The explosion of social media and its use are widespread in almost every industry. Each day, companies in all industries make use of social media in a number of ways to reach consumers to transmit information, support or service. However, according to several consumer groups, “consumers now confront a sophisticated and largely stealth interactive medical marketing apparatus that has unleashed an arsenal of techniques designed to promote the use of specific brand drugs and influence consumers about treatments for health conditions.”
Accordingly, these consumer groups filed a lengthy and nasty complaint at the Federal Trade Commission (FTC) last week charging far ranging wrongs about pharmaceutical companies using social media and digital marketing to reach consumers. These groups sent copies of their complaints to Capitol Hill, FDA and the media. It appears from their strategy that the groups are trying to get FTC and Congress to limit all digital marketing by pharmaceutical companies.
The filing groups include the Center for Digital Democracy, Consumer Watchdog.org, US PIRG and the World Privacy Forum. In interesting coincidence, all of these organizations except for the World Privacy Forum are either started by consumer advocate Ralph Nader or their executives worked for Nader.
Although it asks FTC to investigate health media, including WebMD, HealthCentral, Google and AOL, it is aimed also at pharma and pharma marketers and is designed to smear virtually all use of digital media to target patients and professionals. It calls out several digital targeting techniques and asserts that they are unfair and deceptive, thus subject to FTC jurisdiction.
According to a press release posted on the Center for Digital Democracy’s website, the 144-page complaint called on FTC to investigate and remedy unfair and deceptive digital marketing and advertising practices that consumers and patients face as they seek health information and services online. The Center also published an executive summary, detailing the techniques identified in the complaint, which the consumer groups believe “threaten consumer privacy and potentially put the public health at risk.” A summary of some of the techniques are listed below.
- Medical or Disease Condition Targeting, in which consumers or patients who express a particular health concern or interest are digitally profiled, tracked, and served ads and content based on the collection and analysis of such information. Among the many sensitive categories used in condition targeting are depression, COPD, diabetes, and asthma.
- Social Media Monitoring, through which health and drug marketers engage in online surveillance of the conversations consumers and their networks of friends have about brand pharmaceuticals, medical conditions, and treatments.
- Behavioral Targeting, based on online data collection that analyzes a consumer’s Internet activities (which some call the “patient online journey”), in order to deliver marketing and advertising that zeros in on their medical concerns. Health and medical condition behavioral targeting is also used by online ad auction exchanges that sell access to a particular consumer in real-time for advertising purposes.
- Viral and word-of-mouth “buzz” marketing campaigns sponsored by pharmaceutical companies or health-related marketers that seek to drive sales of specific prescription and over-the-counter drugs.
- Unbranded online medical condition websites that appear to provide independent information on a particular disease or condition, but which are actually sponsored by a company whose products include treatment for the medical condition or problem addressed by the site.
- Seemingly independent testimonials or advice online, including through social networks and online video channels or sites, that are in fact the result of sponsorship arrangements and financial support by a pharmaceutical or health marketing company.
- Free online newsletters (WebMD alone offers nearly 50, covering such topics as arthritis, cancer, and weight control) and discount coupons (FirstRxSavings.com offers “hundreds of coupons for prescription and non-prescription drugs”) are used to collect personal and other digital information from consumers, which is then used for profiling and targeting.
- The practice of “e-Detailing,” where physicians, nurses, and other health professionals are targeted via sophisticated digital marketing techniques designed both to influence their decision-making regarding specific drug brands and closely monitor their behaviors. These practices, unknown to patients and consumers, can have a direct effect on their healthcare costs and methods of treatment.
- The growing promotion for the use of electronic medical records by online health advertisers, such as Google and Microsoft, that also have a significant business in digital health marketing.
- Neuromarketing practices, which draw on the techniques of neuroscience to develop advertising campaigns for medical products that make direct appeals to the consumer’s subconscious.
Claims About Social Media & Pharma
For the groups who filed the complaint, their main concern seems to be that the pharmaceutical industry is spending approximate $1 billion on social media marketing without any sort of rules or regulations regarding its use. As a result, these groups feel that the “online marketing health industry has presented to the FDA and the public a fairytale version of digital marketing, where all consumers become empowered “e-patients,” able to form powerful helping communities. While some might view this as a positive thing—patients seeking out health information and ways to treat their conditions—consumer groups believe that medical information provided online thus far “has been structured to engage in aggressive tactics that threaten privacy, raise questions about the fair presentation of independent information, and advance the sales of prescription drugs and over-the-counter products.”
For example, Jeff Chester, executive director of the Center for Digital Democracy (CDD), stated that “By using powerful digital marketing tools, pharmaceutical and online health information companies now have unprecedented abilities to take advantage of consumers.” He further noted that the marketing techniques described above “have been purposely designed to tap into the concerns and anxieties of individuals who are going online to seek health information.” CDD believes that this puts patients at risk for unfair, deceptive and non-transparent practices, that will only increase as the country moves to digital medical records. To others, “Online health marketers are taking advantage of consumers at time when they are most vulnerable–worried about their own or a loved one’s health.” For consumer groups, this trend undermines patient privacy.
