A few months ago I wrote an article for MM&M that ran under the headline, “Coffee over copay: how did it come to this?” in which I argued that there is a value misalignment between the pharma industry and the people for whom we make our products. The resulting backlash can be seen in decreased sales of branded pharma products, increased regulatory scrutiny and downward pressure on prices.

Judging from the emails I’ve received, that article touched a nerve among pharma marketers who see fundamental flaws in our current business model that we need to fix to stay vital and competitive into the next decade. In response to that, and borrowing from some of the feedback that I received, I would like to propose as follow-up these Rules for the New Pharma Value Proposition.

Like any good marketer, my goal here is to maximize the value of the assets we have while taking into account the changing environment in which we operate. These new rules are designed to challenge the paradigms that have guided pharmaceutical marketing for the past generation, and suggest ways to deliver (and get compensated for) a broader and more relevant value proposition for the patients and healthcare professionals we serve. Each of these probably deserves its own article, but I feel it’s important to lay them out here in one place where one can see the many dimensions of both the challenges we face and the responses we need to undertake.

1. This is not just a marketing problem: If we want the public to see us differently, we have to be truly different, and everyone within our companies has a stake in making this happen, from the people who design clinical trials to the team that puts the end product on the truck, and everything in between. Consumers know when something is real and when it only runs skin deep, and part of our problem today is that too much of what they’ve been seeing from us consists more of the veneer of promotional communications, and not enough of the heart and soul that really drives what we do.

2. MedRegLegal needs to take a more activist role: Right now, most of our interaction with the outside world takes place along two dimensions between label and not label. We have to figure out a way to introduce a third dimension that takes into account the quality and relevance of the information that’s being communicated, and find a voice between the sterile data of the PI and the banal generalities of approved promotion.

This is going to require a more activist role from our MedRegLegal teams because they are the ones with the training, credentials and disposition to drive these conversations. I appreciate that they are also the people being challenged from the other direction by new and more restrictive constraints about who we can talk to and what we can say. That’s why it’s important to make it clear that this is not about getting away with bad science or irresponsible disclosure of inaccurate data. It’s about making a qualitative change to the conversation so that the people we’re here to serve have access to information that is useful and relevant to the decisions they need to make.

3. “Social media” isn’t about computers and smart phones: Long before any of us typed the letters “www” into a browser, patients, caregivers, nurses, therapists and other HCPs were meeting in church halls, office reception areas and community centers to share their knowledge and the experience of dealing with their healthcare issues. A digital strategist friend who works across industries commented recently, “In every other industry, we are waving flags and shouting from the rooftops to try to identify people with common interests with whom we can engage. Healthcare is the one area where you have all of these people looking for information, yet we can’t find productive ways to answer their call.”

So while Twitter, Facebook, Pinterest and the other social media provide seemingly unlimited opportunities to “be social,” they haven’t answered the fundamental question of how we can participate in a meaningful social discourse with our patients.

Figuring out how we can bring all of our knowledge and experience to bear is going to be critical to our continued relevance and value in the coming years. It has nothing to do with digital technology, it has everything to do with human beings listening, appreciating and responding to fellow human beings.

4. Stop using the term patient-centric: It’s no coincidence that the rise of the term “patient-centric” has been paralleled by the decline in public perceptions of the pharmaceutical industry. The question of which came first is a real chicken-and-egg issue. Many pharmaceutical companies have championed “patient-centric programs” in a well-intentioned effort to counter negative perceptions and focus attention within and without the pharma business on all that we do to help improve patient health outcomes. On the consumer side, they say that too many patient-centric programs turn out to be thinly veiled promotional efforts, and that has contributed to their cynicism and disillusion with our business.

Whatever the origin, the problem now is that we’ve become so accustomed to using the term that it’s being driven more by reflex than conviction. Admit it, how many of us have been involved in reviewing promotional materials or a planning document where someone says, “We need to insert the word ‘patient’ in here in a few places,” and everyone nods in assent?

I think if you asked many patients, they would be just as happy to hear us say that we’re “cutting-edge-medical-science-centric,” or “integrated-healthcare-delivery-centric.” If we are those things, we are by definition looking out for our patients’ interests in the best ways we know how. If we’re not, all of the best patient-centric intentions won’t add a dot to our value proposition.

5. Get ready for a world in which drugs are no longer the center of healthcare delivery: The last century has truly been “the Century of the Drug,” as the explosion in pharmaceutical discoveries has made the dispensing of pills, tablets and syringes synonymous with healthcare delivery.

How many times over the years have we heard it said by physicians and patients alike that an office visit is not complete if the patient doesn’t leave with a prescription. We even call it the “practice of medicine.”

Yet we don’t have to look too far ahead to see that as our understanding of disease continues to expand, those pills, tablets and syringes will increasingly become just one part of a much broader health and wellness process. In the past year alone, I’ve seen peer-reviewed articles and posters showing that exercise, dance, doing puzzles, prayer, social interaction, eating certain foods, sleeping better or owning a pet all have the potential for meaningful impact on patient outcomes in various disease states. Personalized medicine is adding yet another dimension.

In this new world it will be impossible to maintain the conceit that our drugs are the one thing responsible for patient outcomes, as our promotional materials currently suggest. Instead we need to find a new place within this emerging concept where our products are seen, not as panaceas but as catalysts or potentiators. Already some of our clients are exploring approaches that blur the line between what is a drug, delivery system, diagnostic, medical food or other wellness tool.

The biggest challenge here may be on the regulatory side where these broader dimensions of the healthcare puzzle are seen as “noise” that has been scrupulously eliminated from our clinical trials. This leads us back to Rule #2 in that we have to look to our MedRegLegal colleagues to push for new thinking on what constitutes full and balanced disclosure. But it also falls to us on the promotional side of the business to recognize that the best way to advance our interests lies in advancing the optimal practice of health and wellness care, whatever technology is involved. In some sense, this may be the true “patient centricity” we’ve been looking for all along.

There is no question that the pharmaceutical business is in a state of transition together with every other component in the delivery of health and wellness services. We all agree that 2020 is going to be very different, most of us just can’t say how. We in the pharmaceutical business have both the resources and opportunities to help drive that change, but it’s going to mean leaving behind our comfort zone and conceiving our product, and more importantly our value proposition, in a whole new way. These New Rules are a first step in that process.

Michael McLinden is partner, chief strategy officer, Mc|K Healthcare.