ABPI Code & digital content myth-busting

Dr Rina Newton busts some myths to demonstrate the commercial wins when ABPI code compliance is not considered digital content’s arch nemesis.

Top ten takeaways
1. Ditch prescribing information
2. Don’t recertify website content
3. Check digital content when it goes live
4. Use social media to advertise meetings
5. Cite third party websites in social media posts
6. Use the right hashtags
7. Like and share company approved posts
8. Don’t have log-in restriction
9. Do not rely on agencies for all your digital know-how
10. Don’t worry about others

1. Ditch prescribing information
Digital promotional material can provide prescribing information (PI) either as embedded content or as a single direct link. However, the ABPI Code of Practice (Code) allows companies to replace PI with the summary of product characteristics (SPC), as long as the medicine’s legal category and cost is added to the promotional material itself. This means that the compliance and commercial risks of using PI could be avoided if companies simply swapped to using the SPC.

Disadvantages to digital material linking to PI, instead of SPCs:
• PI not being present – if PI in digital materials is moved or deleted, then promotional material that uses that link will therefore not be compliant.
• Link to PI is broken – this is not just an issue at the start but during the entire life cycle of digital material and demonstrates poor oversight.
• PI content is not updated – this can be an issue if product SPC changes affect the PI and the PI is not updated at the same time as the new SPC goes live.
• PI is not read – If PI is embedded into webinar content then the company must make sure that the speaker is well briefed and understands they must allow the audience sufficient time to read this.

Commercial and compliance gains to ditching PI:
• For digital promotional content, always link (using a specific URL) to the product SPC on the Electronic Medicines Compendium (EMC) website provided by Datapharm; it’s current, complete and accurate. All you need to do is add the medicine’s legal category and cost to the promotional material itself.
• By not embedding PI into digital or electronic material, your content is not always subject to change when the PI changes, thus allowing you to use and repurpose content for a full two years.
• By not having to create, review and approve PI, there are inevitable efficiencies realised in terms of time and resources, not to mention the fact that concerns around PI content (eg what constitutes a ‘serious’ side-effect?) evaporate.

2. Don’t recertify website content
Certified material must be recertified every two years to ensure the content is still current and accurate. The recertification process allows companies to simply produce a new certificate every two years without changing anything on their digital content, including the ‘date of preparation.’ Whilst this process saves time and resources, it can attract complaints and therefore negate the benefits of recertification.

• Many companies1 have received complaints that their website content was ‘old and uncertified.’ Whilst some can successfully defend allegations through providing the new certificate, they would never have got these complaints in the first place if they had simply reapproved their website with the latest date of preparation.
• Replacing recertification with reapproval ensures websites look and feel current – after all they are customer, public and competitor-facing, so it is in the best interests of the industry to adopt a compliant and commercial strategy of avoiding complaints rather than having to defend them.

3. Check digital content when it goes live
It is only a Code requirement that hard copy materials are checked to ensure they are identical to the electronically certified version; there is no similar Code requirement to check that live digital material is identical and compliant. However, cases in this area suggest that things can change when a certified flat PDF goes live digitally, suggesting there should be oversight.

It therefore makes sense that this important verification check is added to company processes to avoid compliance risk when digital materials go live.

“It is important that aspirational objectives do not prevent easier stuff from happening”

4. Use social media to advertise meetings
Given the Code and GDPR requirements for pharma companies to have the prior consent of recipients of promotional or non-promotional emails, there are consequently many complexities involved with gaining and storing such consent on validated databases. Social media provides an alternative, easy and effective way for the industry to advertise their promotional or non-promotional meetings. However, the inherent fear and conservatism that exists within the industry leads to many failing to identify the advantages here or incorrectly over-interpreting requirements.

If we consider using LinkedIn to advertise a company’s promotional webinar, the risks in this area can be easily mitigated (not all the risks have been included)

Use social media to advertise meetings

As the company’s social media post will be approved, UK employees (or agencies acting for the company) can then like and share this post, which means its reach may be far greater than any email permission database – a commercial and compliance success.

5. Cite third party websites in social media posts
There appears to be reluctance to cite third party websites in pharma social media posts. This may be because companies feel they would be held liable for the content on these websites – not an outrageous suggestion given the PMCPA has ruled twice2 that pharma companies will be responsible for third party websites cited in pharma’s hard copy materials.

However, if it is made as clear as possible in the post itself that this is an independent third-party website, by not using URL shorteners, or by @ mentioning the third party, then an AstraZeneca ruling3 suggests a company would NOT be liable for the content on a third party’s website.

This is an important aspect when we consider that pharma social media posts tend to cite only their own websites or events – whilst there is nothing wrong with this, it may help credibility and improve reputation if those that access our social media posts could see and find other sources of useful information.

“There appears to be reluctance to cite third party websites in pharma social media posts”

6. Use the right hashtags
Often when we train companies in this area, we challenge the use of hashtags. This is nothing to do with the Code, but more, what is the point of creating, reviewing, and approving social media posts and articles if no one can find, read or understand them?