Accordingly, the consumer groups want FTC to “protect consumers by ensuring that their health and medical data–including their use of online health services — receives the highest form of privacy safeguards.” Ed Mierzwinski, director, Consumer Program, USPIRG said that “No consumer should be forced to confront a vast system of invisible and unaccountable online profiles that label them as someone who has or is concerned about a life threatening disease, serious medical problem, and then be ‘condition-targeted’ across the Internet and likely off-line as well.”
Recommendations
The consumer groups expect that in its forthcoming new privacy report, new and effective safeguards will be proposed by the FTC to protect consumer health and medical privacy online. Nevertheless, the four groups called on the FTC to undertake the following actions:
- Examine and analyze the data collection and usage practices of pharmaceutical advertisers, in order to assess the extent of consumer information collected through websites, social networks, online video sites, and other interactive means.
- Require companies engaged in digital marketing of health products to provide information on the kinds of online targeting techniques and methods they employ, especially behavioral advertising and retargeting.
- Conduct a review of the privacy policy pages on health and pharmaceutical websites and services, including the leading social networks promoting health products.
- Analyze how health-related social media marketing influences consumer behavior and attitudes concerning drug use and various medical conditions.
- Investigate whether there is a violation of the FTC’s Endorsement guidelines (which have been extended to the Internet) when advice is given to patients or consumers from seemingly independent health bloggers who fail to disclose that they are paid or sponsored by pharmaceutical or other companies.
- Investigate the use of “unbranded” sites funded by pharmaceutical companies, in order to assess whether such sites are structured and designed to support the promotion of specific drugs.
- Conduct an inquiry on the use of neuromarketing-related techniques designed to influence or measure subconscious responses.
- Work with the Food and Drug Administration and other appropriate agencies to develop a set of policies for regulating the use of behavioral targeting, data collection, and other digital techniques in the marketing of drugs and health-related products.
A good recommendation for these groups is to conduct some research first. It would be interesting to see how patients used information conveyed through social media and what they thought about these practices. Given the use of social media is a recent tool in medicine, and the legitimacy unknown to many, one would assume that like commercials or advertisements, patients armed with information from social media would bring questions to their doctors about such drugs or treatments.
If that is the case, then social media serves an important purpose for connecting patients with their doctors to address their health concerns. This data would also prove valuable because it could show what forms or mediums of social media patients desire to receive information about drugs from, and which forms are most effective. Information such as this could provide a useful tool to health marketers to reform practices within their industry to provide more useful, unbiased and patient-centered information.
Discussion
The impact of this complaint is significant because it represents a dangerous extension of the attacks on pharma marketing in Washington and will feed press attacks on the pharmaceutical industry. One commentator however, noted that the compliant is perhaps “the best review of healthcare-related digital marketing techniques” he has seen. While he recognized the innovativeness of many of these techniques, he noted that the consumer groups believe such practices are unfair and deceptive.
Consequently, the complaint could lead the FTC to open an investigation and create a protracted public relations problem. Presently, the online industry is already in a tough battle with some in Congress and the FTC over their proposals to increase regulation of behavioral targeting. This complaint will essentially extend this inquiry into professional marketing of health information and will increase the public visibility of many important marketing tools. The leading online marketing trade associations, including AAAA, the Direct Marketing Association, Association of National Advertisers and the Interactive Advertising Bureau, have created a significant self-regulatory program that has gained considerable government support, but is discounted by these consumer groups. The health products industry will more than likely be joining these groups to find additional self regulation to protect online privacy
As all stakeholders in this process wait for guidance on the use of social media in drug marketing and advertising from the FDA or FTC, pharma and other health online marketers are pressing the FDA for new rules that would allow them to expand digital and social media advertising. The main thrust behind their argument is to reach populations of patients who do not adhere to their medications and to provide more resources for patients currently undergoing treatment to better understand the nature of their condition and any negative side effects or concerns that might create an obstacle to achieving the desired outcome.
Expanding the reach of social media is also seen as an important role in reaching patients who go untreated or spreading awareness about conditions that go undertreated or undetected. It is also seen as a potential resource for patients with chronic diseases who may decide to take “drug vacations” when symptoms from their illness disappear, although the underlying medical problems are still present. It is obvious that there are many good reasons why pharma wants to reach patients but there is also clearly a need for guidance about what is ethical and appropriate.
Before consumer groups call for a ban on truthful commercial speech that is likely to help patients, reduce health care costs, and lead to better detection, prevention, and treatment, a middle ground should be sought. Every industry uses social media and similar tactics to target populations, when the outcomes are clearly not as beneficial.
Given the rapid pace of society and the growing demand for health information from patients and practitioners, social media can act as a bridge to help the public access information in a convenient and reliable way. While demanding transparency and protection for privacy are legitimate claims, these consumer groups must realize that by attempting to eliminate or severely restrict an extremely valuable resource of information for patients could produce more harm to patients than good.