S&R Blog


This Article Rated “R” For Scientific Rigor and Relevancy

I’m one of those weirdos who most enjoys a movie when I know the plot or ending beforehand. 2001: A Space Odyssey? More interesting when you know the ambiguous plotline and can really think about what the surreal imagery and multilayered themes mean. The Godfather? More enjoyable if you’ve already seen the climactic, juxtaposed baptism/murder scene near the end of the film.

Often I’ll put a movie on my Netflix queue, then go immediately to Wikipedia to read the plot summary. And I just might take that DVD, watch the final scene, then view the movie from the beginning. Why? Well, I like surprises and plot twists and all, but I just find it more enjoyable to know the “end” so that I can better understand and more enjoy the “means”.

I got thinking about how this peculiar behavior relates to reading journal articles after seeing Teresa Rogstad’s recent AMWA Journal feature (2009;24(4):176-181), “Judging the Quality of Medical Literature.” In a succinct review, she lays out the key things (eg, study design, bias, sample size) to assess in determining the “methodologic strength” and “application usefulness” of published research. Now on my burgeoning “must-read” list for nonscientists in Pharma, her article might be of value to even the most CONSORT-literate folks.

Consumers of scientific literature might well combine my contradictory movie habit and Rogstad’s criteria by approaching their next scientific article as follows:

  • Read the Abstract (plot) to help assess the quality and direction of the study.
  • Read the Discussion section (ending) to understand the research implications.
  • Read the entire article to understand the data’s finer points and full meaning. As with a film, this method can help maximize the reader’s use—and dare I say, enjoyment—of the “story” that the writer and researcher(s) have crafted.

We at SRMC believe this assessment of the quality of the research “story” is crucial to the most effective use of published clinical data. And it’s one of the many capabilities that we offer to help clients who want to optimize the impact of the research articles they use to support their products.

So if you’ve ever asked yourself—Is this/that journal article good? or Should I cite this study?—we can help you find the answer. And if you have questions about how the movie ends, we can answer those, too.

Ted J. Slowik, PhD

Director, Scientific Information, S+R Medical Communications
teds@srmedcom.com



It’s Not Your Father’s Oldsmobile!

In its heyday, GM developed an advertising campaign for their Oldsmobile brand in an attempt to sway younger buyers.  Oldsmobile had been a long standing success for GM among middle-aged and older buyers, but they wanted younger customers. So they came up with a new campaign, “It’s not your father’s Oldsmobile”, which spoke to the innovation, sleek styling and sex-appeal that an Oldsmobile could provide.

At the risk of sounding like my own father, I have concluded that doing business today is a lot like that now-famous Oldsmobile campaign.  Doing business today is not based on the practices I was taught to honor, respect and hold sacred.  In fact, today’s business world is quite like the Wild West—plenty of outlaws, snake-oil peddlers and people looking to be the “biggest gun in town”.

The first difference I find is the ability to take people at their word.  With all the muttered promises, downright lies and “handshake” deals that frankly are not worth a damn, you simply can’t do that anymore.  Could it be a generational gap? New generational values? Or am I becoming an old fart?  It almost doesn’t matter, because when you are unable to trust people to do what they say, something is wrong.  Taking people at their word should mean that there is an understanding between two people that certain expectations will be met.

The second difference is a growing inability to conduct business on a face-to-face basis.  As I compose this blog on my computer, check my smart phone for text, e-mail messages, check my voice-mail and find comfort and safety behind my computer screen, I understand where some of the problem resides.  The ability to engage people in a “live conversation”, either face-to-face, via the phone or via virtual meeting technology is increasingly more difficult.  But I simply can’t think of many successful personal or business relationships I have had where I wasn’t able to interact with people “live”.  Really, how can you build trust and understanding when you have to submit proposals and information via a “blinded web portal”?

The final difference is the “it ain’t grown here” mentality.  My business, in great part, depends on selling ideas, creativity and high-quality implementation of those ideas.  Yet it often feels like that is not what our clients really want.  The typical interaction with our clients is often very one-sided: the client says, “We want an electronic sales program that looks like this and says this, and we need a price for that by tomorrow afternoon.”  Now, some of you reading this might ask, “What’s wrong with that?”

