Before we ponder the specifics of the 2021 MM+M/HealthLink Dimensions Healthcare Marketers Survey, let’s start with the obvious. First: Oy, what a year. Second: Considering the canceled conferences, shuttered mailrooms and pandemic sorrows, budgets held up remarkably well.

Indeed, amid everything, healthcare marketers earned their agility badges, finding better ways to get product messages to the right audiences.

Annual marketing budgets remained stable in 2020, at $7.7 million. A slim majority of respondents (51.9%) spent more, while 27.9% spent less and 16.3% spent the same. Overall, respondents devoted about 59% of total marketing dollars to reaching healthcare professionals and about 22% to consumers and patients.

For pharma brands, spending did fall a bit. It slipped to $12.5 million from $13.2 million, with nearly a quarter cutting spending. But spending for biotech brands rose (to $6.4 million from $5.1 million last year) and spending on devices also nudged upward (to $2.5 million from $2.2 million).

While those working at smaller companies were more likely to say spending had been trimmed, the difference was small. In large companies (those with $500 million or more in annual revenue), 52.6% said they increased marketing spend and just 28.1% said they cut it. In smaller businesses, 50% spent more and 33.9% spent less.

But that relative stability masks dramatic channel shifts, all of them requiring advanced digital solutions. “The race to digital transformation was front and center during the initial months of the pandemic,” says Greater Than One chief technology officer Ken Winell. “When our clients’ sales reps couldn’t get in to see providers and couldn’t go to live congress events, they needed to pivot quickly.”

Not surprisingly, more companies cut spending on sales reps for in-person calls. The choice wasn’t entirely their own, as hospitals and medical groups put the kibosh on in-person meetings, often indefinitely. They also trimmed their outlays on sales materials.

But they quickly pumped some of those dollars into new ways to support those reps as they mastered fully digital selling. 

Winell believes that has proven an unexpected upside. “Pre-pandemic, a rep was lucky if they got five minutes of an HCP’s time,” he explains. “Now, they’re talking for 30 minutes. Physicians really want to understand the therapeutics.”

The hitch? When doctors want to talk, they want it to be instantaneous, requiring new always-on connections. “The ability to reach our customers will continue to be challenged even as the lockdowns ease,” says Andrew Mar, associate director, HCP marketing biologics at Sun Pharmaceutical Industries. “Engaging with our customers will be our top priority to ensure information exchange is still happening, and it has to be a two-way street.” 

Nearly 57% of respondents say they reallocated funds between sales-rep support and non-personal promotion. Geofencing and email were big recipients of these reallocated funds.

Canceled medical congresses also called for switched-up spending plans, with 45% of respondents saying they cut spending for these events. But here, too, marketers moved fast.

“While many aspects of our in-person tactical execution plan was disrupted by the shutdown due to COVID, the interactions we had at congresses were quickly replaced by virtual Zooms and GoToMeetings,” Mar notes. “The opportunity to reach our customers, drive engagement and build relationships was significantly impacted. The lack of in-person interactions forced us to quickly pivot and develop creative and clinically relevant content that could be deployed digitally.”

The bar for that content is higher than it had been for in-person events. “We are seeing a lot of sophistication — a virtual booth didn’t cut it,” Winell says. “Doctors don’t want to talk to a chatbot. They want live, physical reps on the other end, so they can get all their questions answered.” He says that has led to more exploration of in-depth communication tools, such as forums and podcasts.

Kevin LaWall, global commercial leader at GlaxoSmithKline, says he was similarly impressed by the quick response of colleagues and partners alike. “During the course of a meeting, the interaction level may actually be relatively low during the scheduled dates,” he says. “But the content will be available for six months.”

Some meetings, he adds, have been configured so that they happen live, with real sales reps staffing them and answering questions as they’re posed. “It’s impressive how many creative ways people are finding to connect with physicians to meet educational needs.”

As for the channel mix, it was basically all digital, all the time. More than nine in 10 of those reaching out to HCPs and 85.3% of those reaching out to consumers used some manner of digital tactics.

