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Is PAAB Doing a Good Job in Educating us on Social Media Regs in Canada?

Several months ago, the PAAB (Pharmaceutical Advertising Advisory Board) held 3 social media marketing sessions called “Social Media Marketing in Pharma: What Works in Canada”, twice in Toronto and once in Montreal, where they provided some of their insights on Canadian regulations regarding pharmaceutical social media marketing.  This meeting even had a representative from Health Canada as a panel member.

Then earlier this month, they presented even more guidance at the Eye For Pharma eMarketing Canada conference.  Just yesterday, they made their slides from the conference available on the PAAB website: PAAB Guidance on Social Media Marketing (61 slides). Enable audio on your computer as each slide has audio. The audio track on each slide is by Patrick Massad (Chief Review Officer at the PAAB).  Beware – the file is huge.  It slowed my computer down for several minutes.  But once you go through the slides and audio, you will find that it is full of valuable information, some of which was not presented at the recent eMarketing conference due to lack of time.

The PAAB has also made itself more available to the Canadian pharma community by setting up a LinkedIn, FaceBook and Twitter profile.  The PAAB has been using these avenues to not only update the industry on PAAB activities, but also to share information about social media from other countries.  On Twitter, the PAAB even posted a request for people to join one of their social networs and to start a discussion.

As far as I know, the level of outreach by the PAAB to the pharma industry with regards to guidance on the regulations that impact social media marketing is the first of its kind worldwide.  Please correct me if this is inaccurate.  I am aware of the FDA meetings held a while back, but so far, no guidance has been made available since those meetings.

Whether we like the regulations or not, and whether we feel the regulations are doing justice to the mantra of social media being open for engagement by all stakeholders, we have to give credit to the PAAB for their efforts in helping the Canadian pharma industry understand what we can and cannot do within the legal framework.  I am not a fan of the current Rx DTC regulations in Canada.  They are outdated, and I would like to see these regulations re-visited and modified.  But I don’t blame the PAAB for those regulations.  They did not make the rules.  They just help us work within them.

The only recommendation that I would have for the PAAB (and Rx&D as well for that matter), is to include something about social media guidelines as part of their overall set of guidelines.  Perhaps that is in the works and I am just not aware.

Do you think the PAAB is doing a good job in educating the Canadian pharmaceutical industry on how to apply current regulations to social media campaigns?  Do you have any suggestions for them to improve their outreach to the industry?

Disclaimer:  I have been involved with the PAAB on various social media activities, but this post is my personal opinion.  The PAAB has not had any input or influence in the content of this article.

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PAAB Offers Guidance on Regulatory Social Media Thought Process

Eye for Pharma organized the 1st eMarketing Canada conference, which was held in Toronto, on November 1-2 2010.

Patrick Massad (Chief Review Officer at the PAAB, Pharmaceutical Advertising Advisory Board) presented an algorithm to facilitate the regulatory thought process when planning a social media promotional activity.  Here is the suggested algorithm:

1) Is this advertising?

2) Who is the intended audience?

3) What restrictions should I consider for this audience with respect to disease and product schedules?

4) What mechanism will I use to limit access to that audience?

5) What is the sponsor’s tolerance for uncertainty & risk?

6) How will I align the site with this tolerance level?

7) What are the regulatory consequences of adding and/or linking other tools/content to my site?


Here are some highlights of Patrick’s presentation with regards to the very 1st step to detemine if tactic in mind is advertising or not:

Health Canada’s definition of advertising is as follows:  “any representation by any means whatever for the purpose of promoting directly or indirectly the sale or disposal of any food, drug, cosmetic or device” (as per section 2 of Food Drugs Act).

If this does not help to answer the question about whether the promotion is advertising or not, you can then refer to Health Canada’s policy document “The Distinction Between Advertising and Other Activities”, which lists the following 7 questions:

•What is the context in which the message is disseminated?
•Who are the primary and secondary audiences?
•Who delivers the message (the provider)?
•Who sponsors the message and how?
•What influence does the drug manufacturer have on the message content?
•What is the content of the message?
•With what frequency is the message delivered?

By answering these questions, the intent of the promotion becomes clearer as to whether the tactic is advertising or informational.

The intented audience and type of drug will determine which regulatory body needs to be consulted.  See this article here if you need assistance to determine which Canadian regulatory body to consult for your promotional campaign.

For more information about PAAB guidelines regarding social media, see Highlights from “Social Media Marketing in Pharma: What Works in Canada”

What do you think of this algorithm?  Would you add, delete or change any of the suggested steps?  Please leave a comment below.

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The 1st Canadian Pharma Ad on FaceBook?

A brave Canadian pharmaceutical company has taken the plunge and is giving FaceBook direct-to-consumer (DTC) advertising a try. King Pharmaceuticals has been promoting its EpiPen.ca website via the following English and French FaceBook ads:

The call-to-action is to take the allergy risk test, but it appears as though the main objective of the site itself is to introduce the new EpiPen and EpiPen Jr (0.3 and 0.15 mg epinephrine) Auto-injectors (“EpiPen”) to Canadian consumers and healthcare professionals.  Both the FaceBook ads and the site are DTC advertising.