What’s wrong is that it may not be true that an electronic sales program is the correct solution to the problem they are trying to solve.  What has been lost is the long-term strategy (translation: today’s stock share-price) that’s critical to the process and driven by the following key questions: What do your client’s customers really want?  How should you create messages and images that ensure your customers understand and accept your brand?  What media will best reach the demographics of your target audience?

If the above are, in fact, the hallmarks of business practices in the future, so be it.  I personally don’t agree with doing business in these ways—but then everyone has their own opinion (and orifice).  It’s just that when you can’t trust people, interact with them on a face-to-face basis and expect them to have an open mind on how they manage their business, it, doesn’t bode well for the future.

So, with that in mind and that said, I think I will change my Depends, wipe the drool from my chin, sit on the front porch of the assisted-living center and try to find some Oldsmobile ads in the magazine I am reading.

David H. Recht

CEO North State Resources
Holding company for S+R Medical Communications



Which industry’s ads are most trusted by Americans?
February 8, 2010, 7:49 pm
Filed under: Uncategorized | Tags: , , , , ,

If you answered pharma, then you’re right when compared only to the financial industry. But according to a new poll conducted by Harris Interactive and AdweekMedia, when compared to the soft drink, fast food, and auto industries, pharmaceuticals ads come in as least trustworthy by Americans.

Of the five industries about which the poll inquired, soft drinks had the highest “most trustworthy” vote (34 percent) and the lowest “least trustworthy” score (4 percent). Fast food was the runner-up in both respects (22 percent “most trustworthy,” 10 percent “least trustworthy”).

Each of the polls’ other three ad categories had more negative than positive votes. Pharmaceuticals was ranked “most trustworthy” by 18 percent and “least trustworthy” by 29 percent. The automotive industry fared a bit better, at 14 percent “most trustworthy” and 19 percent “least trustworthy.” Financial services did worst of all, at 13 percent “most trustworthy” and 38 percent “least trustworthy.”

Want to weigh in on the conversation? Check out the full article here at Adweek.



Why Pharma Is Pushing Its Drug Pushers Out

New day. Same story.

Source:Minyanville

The pharmaceutical industry is going through a transformation — not only has it been consolidating with mega-mergers like the one between Merck (MRK) and Schering-Plough, but it’s facing a major patent cliff as the revenues from the blockbuster drugs of the 1990s fall prey to generic competition.

Yet, these larger changes have led to shifts in other parts of the industry, too. Since Big Pharma can no longer rely on new blockbuster drugs to pad their top line, these companies now have to transform how they do business to include the biotech model of finding drugs for diseases with smaller patient populations. This also means a major overhaul of how the industry sells its product to the masses.

Pharmaceutical sales reps will be the first to tell you that the industry is scaling down. Once plentiful — there were more than 100,000 reps in 2005 — the drug sales rep is quickly becoming part of the past. A recent report by Deloitte proclaimed to the industry to change its sales models or bust.

An article in the Indianapolis Star this week shows just how much sales rep are despised by the very doctors they’re supposed to woo. Doctors have been pushing for sales reps to make appointments and cut down their pitch time. In some cases, doctors are asking to ban their presence altogether (one in four doctors now refuses to meet with reps, according to the Deloitte report).

But doctors’ dislike of this incredibly aggressive and confident class of individuals isn’t the only reason that the sales rep is becoming extinct. Doctors are no longer the key decision makers when it comes to what drugs are being prescribed. That decision now rests heavily with consumers (who are highly affected by direct-to-consumer advertising), and even more so with insurers who are the primary payers for the often over-priced drugs being pushed by the pharma companies.

Pharmaceutical companies aren’t blind to the problem. The past year has been a bloodbath for pharmaceutical peddlers. AstraZeneca (AZN) said in 2007 that it would cut 7,600 people by 2013; it later upped that number to 15,000. The company didn’t say where those jobs would come from, but the sales force was offered the buyout first. Sepracor, wholly-owned subsidiary of Japan’s Dainippon Sumitomo Pharma, reduced its number by 530 in 2009, bringing its sales force to 1,325 people. King Pharmaceuticals (KG) eliminated 380 field sales positions last year, bringing its total number of reps down to 720 and Sanofi-Aventis (SNY) cut 750 people from its sales roster.

