It’s not even in beta yet, but Facebook’s Graph Search, announced last month, is sending tremors through the advertising landscape and looks likely to upend Google’s near-monopoly on search advertising. For pharmas and other healthcare companies, the impending arrival of social search raises thorny questions but promises tremendous opportunities.

Given the premium patients place on the testimony of friends and family in matters medical, imagine if, having just been diagnosed with a condition, you could identify friends—and friends of friends—that suffer from the ailment with the click of a button, since many users self-identify as being part of disease or condition communities.

“You’re going to look for people who are looking for friends who have possibly been diagnosed with what you’ve been diagnosed with and want to connect with somebody, or who are looking for groups where they can go and have conversations with people to help them through this traumatic experience,” said Justin Freid, director of search engine marketing at Communications Media, Inc. 

The potential for advertisers looking to reach specific patients and physicians—not to mention the regulatory perils—is pretty clear.

“As users become increasingly accustomed to search, social and shopping morphing into a more seamless, holistic user experience, the entrenched boundaries will dissolve, and with them our more traditional notions of privacy, risk and potentially even adverse event monitoring, management and reporting,” wrote Pixels and Pills’ Mike Spitz in a recent post. “But until then, digital health communicators beware!”

Facebook has, so far, proved mostly a dud as a communications vehicle for pharmas. Fearful of triggering, and inadvertently running afoul of, adverse events reporting requirements, pharmas initially set up pages for their products sans comments, then pulled them when, in August 2011, Facebook mandated that comments be allowed. Corporate pages are, for the most part, dreary, musty, cobwebbed affairs.

“Right now, they’re not interactive and they’re barely looked at or engaged with by a lot of people, so they’re almost just placeholder pages,” said Jack Barrette, CEO of WEGO Health. “This is going to make them even less useful. Companies are going to have to ask themselves: What is our strategy for getting people to find our content useful and become friends and fans and followers of our pages, because we need people to connect with us in order to connect with their social graph and for us to be found. If Graph becomes the primary means of navigating the world’s largest social network, and your corporate page has few fans or friends because it’s frankly just snipped up corporate press releases, it’s irrelevant.”

The social network has irked advertisers, who complain of opacity and question the effectiveness of advertising on Facebook.

“One of the biggest misconceptions about Facebook advertising is that people thought it would perform more like search engine marketing than display advertising, that you would see a lot of people clicking on an ad and it leading them to a page where they would complete some type of conversion,” said CMI’s Freid. “But when people are on Facebook, they’re not actively searching for a product or service – they’re looking at pictures of their friends, updating their status, seeing what restaurants their friends like, things like that. So it’s a more disruptive form of advertising, and more similar to display than SEO.”

“This creates a potentially warmer and more intimate space for engagement,” says Merck’s Craig DeLarge, “because Google is the whole world, but Facebook is my neighborhood, and search is just going to make it much easier for people and communities and companies and advocacy groups and bloggers to find one another and create self-organizing communities and networks around a condition.”

“And of course the question is how pharma will engage that,” adds DeLarge, “and we’ll grapple with the usual angst around what will FDA think of that. It’s going to be really wonderful for the non-branded social responsibility stuff that pharma does, but on the branded side, it’s going to be standoffish because of the usual suspects, like adverse events and off-label discussion.”

At the very least, Google will have company in the world of search, and pharmas will need to up their game on Facebook.

“If you search for ‘HIV video’ and you haven’t liked the Gilead site, it probably won’t come up, even though Gilead has 25 wonderful videos for you,” says WEGO’s Barrette. “So step one is, every company needs to make sure they have an active ‘Fan’ and ‘Like’ acquisition strategy, because that becomes the new SEO.”