Although King Pharmaceuticals launched the new EpiPen and EpiPen Jr Auto-Injectors on April 14 2010, I first noticed the FaceBook ad on Monday May 10th 2010.  Of course, it is possible that the ad was launched sooner and that it just came to my attention later.

Can a prescription Rx brand copy this social media model?

EpiPen falls under “ethical pharmaceuticals” in the regulatory system.  However, it is not a schedule F product (prescription required for sale).  Therefore, section c01.044 of Canada’s Food and Drug Regulations Act (which limits pharmaceutical DTC advertising to only product name, price, quantity) does not apply.  To promote a prescription product (Schedule F) in a FaceBook ad (DTC), only the product name, price and quantity would be allowable because it is a public direct-to-consumer placement.  Since the PAAB approves campaigns as a whole, this would also apply to any website that the FaceBook ad would link to.  For more information about Canadian regulatory requirements for prescription products promoted in social media, see Highlights from “Social Media Marketing in Pharma: What Works in Canada” or contact Patrick Massad at the PAAB.  If you are interested in learning more about Canadian regulatory guidelines for other types of healthcare products, you might like this article.

Is this the first Canadian pharma ad on FaceBook?

As far as the ads that I have seen on my personal FaceBook profile, this is the first one that I have seen from a Canadian pharmaceutical company.  There may have been others.  I might have missed them, or perhaps I was not part of the target market for the ad.  So unless somebody tells me otherwise, I do believe that this is the very first branded FaceBook ad by a Canadian pharmaceutical company.  In fact, I have not seen an unbranded FaceBook ad by any Canadian pharma companies.  I you know of others, then please share in the comments section.

Is the FaceBook ad driving traffic to the EpiPen.ca website?

Since the EpiPen FaceBook ad seems to have the objective of driving unique visitor traffic to the EpiPen.ca website, it is reasonable to track traffic to the site as an ROI measurement.  As an outsider, I will use data from Alexa and Compete. The following data and snapshot were taken on May 12 2010:

  • Alexa traffic rank as of May 12 2010 is 1,562,812
  • Alexa traffic rank in Canada is 27,244.
  • 1,177 monthly unique visitors to the website in February 2010.

In a few months, I’ll take another look at the data from these two sources to see if the website gets a peak in their traffic.  This could create some interesting discussion.  Stay tuned !!

Congratulations to King Pharmaceuticals for taking this innovative step.

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Canadian Pharma/Healthcare Regulatory Guideline Revisions – Jan 2010

Love them or hate them, as a medical marketer, you have a ton of regulatory guidelines to follow.  And they seem to change on a regular basis (some guidelines change more frequently than others).  In this blog post, you will find a list of some of the Canadian healthcare guidelines with links that will lead you to the document(s) of interest. The only revisions that took place in January 2010 are in the Rx&D code (see below for details of these changes).  A few other revisions for other sets of guidelines are expected over the next couple of months.  Although the details on the other revisions have not been shared with me, I made a note of when the revisions are expected to take place.

NOTE: If you have marketing collaterals or campaigns that need pre-clearance, but you are not sure which regulatory body to contact, take a look at yesterday’s post; Algorithm on choosing the appropriate Canadian healthcare regulatory guidelines.


New 2010 Rx&D Code of Ethical Practices (not yet posted on the Rx&D website, but coming soon). Here’s a peak at the upcoming changes.  Only section 15 has been revised in the 2010 code:

Section 15.4 Penalties

  • In 2009, the 1st, 2nd and 3rd code infractions were published in the Rx&D Update.  As of 2010, these infractions will be published on the Rx&D website.  All postings will remain on the website for 24 months from the date of the final decision.

New section 15.4.1 Compliance Statement (3 statements as part of this new section)

  • Within ninety (90) days of the final decision date with respect to any Code infraction, the Member must clearly indicate in writing to Rx&D that they have halted the activity or otherwise addressed the issue that caused the infraction. A copy of this compliance statement will be posted on the Rx&D website with the relevant decision of the IPRC.
  • In the event that Rx&D determines that the Member has not complied with this requirement, the Member will be deemed to have deliberately contravened one of the Guiding Principles, and the penalties set out in Section 15.3, 15.5.1 and 15.5.2 will apply.
  • In exceptional circumstances, a Member, acting in good faith, may believe that more than ninety (90) days will be required to comply with this Section 15.4.1. In this case, the Member must file a written extension request with Rx&D within ten (10) days of the decision date, providing a detailed supporting rationale for the request, and an estimate of the time required. Rx&D will forward the extension request to the IPRC who will evaluate the extension request and make a recommendation to the Rx&D Executive Committee (EC) within ten (10) days of its receipt. The EC, in its sole discretion, may elect to grant such an extension to the Member.