Jump to 2010: Pfizer (PFE) cut 556 sales reps as part of its broader layoffs due to its merger with Wyeth last year. Earlier in the month, Merck eliminated 400 positions from the Schering-Plough headquarters in New Jersey with a majority coming from the sales team. This is on top of the 1,000 sales reps that Schering laid off in 2008 before its merge.

So how will the new pharmaceutical sales landscape look?

It’s likely that insurance companies are going to be playing an even bigger role in which prescriptions become the drugs of choice. Meanwhile, Big Pharma will likely look to outsourced sales rep to educate those same insurance companies. As a plus for doctors, their knowledge will likely have to come more from medical journals and other non-biased sources.

“Pharma’s challenges require a detailed understanding of each stakeholder’s role and contribution to value,” says W. Scott Evangelista, principal at Deloitte. “By better understanding every stakeholder’s unique needs and motivators, a pharma company would be better equipped to improve its internal capabilities — e.g., knowledge, skills, tools — to interact more effectively with each constituent.”



What do physicians really think about Big Pharma?

According to Dr. Candida Fink’s latest blog post on PsychCentral, not highly. In what clearly wasn’t a good year for pharma in terms of reputation, Dr. Fink highlights why she will “no longer see any drug reps.”

I didn’t want to hear from them, and I haven’t since. I avoid lectures and meetings that drug companies sponsor, and I use no drug company pens or notepads. The longer I avoid direct contact with drug company reps, the better I feel about it. The further removed I am from these things the more I realize I was getting a lot of my information about medications from company reps who had vested interests in my using their product. I realized that I don’t need samples, because the companies give samples only of their newest products, and those don’t have the research or track records that the older products have. Furthermore, the older products are now available as generics, which ultimately save my patients far more money than they save by taking a few free samples and then paying for the priciest, newest product.

Obviously, this is the opinion of one physician, but the points Dr. Fink brings up about her disdain for pharmaceutical marketing tactics have been echoed more than once lately. So if not from pharma companies, where would physicians get their information about products? According to Dr. Fink,”That isn’t to say I don’t keep informed and try new products that are appropriate for certain patients, but I do so based on research and my patients’ needs, not who bought me lunch last week.”

Samples, proper medical education, and other informative materials should be needed to help improve patient outcomes. But physicians seem to be turning their heads the other way.  If pharma doesn’t heal the wounds and restore the trust with physicians, credibility will be the least of its problems. What do you think?

Read Dr. Fink’s post here.



Will medical education help to fill the credibility gap in pharma?

David H. Recht of North State Resources Inc. and Kelli Soare and Ed Leon of S+R Medical Communications discuss how credible, needs-based branded medical education can help to make the pharmaceutical industry a trusted resource for physicians once again.

Source: Med Ad News

Recognizing the erosion of trust physicians have in the information they receive from the pharmaceutical industry, the healthcare advertising agency S&R Communications Group has recently re-engineered into two specialized companies, S+R Medical Communications and Friday Morning. Friday Morning will provide insight on a project basis into what physicians will and will not respond to as promotion. Meanwhile, S+R Medical Communications will provide educational vehicles that brands need to rebuild trust and help physicians and patients make better, more informed choices in healthcare.

To learn more about the need for credible branded medical education, Med Ad News spoke with Dave Recht, CEO of North State Resources – the holding company for S+R Medical Communications and Friday Morning– along with Kelli Soare, senior program supervisor, and Ed Leon, senior program director, both of S+R Medical Communications.

Dave Recht: The trust issue has crossed the boarders of promotional strategies in a pretty pervasive way. It’s not just the advertising. It’s not just the sales rep, but there’s also the trust issue in the whole area of medical education. Part of that stems from the fact that there are cases in which physicians look at any of the information that’s coming from the pharmaceutical industry and they’re very skeptical about it.

I’ll also say, immediately 180 degrees to the opposite, that one of the areas that continue to be described, at least to us, and other reports we’ve seen is that they do want education.

