Dr Alfred Steinhardt presented a really interesting case study where social media had been used to reduce clinical trial recruitment down from six months to five weeks.  The cost-saving implications for this are huge! 

He also mentioned a fantastic example where social media intelligence had unmasked a competitor creating multiple online profiles to negatively influence consumer behaviour via social media groups!  Sadly he would not divulge more information on this.

There was also a very brave step by Sanofi to have a lawyer come present at the conference.  Audrey Hagege presented on how legal need not be a barrier but should be a partner in social media development.  I thought it was fantastic to see someone from legal there and I really have to say hats off to Sanofi for have legal not only attend but also present.

We also had a large presence from the #hcsmeu twitterati.  There was @thibaudguymard from Merck who talked about Univadis France and some of the great work they are doing.  Having seen Shona Davis present around Univadis from the global point of view last year it was great to see the local point of view.

 We then also had a whole array of twitterati present “virtually” through video thanks to my ex-colleague Piotr Wrzosinski from Roche.  It brought back many happy memories I must say!

It was also interesting to see such a broad array of social media being presented.  Besides the Facebook and Twitter initiative already mentioned there was also a presentation by James Finney from Novozymes around their use of Linkedin and Claire Perrin from Lilly demonstrated an mhealth initiative in depression.  I was so impressed with the app that I wanted to get my father to download it to show to my brother (a GP) but sadly I could not find it in on iTunes.

Perhaps my very favourite presentation however was the one that brought us all back to the reality of social media.  Ben Furber from Asthma UK talked about having fun online and … the fact that social media is all about cats!  How true!  Yes at the end of the day social media is and always will be about cats ;)

BMkQoByCEAAHrNn GetImage

eDetailing – it’s more than just iPads

I like to think that most people in the pharma industry now accept that digital is an important channel that they need to think about and include in their marketing plans.  Marketeers now include digital in their brand plans and the number of dedicated digital marketeers within pharma is growing.

Another area where we are increasingly seeing digital is in sales, with more and more reps being given iPads to use in their details with physicians.  This is not, in my opinion, edetailing – this is essentially still a traditional detail but using modern, digital, detail aids.  I find it can be really confusing that some companies call a traditional detail (i.e. face to face) that uses iPads an edetail while to others an edetail is a detail delivered electronically (as opposed to face to face).

Edetails (the non -face-to-face sort) themselves also have various formats – again rather confusing.  There is the self-serve edetail which is a pre-recorded video / presentation which the physician can watch, pause and stop as needed.  There is then the rep edetail which is more like a video conference between a rep and a physician (but where you can also still have the presentation element).

This confusion also means that companies who have implemented ipad detailing (let’s call it idetailing) think they have innovated when in reality they have only moved with the times.  It also means that they are not fully optimising the opportunities that digital presents.  The value that a true edetail brings is that the doctor can schedule them at a time to suit them – not just within office hours.  From the pharma company point of view the value is that edetailing cuts costs.  Even when using a live rep to do an edetail the rep no longer has to travel, cutting down on travel expenses, and could even conceivably work from home and work part-time, opening up opportunities to people who require flexibility around work.

The other value that edetailing offers to companies is potential access to physicians who are no longer seeing reps or who are too expensive to send a physical rep to (for example in rare diseases).

There are of course concerns that edetailing of this nature will make the traditional rep (and I mean the face-to-face rep not just a rep without an ipad!) redundant.  However this should not be the case.  edetailing is often an extension opportunity to traditional detailing – and in fact it has been shown that the most effective sales technique is in fact the mix of traditional detailing with edetailing (see graphic below).   What will change however is the role of the rep and this has already started in some companies.

Source: PM360

Source: PM360

The rep of the future will become an orchestrator rep – he will provide a more concierge like service to physicians, providing them with product information but also information around the digital services that the company offers, or information from recent conferences for example.  The role of the rep will move away from the traditional hard core sales focus to a value focus – providing information rather than pushing sales messages which the physician is not interested in.  Of course sales will still be the objective but the sales message will be delivered in a more customer centric, value driven way and this will then be supported by the edetail online.

The value that edetailing provides means that more and more pharma companies will start to use it, but, as much as I am a fan of digital, I believe there will always be a place for the face-to-face rep. The future though will be totally value driven and value comes from partnering human and digital interactions.

