As social networking Web sites court big pharma with new services, firms now must decide whether such forums can play a useful role in collecting data and monitoring markets.

Online forums, such as Sermo - which claims to be the fastest growing online physician community - entice companies to participate by touting potential market research opportunities as well as the chance to gain input on topics, such as continuing medical education.

Pharmaceutical firms seem eager to join the discussion, which is just one step in the greater push to integrate new technology and R&D innovation. Online promotion is of increasing interest to pharmaceutical companies, which are looking for innovative ways to monitor markets and reach stakeholders as their business environment changes and restrictions increase on current marketing techniques.

Sermo, though free, and convenient for physicians to join (the site claims it takes one minute), only asks participants for MD/DO credentials and primary and secondary specialties or interests. Without more specifics about its members, site queries offer firms expansive feedback, yet relatively crude data.

Online forums range from those geared to physicians, like Sermo, to others specifically for patients, such as the sites PatientsLikeMe.com (¹ Also see "PatientsLikeMe.com Social Web Site Is Resource For Drug Market Research" - Pink Sheet, 5 May, 2008. p. 26) and iGuard (² Also see "Rx Safety Is The Hub For Social Networking Site iGuard; Registries Will Fund It" - Pink Sheet, 28 April, 2008. p. 20). Pharma's growing participation in and monitoring of these is a nod to the breadth of information available at the click of a button and to the fact that more people are getting information this way.

"Social networking sites ... could be game changers right now," said Glenn Sabin, a principal analyst at ZS Associates, a consulting firm. Such sites, however, will not displace other modes of data collection overnight, he cautioned. "They need to show they can [collect data] as, if not more, cost effectively [as other methods] ... and they also have to show [the data are] relevant."

To this Sermo says: Yes, we can.

Sermo Sweet Talks Pharma

Sermo offers several services that companies can buy to survey physicians in its online community (see chart: " ³ Sermo Services Sprout With Pharma In Mind "). Since the site launched in 2006, it has secured relationships with ten leading pharma companies, notably Pfizer, and has a physician community of more than 100,000 members, up from about 30,000 in September 2007, CEO Daniel Palestrant said in an interview (⁴ Also see "FDA Closes Gap In Postmarketing Dialog With Physicians Through Online Site" - Pink Sheet, 17 September, 2007. p. 16).

"We realized clients ... wanted to have our people come up with a campaign or solution for them to purchase a la carte," Palestrant said. "A growing number [of companies] that come to us have a need, like a need to raise awareness of a new indication ... and after listening, we come back with a campaign."

Sermo argues that the site can ease the often lengthy and costly research process needed to carry out clinical trials by offering an outlet for feedback at each stage - from design to research and feasibility studies. This approach can, ultimately, reduce cost, Palestrant claims.

Companies can expect to pay a third to half of what they would pay for, say, a private discussion about protocol design, with use of Internet services, Palestrant said. Firms save on travel costs by coordinating a group of physicians to survey online.

Turning to the Web for less costly and faster research is hardly a novel idea, however, and pharma companies maintain that this is not their sole motivation.

What Makes Firms Click?

Pfizer, which was the first firm to announce a partnership with Sermo, in October 2007, said the collaboration has offered insight into how physicians engage in scientific exchange and what information they value.

Pfizer physicians can initiate discussions with the community, when relevant, under the agreement that they disclose their identity and affiliation (⁵ Also see "Pfizer Gets Access To Physicians’ Online Conversations Through Sermo Deal" - Pink Sheet, 15 October, 2007. p. 12). Unlike non-corporate physician members, physicians employed by Pfizer do not participate in posts they do not initiate, the firm said. The site does not allow non-physicians to post under any circumstances.

Earlier this year, Pfizer VP-External Medical Affairs Cathryn Clary used Sermo to initiate one such discussion about the rationale behind the firm's decision to stop funding for-profit continuing medical education programs. The pitch to the anonymous physicians shed light on negative views of the decision, she said at a conference (⁶ Also see "Industry-Funded CME To Go Way Of Dinosaurs? ACCME Comments Lumber In" - Pink Sheet, 29 September, 2008. p. 18).

More broadly, Johnson & Johnson, which also is testing the waters of social networks, says such sites offer firms an opportunity to gain perspective on their products, drawing insight from physicians and patients

"These forums get companies talking about products ... companies need to become part of the conversation," said J&J spokesman Marc Monseau, who runs the company's blog jnjbtw.com.

But as more firms channel research queries and ideas through the Internet, they are treading carefully through the online space, which remains unregulated by FDA.

Limits In A Limitless Space

Though Sermo does not promote products or run any advertisements, Palestrant says "if there's a discussion around a drug, or a disease, a manufacturer can indicate to physicians that they have an expert on that topic," which can spark further conversations. Regulatory lines become blurred, however, should manufacturers mention specific products.

Some companies, like J&J, are taking matters into their own hands and drafting internal guidelines for Internet communications to stave off action that may warrant negative attention.

Another potential concern is that the sites only recruit certain types of participants, which can be a limitation, particularly for larger firms, says Peter Frishauf, founder of the site MedScape Today and consultant at PFKC Ltd. Physician-only restrictions can be "a little bit limiting," he notes. "It's a somewhat dated concept that other clinicians who are equally, or even more informed than physicians ... cannot participate in a discussion."

Practitioners who do not make the "physician" cut often include certified nurses, midwives, podiatrists and pharmDs, to name a few whose opinions may be of interest to firms.

The anonymity of online communities offers a safe space for dialogue, though it fails to provide follow-up opportunities or assurance that the physicians surveyed are the right fit for the research topic, even if the respondents fit criteria for a more general query.

Younger, biotech firms with simple pipelines containing one compound may be best suited for these sites because they are looking for cost savings and because they tend to target narrower populations. Palestrant observes that, for these reasons, smaller companies are quickly joining Sermo.

Biotech interest in online forums should come as no surprise given their push to innovate, said John Kamp, executive director for the Coalition of Healthcare Communication. "You have, often times, very effective and efficient patient groups that do the social networking, so it's reasonable for them to be the ones that are first ... it's the most obvious place for experimentation to happen."

- Carlene Olsen (c.olsen@elsevier.com)

Social Networking Sites: Small Step For Firms, Giant Leap For Research

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