As marketers scrambled to find ways to connect with audiences, they raised spending on every digital option: video, mobile, machine learning, AI, analytics, marketing research, automation, paid digital and websites. Some of the biggest increases came in paid digital, with 44.2% dialing up their investment, followed by social media (37.2% increase). By contrast, only 8.5% lowered paid digital spending and 7% trimmed their social media budget.

Social media ranked as the single most important emerging channel, with 62% of respondents saying it offers the most opportunities for marketers in the year ahead. Patient engagement ranked second, at 57.4%, followed by the growth of consumerism in healthcare (55%).

More tried-and-true avenues, such as print, TV and radio, public relations and direct marketing, also gained in prominence. They took up an average of 7.2% of total marketing budgets.

Another shift — if not in dollars budgeted — arrived around the recalibration of a brand’s tone of voice, especially as it pertained to finding compassion for newly vulnerable physicians. Many lost their practices, while others fled the field. Others have been worn down from the effects of battling COVID-19 day after day.

“The frontline work is exhausting and there’s a big psychological effect,” Winell says. “We have a reckoning that’s coming, including physician suicides. Their mental health and mental wellness is really important.”

While he is buoyed by the increase in applications to medical school, Winell notes that “it’s really depressing to see the people that have been affected in such a negative way.”

While 72.9% of respondents said the pandemic’s impact on the healthcare system presents the most pressing challenge, they haven’t lost sight of more familiar obstacles. Almost 63% name pressure from payers/managed care as a significant challenge, while 58.1% cite clinical development and time-to-market issues, 55.8% smaller launch budgets and 52.7% concern around FDA regulations/guidelines.

Even in a year of unprecedented disruption, many respondents experienced minimal change: 45.7% said the pandemic didn’t cause them to alter any plans. LaWall, who works on GSK’s early-stage pipeline development for chronic hepatitis B, says much of his day-to-day work is the same as he looks for insights in and around payers, positioning and patients.

But there’s no denying that COVID-19 reshuffled most every hand. Pharma has traditionally dealt in risk-based decision-making, often before there is much data. Yet as billions of Operation Warp Speed dollars flowed from the U.S. government, they were prompted to deprioritize other lines of research. 

As key personnel were reassigned to the push around COVID vaccines and therapeutics, many projects got pushed to the back of the line.

Still, the fight against COVID-19 has given the industry an injection of confidence, especially about its ability to innovate. “A year ago, how many people would have bet that Moderna and Pfizer would have had the results that they had? Had vaccines been developed in the conventional way, people would have placed their bets differently,” LaWall says.

The overall effort has burnished pharma’s image. “It’s the kind of investment we’ve never seen before, and it shows that virtually any area can be solved through smart science,” LaWall continues. “If we are willing to make the bet and go after it via a wartime-type effort with government and industry partnerships, it can be done. It just takes a lot of cooperation and different mindsets. And that’s fantastic for the industry.”

That ambition can extend to all disease states, including hepatitis B. “Many people say, ‘Oh, you’ve got good antivirals that keep the disease in check.’ And we do,” LaWall says. “But wouldn’t you rather have a cure?”

Winell agrees, adding that the positivity and ambition should pay off for marketers as they scurry to recruit A-list talent for these increasingly omnichannel initiatives. “Some of the companies we work with can’t get new talent in fast enough,” he says. “People really want to work in pharma.”

The rise of digital health, aided by widespread acceptance of devices such as Fitbit, Apple Watch and Garmin, continues unabated. “Marketers who understand just how big that data reach really is and understand how privacy is going to shift it are really at the forefront,” Winell says. “But how do you control all the information in a respectful way, without giving up privacy, and at the same time deliver to the marketers?”

The marketers who successfully manage myriad channels will likely reap the rewards. “Understanding the omnichannel philosophy is key — that ‘wherever you are, that’s where I am’ way of marketing. That’s the kind of nuance brands need to succeed,” Winell continues.

Mar agrees. “There are long-lasting changes that will come out of this pandemic,” he says. “The ability to connect in-person will be challenged and the necessity for business travel will be heavily scrutinized. As we adopt technological advances in the way we reach our customers, the traditional way we do business will be forever changed.” 

