MSLGROUP in the Netherlands' report on the 'Shifts In Healthcare Communications' highlights five shifts that are changing the way we conduct business, namely • Increase of online engagement for OTC • Visibility of online brand preference needed • Seeking authenticity; consumers value information themselves • Marketing becomes personal, bite-sized, searchable and shareable • Integration of On- and offline platforms The report focuses on the challenge pharmaceutical companies will face in the coming years: attracting the attention and meeting the needs of the consumer on a new level.

1. Consumer & Healthcare:
The shift in healthcare communications

2. In this whitepaper, MSLGROUP in the Netherlands focuses on the great challenge pharmaceutical
companies will face in the coming years: attracting the attention and meeting the needs of the consumer
on a new level. Needs which are heavily influenced by mass communications becoming personal and
moving to mobile channels. Purchase decisions are made 24/7 and increasingly driven by social media. In
this process visual content and content marketing are becoming dominant.
This development goes hand in hand with the Dutch government policy where people should take more
responsibility for their own well-being. This results in more prescription medicines becoming available as
OTC, a trend that has already been established in other Western countries. All over the world consumers
need the right information more than ever. Drugstores, pharmacies and pharmaceutical companies can
play a vital role in providing them with this information.
Alex de Vries
Bart van Wanrooij
Renske van de Straat
Introduction

3. 05 Change in consumer communications
06 Technology-fueled shift in consumer PR
08 Change in the pharmaceutical world
09 Patient-central thinking
10 Change is coming
11 Regulatory status 2013-2014
CONSUMER & HEALTHCARE: THE SHIFT IN HEALTHCARE COMMUNICATIONS
Content

4. Change in
Consumer Communications
CONSUMER & HEALTHCARE: THE SHIFT IN HEALTHCARE COMMUNICATIONS
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Shift from offline to online
With the rise of internet in the last decade,
consumers are now online nearly 24/7.
They are continuously exposed to messages
during the day (and night).
Those messages used to come in through
newspapers, radio, TV, advertisements in
magazines and on billboards. Now all websites
show advertisements and communications
are usually a mix of on- and offline. A print
advertisement or TV host can refer to a website or
social media channel.
Through technological improvements such
as faster internet, better network service, etc.,
everyone is online. It’s important to keep in mind
that your brand is influenced from many directions
and you’re exposed to your stakeholders at all
times.
…to conversations/engagement
The conversation with consumers is now on 24/7.
Communicating as a brand or company is no longer
a one way street: consumers can be expected
to respond to your messaging, either directly or
through their own blogs/pages on social media.
Communicating with your consumers has become
a conversation.
Communication has gone from public relations to
people’s relations, focusing more on authenticity, a
personal and genuine approach of the consumer.
…to social media
With the increase in popularity and availability of
social media such as Facebook, Twitter and more
recently Instagram, Pinterest, Vine, Google+,
consumers are interacting. All the time.
Not just from their desktops at home or at work,
mobile technology has made it possible to
be online on the go too. This development is
explained into further detail in the next chapters.
Conclusion
Mass communications are becoming personal and
moving to mobile channels.
The way of ‘conversing’ with your
consumers has also changed: a
personal approach is greatly valued
by your consumer.

5. Technology-fueled shift
in consumer PR
CONSUMER & HEALTHCARE: THE SHIFT IN HEALTHCARE COMMUNICATIONS
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Mobile: Consumer on the go
With the rise of smartphones and tablets,
consumers are now accessible and within reach 24
hours a day. They are no longer bound to their home
computers, print media or radio and/or TV when
looking for information.
By late 2013, 67% of Dutch people owned a
smartphone. Only 65% own a pc/desktop: the
smartphone has literally taken over.
Social media in the Netherlands
Facebook remains a consistent presence in the
Netherlands: by late 2013, 72% of the Dutch
population had a Facebook account which on
average was visited 24 times a week. The total
amount of active Twitter users is declining, mainly
caused by teenagers who were heavy users but are
now moving on to Instagram and Snapchat to
connect with their friends.
Mobile purchase decisions
When consumers are in a store, they can look up any
product online before deciding to purchase. What
have others said about the product, is there a
cheaper alternative or good deal available
elsewhere?
Purchases are also considered 24/7: on the train to
work, while making dinner, when exposed to an
email or social media post, during a night out with
friends or picking up children from school.
2014: The year of visual content and
content marketing
With the rise of image-oriented social media, visual
content has become more important than ever. Most
social media only show one or two lines of text
before cutting off the message. An image or video
will therefore attract more attention and ultimately
engagement.
Shift in popular social media platforms
Social networks Facebook (for private use) and
LinkedIn (for professional use) have been around for
quite a while. The same applies to blogs and social
medium Twitter, a microblog allowing you to share
content in 140 characters or less.
New to the social media scene are so-called ‘visual’
media such as Pinterest, Instagram and Vine. These
media offer a chance to share and engage through
videos and images.

