City of Paris

Marketing communication managers juggle a number of related roles, as project manager (56 percent), agency liaison (56 percent) and brand champion (44 percent), according to the recent poll on our website. Running close behind were budget manager (33 percent), marketing cheerleader (22 percent) and trade show coordinator (11 percent). Our sample size was small—17 people cast their votes—but I am inclined to believe that these are people who matter, because they are sufficiently engaged in marketing communications, very likely as practitioners, to take the time to share their views.

The good news is that almost half of those who voted believe that marketing communication managers are brand champions. In my mind, this is perhaps the single most important role from the perspective of company need as well as professional advancement, not to mention making life easier for those of us on the agency side. The brand champion is a holder of a vision and a leader and thus has a strategic role that can impact bottom line results, which is why I believe that this is the role that can help propel a more exciting and rewarding career trajectory. While many marketing and product managers may also view themselves as brand champions, the marketing communication function is unique in its day-to-day focus on shaping customer perception—even in such routine and often mundane tasks as trade show coordination. And, unless a marketing communication manager embraces the role of brand champion, he or she will fall prey to becoming a full-time tactician with, most likely, a lackluster brand. So what if all projects are completed on time and on budget?

A friend pointed out to me that he wished there were a better term than “agency liaison,” because the word “liaison” seems rather passive, but he thought it was better than the often-used “agency contact.” I agree, for the effective agency liaison is a leader who sets clear directions and defines lofty but achievable goals, a salesperson who can convince management on myriad strategic and tactical issues such as resource allocation and agency choices and all the way to convincing the team to take a risk with the big idea, as well as a fastidious process driver who will sweat the details, making sure all bases are covered and everyone is on the same page. Does it surprise you that there are so few great clients?

I chuckled when I noted that no one put down “creative director” as one of the roles. Phew!

On February 7, the Chinese press reported that Gao Qiang, former minister of health and most recently party secretary at the Ministry of Health (MOH), is moving to a finance post at the National People’s Congress (NPC). Gao was recruited to the MOH from his previous position as vice minister of finance in 2003 during the uproar about the SARS epidemic. As he announced his exit from the MOH, the congenial Gao laughingly noted that he had used up all his brain cells in the past six years over healthcare reform and the many problems with the transitioning health system. Indeed, Gao presided over a period of increasing public dissatisfaction with the cost of care and access to care, as well as deteriorating physician-patient relations and growing impatience while the public waits for the long anticipated healthcare reform plan to be unveiled. At the press meeting announcing his departure from the MOH, he noted that the State Council had just approved the budget necessary for the reform and, following the annual NPC meeting in March, a national conference will be convened to focus on moving the new plan forward.

Shortly before Gao’s departure from the MOH, he responded to numerous posts on the Internet that resulted from the Chinese government’s effort to solicit public input about healthcare reform. Of 63,296 people who cast their votes online, 40.3 percent believe that the root of healthcare problems in China is the lack of government financial support and the commercialization of hospitals, which were previously owned and operated by the government. “Every time I go to the hospital, I feel like I’m entering a market, where doctors are like salespeople, except that the prices are not negotiable,” commented one of the respondents. Another 25.4 percent believe that the culprit is the practice of hospitals undercharging for physician consults based on an archaic fee structure and then making up the loss with pharmacy and procedure charges. “The doctor’s mission is to help the wounded and save lives. Yet, in today’s environment, doctors are forced to become merchants,” reads another comment. In summary, “Most countries around the world have government-funded healthcare. China is the world’s third largest economy. Why can’t we do likewise?”

Gao agreed that inadequate government funding for healthcare is the primary reason for patient dissatisfaction with physicians and overall care. “Government funding for healthcare has been seriously lacking for a long time. As a result, hospitals have to focus on revenue from patients to maintain operations and fund any development. This puts the healthcare workers and the public on opposite sides, and is a key reason for the tension between physicians and patients,” according to Gao’s analysis. He further stated that healthcare couldn’t rely on market forces alone. “The market system can be a driver, but such principles cannot be applied en bloc in our situation. Protecting the public good and adjusting the classification [compensation] for healthcare workers are two key issues that must be addressed, but we cannot sacrifice one to satisfy the other.” In his view, many elements of a market system, such as encouraging orderly competition and rewarding performance, are necessary, as is the deployment of public funding to advance healthcare. Therefore, the appropriate solution will require a balance of market forces and government intervention/investment. He suggested that all of this begins with government leadership and commitment through substantive investment in healthcare. The social forces that follow will drive improvements in healthcare workers and then increase the support, understanding and active involvement of the public.

If you’d like to read more about healthcare in China, see my article. If you would like me to write about healthcare in China on a regular basis, please post a comment and I will make it happen!