If you start out with the mission that pharmaceutical companies, aside from their discovery and development and marketing component, have an obligation to educate their physician and patient audiences. If you accept that as a basic plank of responsibility for the pharmaceutical industry, what that demands is the physicians are saying, we give you that you guys have the most knowledge and the most insight and the most information about the products that you’re marketing, there’s not a dispute that we don’t think those products can be valuable, but we need to know the information that you have and that we need to know to make informed decisions about which of those products are right for which patients.

If you take that perspective, physicians really do want to be educated. But I think they want to be educated now in a way that they can take that information along with information that they’re getting from a number of other sources – Internet, their colleagues, symposia, publications – and use their brains to filter through what are the best opportunities to treat their patients.

There clearly is a demand and a need for branded medical education.

Med Ad News: Is there a problem with the way branded medical education is being presented? Are they getting what they need?

Dave Recht: There’s some things that need to change. We’ve always taken the perspective on the branded side, or the medical information side, within labeling, that education has a set point, and that is to deliver information that helps somebody better understand and better make treatment decisions. Whether it’s certified education or whether it’s educational information within labeling, we really don’t distinguish that in the sense of one type of education being better than the other type. It is education across the board.

So, if you take that premise and you say to yourself, okay, the first thing about education is it has to be need-based. To go into a speaker bureau or some other educational program in which you’re talking about cough cold products, unless there’s a new revelation and high-powered product, nobody is going to pay attention. So, it has to be based on the educational needs of the doctor in terms of helping he or she make their treatment decisions.

Then, if you base it on need, the second thing that has to happen is it has to be credible. What are the hallmarks of credibility? It’s people whom you choose to associate with in developing the educational material, so your thought leaders and KOLs. They’re respected. They’re well grounded. They have good clinical application and perspective on how a product should be used. Not just the theory of it.

Then the information needs to be transparent. There needs to be a way in which physicians can look at the data that is provided as support for the particular product, and physicians need to be able to see the whole truth and nothing but the truth. That’s another plank of what good education is about. And unfortunately, it isn’t getting delivered as frequently as we might like it to be in today’s world.

Then to me the final point of it is how do you present that information? What is it you choose to do in terms of the different types of mediums? The graphic design. The language you use.

And by the way, when we develop our educational programs, we always look at key principles of adult learning. What are some of those key principles and how do we apply those to the educational process and the programs we’re putting together for an audience?

So, the end of this whole thing becomes a process by which physicians who get an educational event from us … that education should be meaningful, worthy, credible, applicable from a clinical perspective, and it needs to be presented in a way that the physician receiver can easily understand the information and gain knowledge very quickly.

Ed Leon: A lot of clients probably don’t accept the reality that the way doctors get information has changed quite a bit, and it’s changing rapidly. Just like consumers and patients, doctors are active seekers of information much more than they were 10 or 20 years ago. They’re not just passive recipients. You have to meet the doctors where they are, where they’re seeking information. It’s very rare that a doctor is going to sit in his office and just wait for a sales rep to come in and get his first piece of information about a therapeutic area or a product.

Read the rest of the interview here.



Will the Mac Tablet revolutionize EMRs?
January 7, 2010, 9:48 pm
Filed under: Uncategorized | Tags: , , , , , , , ,

After a lull of about 6 months the Mac Tablet buzz has started to heat up again with Apple announcing its release for March. Like the iPhone before it, the medical community has started to hail the Mac Tablet as a revolutionary healthcare device, most notably for electronic medical records (EMRs). Ease-of-use has been a primary barrier to EMR adoption, so Apple – known for intuitive design and usability – would be welcomed by physicians.

The EMR possibilities for the Mac Tablet  have been covered in depth through an article at Softwareadvice.

“The Ultimate EMR User Interface
An Apple tablet would be the ultimate UI for electronic medical records. With a touch-screen display like the iPhone, using the EMR during an encounter would be simplified. For example, selecting an evaluation and management (E&M) code could be as easy as “dialing in” the code with a swipe of a finger…”

But are EMRs really making life for physicians easier? And will the Mac Tablet help? This video begs to differ.




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