An example: A Novartis disease awareness campaign to help patients with psoriasis find useful resources on their own website ‘askforclear.co.uk’ uses the hashtag #askforclear, but if a member of the public or patient was looking for psoriasis information, the simplest suggestion would be to use #psoriasis as well to allow them to at least find these posts.

The ability for compliance checks to also recognise commercial objectives is an important aspect of true cross-functional working.

7. Like and share company approved posts
There seems to be general confusion and concern as to whether individual employees can use their personal social media accounts to like or share posts made by their employers. So often we hear from worried staff, ‘I stay away, just in case.’

Again, we would argue what is the point of creating, reviewing and approving social media posts and articles at the expense of people’s time, if the companies’ own employees and agency staff are not even able to like or share company approved content? It is perfectly reasonable to include in company social media policies the acceptability of this activity and to train staff on liking/sharing such information if they want to, as it is intended to reach a wide audience.

8. Don’t have log-in restriction
The Code requires that certain website content must have log-in restriction. This only applies to websites that are only promotional and intended for HCPs. If there was no information provided for members of the public searching for information on the company’s medicines then they might be forced to access this promotional website, which would not be compliant – log-in restriction would prevent access by non-HCPs.

Back in 2014, the Nielson Norman Group4 (world leaders in research-based user experience) found that demanding that users register or log in before they see website information has ‘high interaction cost and defies the reciprocity principle.’ In other words, people feel obliged to give something back when they receive something initially; if we expect users to give information first, that obligation is lost.

It is acceptable under the Code that instead of adding log-in to such websites, pharma companies can simply add a disclaimer to verify if a visitor is a member of the public and redirect them elsewhere. This would compliantly allow such visitors to access other websites to find relevant information tailored for them.

9. Don’t rely on agencies for all your digital know-how
Digital agencies have an enormous wealth of knowledge on cookies, search engine optimisation, geo-targeting, paid media, personalisation and programmatic advertising. These terms might scare the average pharma employee, but it is important that aspirational objectives do not prevent easier stuff from happening!

Agencies may have particular areas of strength and companies might engage them to tell them what they need, rather than pay them to carry out what they think they need. They are worthy of a healthy challenge as much as signatories are and should be pushed on both commercial and compliance considerations.

An example: It may be prudent for companies who are considering agency requests to do paid (sponsored) social media posts, to first embrace advertising their meetings via free posts on their LinkedIn and Twitter accounts. This can help stakeholders overcome their initial concerns on content and approval.

10. Don’t worry about others
In 2017 GlaxoSmithKline’s (GSK’s) head of global multi-channel marketing platform was asked5 if a firm can act in a highly regulated industry and still be digital. He replied: “GSK and other companies are already showing it can be done in an ethical, compliant manner and there is a pocket of brilliance.” That could have driven companies to look to GSK as a shining example of best practice.

However, self-proclaimed compliance does not always correlate with the fact that GSK (including ViiV) have been involved in 16 complaints to the PMCPA about digital activities since 2019 and 75% of these resulted in breaches of the Code. If smaller companies looked at GSK cases and realised that even the large companies aren’t always getting it right, they may well steer clear of digital.

There are many occurrences of non-compliant material appearing on platforms such as LinkedIn – not all are complained about. It is apparent that there is a disproportionate dependence on signatories over personal accountability. Don’t let your own thoughts on compliance be delegated to others.

I hope this article has provided some food for thought with respect to revisiting and challenging the status quo in digital areas. Compliance considerations should not be the block – a greater understanding can vastly improve digital activities and therefore hugely benefit commercial organisations.

Pf asked the new President of the Association of the British Pharmaceutical Industry (ABPI), Ben Osborn for his thoughts on the imminent new Code in this digital era.

Ben said: “In times gone by, all you had to think about was whether your paper-based information met all the requirements of the Code.
“In today’s online, post-pandemic world, digital communications are key to ensuring we provide healthcare professionals (HCPs) with timely and impactful information that supports them to do their job. With the 2021 Code applying to all communication formats, it’s essential companies think carefully about the implications of the Code for their audiences when working in the digital arena.

“If you’re doing a piece of promotional activity intended for HCPs, you need to consider the ultimate reach of any digital channels you intend to use and ensure that promotional material does not inadvertently reach the general public.

“An interactive version of the 2021 Code will be available online from the PMCPA, which should help companies navigate and apply it more easily, regardless of the activity they are carrying out.”

References

1. Cases AUTH/2889/11/16, AUTH/2960/6/17, AUTH/2972/8/17, AUTH/2925/1/17
2. Cases AUTH/1801/2/06 AND AUTH/2526/8/12
3. Case AUTH/3162/2/19
4. https://www.nngroup.com/articles/login-walls/
5. “Can Pharma Keep Up With The Challenges Of Digital Healthcare?” Kevin Grogan & Lubna Ahmed 2017 (https://www.cms-lawnow.com/ealerts/2017/03/can-pharma-keep-up-with-the-challenges-of-digital-healthcare)