6. CONSUMER & HEALTHCARE: THE SHIFT IN HEALTHCARE COMMUNICATIONS
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“People should take
responsibility for their
own well-being or
health. Only when it’s
not possible to resolve
health issues yourself,
professional care
and support come in
place.”
EDITH SCHIPPERS
Dutch Minister of Health Care, July 2013

7. Change in
the pharmaceutical world
CONSUMER & HEALTHCARE: THE SHIFT IN HEALTHCARE COMMUNICATIONS
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More medicines becoming available OTC
More and more prescription medicines are excluded
from health insurance packages. This forces the
consumer to increasingly turn to OTC as a treatment.
Simultaneously, the Dutch government pushes for
more medicines becoming available as OTC and the
associations for General Practitioners create
guidelines where OTC products form the first-line
treatment.
..Which creates a different role for
pharmaceuticals
More availability of OTC medicines calls for a
different and more open way of communicating with
consumers, as for example suddenly other
regulations apply. Consumers also need to be more
informed about these newly available medicines.
Increasing competition in OTC
With the shift from prescription to OTC, the amount
of available first-line treatments for a single disease
will increase. For pharmaceutical companies the
need for brand awareness and preference amongst
target audiences will become increasingly
important.
OTC as first-line treatment and the
communication gap
More medicines becoming available as OTC also
means that providing consumers with the right
information in an easily accessible way gains
importance. Currently, drugstores are failing to
inform the consumer appropriately, as it is not their
core business and providing the right amount of
information with other customers lining up to pay
for their products can be challenging. Not being
trained for the purpose is one thing, but the main
issue is that providing information just does not
meet the business model of a drugstore.
Consumers search online for credible information
before, during and after they purchase their
products. In the Netherlands, a quality label was
launched as a collective drugstore initiative. This
label promises the participating stores are
‘specialists in OTC’ and they will provide their
customers with accurate information about the
medicines they purchase.
Pressure on marketing activities
Several companies have been fined over the last
years for influencing health care professionals with
indirect financial support. More strict regulation is
expected and the role of the marketing officer is
about to change. GSK has taken a lead with plans to
cancel targets for marketing staff. Marketing officers
need to find ways to create a new added value. Is the
industry ready for these changes and how will these
changes happen? Executive sponsors are crucial in
the next steps.
The call for transparency because
of questionable marketing
activities by pharmaceutical
companies grows.

8. CONSUMER & HEALTHCARE: THE SHIFT IN HEALTHCARE COMMUNICATIONS
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Ambassador
CustomerInterested consumer
Orienting consumer
Passive consumer
Awareness LoyalSatisfactionSelectConsiderKnowledge
Patient-
central thinking
Patient-central thinking
During the orientation, purchasing and evaluating
process, the consumer faces different needs. Needs
that can be met by external sources, such as peers,
authorities and manufacturers. This is where the
possibilities and challenges lie for pharmaceutical
companies: they can provide platforms where peers
can meet, where authorities get a voice and where
reliable information is easily accessible.
Consider educational content about certain diseases
which raises awareness; knowledge about those
diseases and available treatments, consumer
experiences and satisfaction with the treatment. All
consumer needs.
Currently, available information is fragmented and
pharmaceutical companies are not actively providing
consumers with this information in the way the
consumers would like to receive it.
This content should not be marketing-driven, but
the consumer/patient needs need to play a central
role. They need to be provided with useful
information based on insights about these target
audiences.