Among this year’s 129 respondents, 48.1% work in pharma, 28.7% in devices and diagnostics and 17.8% in biotech. While 12.5% are members of the C-suite, 82.9% are director-level execs or above.

In terms of the audiences marketers are trying to reach, America’s stressed-out physicians top the target list, with 46.5% of respondents saying they increased spending to that group. Patients and consumers are the second most sought-after, with 45% of respondents aiming for that population ramping up spending and fewer than 20% cutting budgets.

Meanwhile, 34.1% of respondents are in charge of just one brand, 23.3% mind two brands and 14% take care of three. 28.9% oversee more.

Survey methodology: 
Respondents included 129 director-level and above, biopharma and devices/diagnostics marketers. Margin of error is between 8% and 9%. Not all totals equal 100% because of respondents choosing “Don’t know/prefer not to answer.” Survey fielded between January and February 2021.

The State of the Healthcare Digital Marketing Union

Larry Dobrow

HealthLink Dimensions president Amar Duggasani

When asked if anything jumped out at him from the results of the 2021 MM+M/HealthLink Dimensions Healthcare Marketers Survey, HealthLink Dimensions president Amar Duggasani laughs sharply. Pointing to a finding that only 94.6% of respondents used digital channels to market to healthcare providers during the current fiscal year, Duggasani quips, “How can that not be 100%? Some part of me wondered whether you have some smart alecks trying to throw off the survey.”

Given HealthLink Dimensions’ digital fluency — the organization boasts the largest database of active practicing HCPs, comprising more than 2.7 million providers — Duggasani would know. The survey results largely line up with his impressions of the state of the healthcare digital marketing union.

“Being as deep in the digital space as we are, we saw a big uptick in our programmatic and email business last year, as well as demand for our data. Overall, that is reflected in the numbers,” he says. “It’s kind of a validation for us.”

At the same time, Duggasani notes the obvious  that 2020 was no ordinary year. “Everything about digital as a channel was already in place, but COVID accelerated its growth. It became the primary channel to reach providers and consumers — because for a little while, it was almost the only channel to reach people,” he adds.

When the first wave of COVID-19 hit the U.S. in March 2020, HealthLink Dimensions reached out to its pharma client base and heard a single message over and over: that companies’ sales forces were grounded and they needed help navigating what came next. Organizations offering CME at face-to-face events were similarly dazed.

Those conversations — and the subsequent pivots to digital tactics and channels — are reflected in the survey results. “The decreased budgets and reliance on face-to-face 

contact, the increases in digital budgets — that jibes with what we’ve seen,” Duggasani says.

So too, he adds, did the jumps in spending on marketing analytics. “I suspect many companies are trying to measure if their changed strategies are working — because when you shift budget, as lots of organizations did in 2020, you want to make sure you’ve got it right. But it’s an iterative process; you’re constantly running experiments.”

Somewhat less expected was the survey’s finding that HCPs are increasingly comfortable with marketing and communications in and around social channels. “When we survey HCPs, social has always been a laggard channel, but in the survey it’s seen as a big area of opportunity for marketers,” Duggasani says. “That bears watching going forward.”

As do the surging budget sums allotted to campaigns and approaches targeting nurse practitioners and physician assistants. In years past, there was a sense among medical marketers that efforts aimed at physicians would ultimately reach NPs and PAs. However, over the course of the last half-decade, marketers have fine-tuned their appeals.

Duggasani and HealthLink Dimensions are very much on board with the increased mindshare — and budget sums — devoted to these crucial audiences. “They understand patients on a deeper level,” he explains. “Plus as we saw over the last year, they’ve responded incredibly well to everything thrown at them.”

As for what comes next, Duggasani has his eye on the mobile realm, a longtime favorite of marketers in non-healthcare verticals. “We are seeing more engagement through text messaging. It has taken off in other markets, but it’s yet to be seen if it will be too invasive in this space,” he explains. “We’ll see who’s the first to really commit to it.”