Pharma packaging – can you join the 21st Century please?

I was recently in a department store and was struck by the amount of effort consumer goods companies put into packaging.  The product packaging can make or break a purchase decision so it is clearly an area that warrants attention for FMCG companies – but what about pharma companies?  The first response would probably be that this is not really a relevant area of concern for a company that sells prescription products.

I, however, would disagree.  This may not have been an issue  in the last century but I think this is now no longer the case.  There are a number of reasons for this but perhaps the main is patient adherence.  This is a topic that has been a headache for the industry for some time – one that has still not been resolved.  When digital technology came to the forefront it was initially greeted as the saviour – the ideal solution for patient adherence.  Subsequently it was denounced as a disapointment – technology did not solve the patient adherence problem.  This was in part because some of the early programmes were too simplistic and did not factor in the complexity involved in patient adherence. Another issue is that technology can only solve part of the problem.  The rest of the problem needs to be addressed in other, more tangible, offline ways.

This is potentially where a greater focus on packaging, and making packaging more consumer friendly, could play a role.  If we take for example pills that a chronically ill patient has to take daily.  There are numerous digital tools now to remind patients to take their pills, but what about just simply labeling the day of the week on the package?  Contraceptive pills do this so why not for other long term medication?  Whilst it may not provide the nudge to take the medication it acts as a reminder, as well as for of documentation, that the pill has been taken for that day.  I for one would be more adherent – I often cannot remember if I have taken my pill for the day, and err on the side of caution by not taking another one (meaning I may in actual fact have missed my pill for the day). I have taken to writting the days on the packaging so that I can check if I forget – but it would be so useful if it was printed on the package.  This would be such a simple but consumer friendly and helpful thing to do – and yet it is not common practice (I have not actually seen it on any pills other than contraception – have you?)

Another area to look at is the patient insert.  This is a bulky piece of paper that comes in the box with the medication.  Whilst the text has improved over the years to be more consumer friendly, the insert itself is an issue.  For products that come in bottles, such as acne lotions, the information is not always printed on the bottle, even if there is space.  I suspect many patients are like me – they take the pills and the bottle out of the box and probably throw the box, insert included, away.  Whilst for pills it may not be possible to print the instructions on the packaging there is plenty of room on bottles.  This way a patient would be able to check and get accurate information around how to use the product once the insert has been thrown away and thereby be more compliant.

One major area where packaging is a huge concern though is for patients with disabilities or movement restrictions, such as arthritis patients.  To be developing packaging that your target market – i.e. the patients – cannot even open seems to be to be a huge issue!  There needs to be more innovation to address the needs of patients who struggle to open packages or bottles.  Packaging should be developed with the end user in mind – not just to comply with regulation or meet storage or distribution needs.  If a patient cannot access their medication then what use is it?!

A final issue I have is around the visual design of packaging itself.  Firstly very few companies give much retail space to the brand name – which differs from FMCG who place far more value in corporate branding than pharma does.  Being familiar and trusting a corporate can have a positive impact on adherence for some patients and again this could be something that companies could dedicate a little more attention to.  The final issue comes again with bottles.  I have in  my cupboard a mix of FMCG products that look good and prescrription bottles that look dreadful.  The FMCG ones I am happy to have out on display whilst the pharma ones go in the cupboard.  It is a no brainer which ones I use more simply because they are visible.  Whilst I am not suggesting pharma invests in beautifying their packaging to the extend of FMCG packaging they could perhaps just modernise their packagaing a bit and make them less ugly?  I warrant this point is very minor but it does bother me as a female patient!

Will any of the above happen?  I doubt it.  This is a very old fashioned industry and packaging is at the bottom in terms of prioritites but it would be great if someone listened and started to make packaging more customer friendly.  Until then I will continue to hide my ugly bottles and write the days on my pill packaging.

Can you guess which bottles get hidden in the cupboard?

Can you guess which bottles get hidden in the cupboard?

A patient’s point of view

I was recently involved in a workshop for a pharmaceutical product and one element we talked about was the emotional journey a patient goes on, and how digital tools played a role in that journey.  This really resonated with me as a patient.

We are of course all patients at some stage or other, but some of us are patients with chronic or long term illness which require on-going treatment.  In my case I have Hashimoto’s, which causes hypothyroidism, and I will need to take thyroid hormones the rest of my life.  My journey as a patient with a thyroid condition has been highly emotional, distressing and sometimes extremely difficult.