Francis Collins, former director of the National Human Genome Research Institute, provided a cogent, multifaceted overview at the Achieving ROI in Personalized Medicine: Barriers, Incentives, and Pathways to Successful Commercialization conference hosted by the Personalized Medicine Coalition. He spoke about Moore’s Law, as some other speakers at the conference did, comparing the trajectory of scientific advances in genomics favorably to the exponential increase in computing power that was the basis of Gordon Moore’s original thesis. “Beating them hands down,” Eric Lander was quoted as saying. Collins cited numerous major projects (e.g., the Human Microbiome Project) and reminded the audience that rapid advances are a given and must be taken into account in any development models. He spoke enthusiastically of the need for rigorous data about gene-environment interaction and thus a prospective large-scale study (dubbed, aptly I thought, “Framingham on steroids” by someone in the audience). Collins also proposed some urgent action items, such as the need for more adequate oversight of genetic testing and the help needed by healthcare providers. He suggested that healthcare providers need education on personalized medicine, later supported by Janet Woodcock, FDA, who commented, “Clinicians dislike information without instructions.” Collins also noted that today’s primary care physicians are not adequately compensated for face time with patients.

On the subject of reimbursement, James Utley, Coventry Health Care, took the audience through the payer’s decision-making process: the determination of medical necessity (essentially a benefits vs. risk assessment) and demonstrated value, which relies on clinical evidence and, in his words, is “unbiased to cost.” The ROI calculation and coverage decision that follows then becomes an actuarial issue, which can affect changes in premiums as well as benefits. Utley referred or deferred to this actuarial decision several times in his discussion. While I thought his presentation shed light on how clinical evidence is reviewed and the level of information required, I was disappointed that it offered no insight on how coverage is determined. Later in the discussion, Utley did make the bold and sobering statement that somehow the nation needs to come to grips with the fact that the pot for healthcare is not unlimited. Indeed, several speakers suggested that the incremental funding needed to advance some of the exciting developments would have to come from reducing wasteful spending.

Which brings me to the subject of healthcare spending and future directions in healthcare delivery. The Hon. W.J. Billy Tauzin of Pharmaceutical Research and Manufacturing of America (PhRMA) gave an impassioned talk about his personal experience with cancer and the very personal treatment decisions he and his doctor had to make. Most important, he made a strong and convincing case for the transition from prevention to intervention, from “sick care” to healthcare, especially in chronic diseases (e.g., obesity, diabetes) that are reaching epidemic proportions.

Change is coming.

Last week, a star-studded panel gathered at the Achieving ROI in Personalized Medicine: Barriers, Incentives, and Pathways to Successful Commercialization conference hosted by the Personalized Medicine Coalition to review the results of the newly completed Deloitte study on ROI in personalized medicine and to offer their perspectives. It was the week after the inauguration. The excitement about personalized medicine was amplified by the optimism around the new administration, and justifiably so. After all, our new president happens to have been the sponsor of the Genomics and Personalized Medicine Act of 2007. At the same time, the economy, rising healthcare costs and the state of the pharmaceutical industry weighed heavily on everyone’s mind. And what resulted was a day of dialogue that was both expansive and sanguine, and a balance of vision, analysis and introspection that I found refreshing.

The fact that the consumer came out as an undisputed winner in the ROI study, led by Paul Keckley, Deloitte Center for Health Solutions, reaffirmed the role of personalized medicine in the future of healthcare. But a host of scientific, business, regulatory, reimbursement and societal barriers challenge the realization of its potential. It is quite clear that better integration between therapeutics (Rx) and diagnostics (Dx) from the start would be desirable in streamlining the development process, but a winning business model for Rx/Dx collaboration remains to be crafted. It was telling when Aidan C. Power of Pfizer pointedly stated that the drug developer would want to keep its options open to work with different diagnostic partners to develop the second-generation biomarker test after launch. Not surprisingly, Randy Scott of Genomic Health commented that the current cost-based reimbursement system for diagnostics is outdated, and he foresees a rebalancing of healthcare spending between therapeutics and diagnostics. This view was supported by a comment later in the day by Janet Woodcock of the FDA, in the context of discussing the need for more data to support science-based medicine, that current reimbursement for diagnostic tests generally is not sufficient to justify adequate study.

Woodcock’s comprehensive review touched not only on the regulatory gaps such as the In Vitro Diagnostic Multivariate Index Assays (IVDMIA) guidance that remains to be taken beyond the draft, and the yet-to-be-published draft of Rx/Dx co-development guidance, but also complex issues around valuation of specific therapies, government incentives for the development of personalized medicine, and the role of academia and federal research funding. Both Woodcock and Francis Collins, former director of the National Human Genome Research Institute, advocated a strong partnership between academia and the private sector. But Woodcock wondered if the reward system within academia, and the scientific community’s innate respect for pure science, would penalize those who engage in translational research.

Next week: The discussion around science, reimbursement and the future of healthcare.