9. Change
is coming
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5 shifts to keep in mind
1. Increase of online engagement,
also for OTC
The increase of online consumer engagement is
apparent. Currently, up to 69% of Dutch citizens
are using social media. Facebook is still the No.
1 platform. Consumers state that the impact
of a message depends on the sender and their
expertise. For OTC-experiences consumers
look for each other via various platforms about
specific diseases.
2. Visibility of online brand preference
needed
To tap into the consumer life cycle in an early
stage (awareness, knowledge) pharmaceutical
companies must provide their product
information through social channels if they
want their brand to be visible in an early stage
of purchasing. Every step of the way the
consumer has different needs and will search
online and listen to peers and authorities
online. Pharmaceuticals should not only
share information, but also facilitate these
conversations.
3. Looking for authenticity; consumers
value information themselves
Consumers today are critical of the information
provided. They look at who the sender is and if
they are (considered) an expert. They will share
the most useful information with their network.
If information is not reliable or has too much of
a perceived sales purpose they will not share
and might even comment negatively on it. You
have to be able to live up to what you promise.
4. Marketing becomes personal,
bite-sized, searchable and shareable
To reach the right consumer, new technologies
provide plenty of opportunities to make your
knowledge, brand or product visible with the
right person. Big data provides a more precise
segmentation of age, location, interest etc. and
therefore more relevant information for the
consumer. Consumers love getting the right
information in small ‘snackable’ portions, and
will share this with their relevant networks more
easily.
5. On- and offline becomes more
integrated
That online activities not only take place in the
living room anymore is no news. However, the
realization that your phone is your most trusted
channel when you are in a drugstore searching
for the right product is not yet integrated into
consumer communications. Even in this stage
communication with consumers continues as
they look up product rankings or find in-store
communications that link to online information.
Consumers make their final decision when they
are not yet your brand ambassador.

10. Adverse events & Challenges
Laws define that adverse events should be reported
within 24 hours after the mention. The reporting of
adverse events needs to be done internally. This
process may seem intimidating, but research shows
the actual amount of adverse events that meet the
requirements to be reported is very low. Should you
have to report an adverse event: it can be done
efficiently with use of special software. We have
noticed more opportunities by being close to the
consumer conversations about products then
threats. The insights gathered from monitoring can
be very valuable in future strategies.
What are boundaries and difficulties
KOAG/KAG checks communications to be
compliant with the law. It’s recommended to involve
KOAG/KAG early on in the creative process as their
internal process tends to take relatively long.
Who influences what
Two self-regulated non-governmental bodies
monitor pharmaceutical promotion and advertising:
‘Foundation Code Pharmaceutical Advertising’
(CGR) for communications aimed at HCPs and
‘Examination board KOAG/KAG’ for public
advertising for all OTC products.
Both bodies educate and share knowledge, create
norms, maintain and monitor these. They work
closely together with each other but also with the
Healthcare Inspection (IGZ).
Social media
KOAG/KAG has given out a guideline for social
media use for pharmaceutical advertising purposes
in 2011. The bottom line of this is “what applies to
offline communications also applies to online
communications”. Social media for pharmaceutical
advertising in the Netherlands currently form a ‘gray
area’, which is very important to take into account
when setting up campaigns.
CGR and KOAG/KAG only advise on matters, IGZ is
legally authorized to give out fines to cases that do
not comply with the law. This usually happens after
CGR or KOAG/KAG raises the issue.
How do we navigate?
It’s recommendable to involve KOAG/KAG in the
(creative) process very early on. This provides you
with an option to alter your campaign to meet
requirements without severe consequences for your
planning and budget.
This will also prevent loss of valuable time further
on in the process.
Regulatory
status 2013-2014
CONSUMER & HEALTHCARE: THE SHIFT IN HEALTHCARE COMMUNICATIONS
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11. DesignedbyMSLGROUPCREATIVE+
Connect with us
Alex de Vries, Head of Healthcare communications
MSLGROUP in the Netherlands
Danzigerkade 23b
1013 AP Amsterdam
+31 (0)20 30 55 900
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