A patient will experience a whole array of emotions as they go through their own journey.  Mine started with joy when I was told I had hypothyroidism – I finally had a reason to my sudden and excessive weight gain.  Unlike in some other conditions I never really felt isolated, in part because I was very open on Facebook about my hypothyroidism, and this resulted in a surprising number of other friends also identifying that they had the condition. I also initially did not have many problems, it was only in the last year or so that things got worse and it was at this point that I would have been in danger of feeling very alone with my condition had it not been for Facebook.

As my condition and health deteriorated, the journey became more emotional and more distressing.  I put on weight again, felt lethargic and was constantly tired, and I felt depressed and low.  I was very miserable.  I also got increasingly desperate.  As an educated woman, working in the healthcare industry, I knew that something was not right with my health – something was wrong.  As per my previous post I received absolutely no support (informational or emotional) from my then doctor.

In the days of old I would have been totally alone at this point in my journey.  I would not have known that it was not right that I was feeling this ill. I would have been totally dependent on my doctor’s response (good or bad). I have no idea how I would have coped with the despair, the depression and the fear (and believe me thinking that you may spend the rest of your life feeling exhausted and listless is very frightening).

Fortunately today we have the internet and social media.  It really was a game changer for me and my disease. I already knew that my symptoms were common for hypothyroidism but what confused me was that I was already on a very high dose and should have felt fine and full of energy.  I was terrified of lowering my dose and feeling even worse (and putting on yet more weight) and yet this is what my blood results indicated I needed to do.  I was also scared that it was just me – that other patients coped fine and it was just my body not working properly.

Through a support group on Facebook I very quickly found out I was not alone.  In fact far from it.  It turns out there are many patients on treatment but having issues with their health, their symptoms and their doctor’s response to their concerns.  It was such a huge relief to find out I was not alone and to have fellow patients to share my story with and to be able to connect with people who felt exactly like me.  The emotional support that this virtual engagement provided was immeasurable.  I no longer felt alone and the feeling of despair went down as I felt there were answers and there was hope.

It was through this support that I found the strength to question my previous doctors’ response and seek further treatment.  I paid, out of pocket, to see an endocrinologist in the UK and I armed myself for that appointment with as much knowledge as I could, from the internet, in order to ensure I received the optimal treatment for me.

My appointment with Dr Morris was like chalk and cheese compared to the Spanish endocrinologist.   He was supportive, listened to me and provided some solid advice, which included bringing my dose down.  The way he advised me took some of the fear out of lowering my dose.

The rest of the fear was taken away because, through my online searches, I had found out that in a very small minority of patients being on too high a dose can cause the same symptoms as hypo even though they are hyper.  Turns out I was one of this small minority.

The other thing Dr Morris did was confirm what I had suspected – my hypothyroidism was caused by Hashimoto’s disease.  Following the Spanish endocrinologist’s failure to tell me what was causing my hypothyroidism I had gone online and done my own research using my blood results.  Through this research I had self-diagnosed Hashimoto’s but it was also great to get it confirmed by a physician.

Armed with this confirmed diagnosis I did more research.  Through support groups and blogs I found out that most Hashimoto patients have some form of gluten intolerance and that eliminating gluten could help improve health outcomes.  Not one of the doctors I had spoken to over the last couple of years ever talked to me about my diet and the impact lifestyle changes could have on my disease.  It was only through interacting with other patients online and doing my own research that I found out about the changes I needed to make to my diet and lifestyle.

As a result of my online research, I now no longer eat gluten and I have reduced the amount of goitrogenic food such as cabbage.   I am also very careful about getting enough sleep and staying healthy.  The impact this has had has been huge.  I feel relatively normal again now, and whilst I still get tired easily I no longer feel depressed or listless.

My emotional journey has now come to a point where I feel confident and hopeful.  Some fear still remains, for example how my need for ten hours sleep will impact my work and the fear that I may feel ill again in the future.  But for now, thanks to resources and information I found online, my main emotions are relief, happiness and hope.   I do not know where my patient journey will take me to next but I am certain I will find the support and resources I will need online.

Sunrise after a dark night

New hope after the despair – just like sunrise after a dark night


Get every new post delivered to your Inbox.

Join 2,520 other followers