Pharmaceutical Advertising Advisory Board (PAAB)

Canadian Association of Medical Publishers
It does not appear as though any new guidelines have been posted, since at the bottom of the CAMP advertising guidelines page, the last update appears to have been on May 11 2009.

MEDEC-Canada’s Medical Technology Companies
Revisions scheduled for March 2010.

Consumer Health Products Canada (previously NDMAC)
No changes, but expect some to come once their new website (along with new organizational name) gets launched within the next month or so.

Advertising Standards Canada (ASC)

  • Any change in ASC guidelines would be from a result of changes with the Health Canada documents.  Since there have been no changes for the Health Canada documents, there have not been any changes for the ‘Consumer Drug Advertising Clearance’ documents of either the Prescription drugs or the Non-prescription / Natural health products (see the two boxes on the left of the ASC screen which allow you to choose the documents required based on the product type).

Health Canada’s documents regarding direct-to-consumer (DTC) advertising of prescription drugs

  • Note that both PAAB and the ASC can provide an advisory opinion on DTC collaterals and campaigns.
  • No changes for any of the following documents.

Health Canada’s documents regarding direct-to-consumer (DTC) advertising of non-prescription drugs

  • ASC and MIJO can provide preclearance services with respect to consumer advertising of non-prescription drugs and natural health products.
  • No changes for any of the following documents.


Note that I am not a pharmaceutical regulatory expert.  I am providing these resources as a service to my blog’s readers.  If you have specific regulatory questions, please contact the appropriate organization.

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ALGORITHM: Choosing the Appropriate Canadian Healthcare Regulatory Guidelines

As a pharmaceutical marketer, you need to be creative and innovative to achieve your brand’s strategic and financial objectives, but you must do so while staying within the regulatory guidelines.  In Canada, there are several sets of regulatory guidelines and codes that relate to Canadian pharma / healthcare advertising and promotion.  How do you know which ones to follow for which circumstances?

Patrick Massad, the Chief Review Officer at the PAAB, presented an algorithm at the “Social Media Marketing in Pharma: What Works in Canada” workshop, which is meant to help identify which set of guidelines to follow in certain circumstances. A modified version is found below.

When in doubt, contact the various regulatory bodies and explain your specific situation to determine which organization is responsible for clearing your advertising / promotional collaterals and campaigns. Note that the Health Canada Food & Drugs Act is the basis for the policies, guidelines, and regulations on drug advertising. Regulatory bodies enforce these.


Rx and Schedule D product

Non-prescription / Natural health product

Promoting to

Healthcare Professionals

Pharmaceutical Advertising Advisory Board (PAAB)

Pharmaceutical Advertising Advisory Board (PAAB)

Promoting to


(have a prescription for the product)

Pharmaceutical Advertising Advisory Board (PAAB)

Pharmaceutical Advertising Advisory Board (PAAB)

Promoting to


Pharmaceutical Advertising Advisory Board (PAAB)


Advertising Standards Canada (ASC)

can provide an opinion on behalf of Health Canada

Advertising Standards Canada (ASC)


MIJO (Formerly BCA)


For those who are curious, the following is a list of promotional guidelines for some other countries;

Medicines Australia

Medical Technology Association of Australia

Agência Nacional de Vigilância Sanitária (Anvisa) / (Brazilian Health Surveillance Agency). Promotional guidelines in Portuguese only.

Danish Medical Association (LF), Danish Pharmaceutical Association (DA), Danish Association of the Pharmaceutical Industry (Lif), Danish Generic Medicines Industry Association (IGL), Parallel Importers of Pharmaceuticals (PI)

Europe: European Federation of Pharmaceutical Industries and Associations (EFPIA)
EFPIA Code on the promotion of prescription only medicines to, and interactions with, healthcare professionals

EFPIA Code of practice on relationships between the pharmaceutical industry and patient organisations

Les Entreprises du Médicament (LEEM)

United Kingdom:
Association of the British Pharmaceutical Industry (ABPI)

United States of America:
Pharmaceutical Research and Manufacturers of America (PhRMA)

Division of Drug Marketing, Advertising, and Communications (DDMAC)

Advanced Medical Technology Association

Note that I am not a pharmaceutical regulatory expert.  I am providing these resources as a service to my blog’s readers.  If you have specific regulatory questions, please contact the appropriate organization.

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Cold-FX: A Fun Canadian Healthcare Social Media Campaign

More and more Canadian healthcare companies see the benefit of leveraging social media for their businesses.  Here is a really interesting example that caught my attention because it encompasses what is critical for a successful social media campaign:  lots of interaction and viral effectiveness.  It also appears to follow the Canadian regulatory guidelines.  Learn more about the Cold-FX social media campaign here.


Afexa Life Sciences, a medium-sized Canadian company with a variety of over-the-counter (OTC) products, has launched a fun social media campaign in November 2009 to leverage their sponsorship of the 2010 Winter Games in Vancouver, BC (“Cold-FX: Official cold and flu remedy of the 2010 Winter Games”).  Cold-FX is the brand that is sponsoring the Olympics and is the backbone of this fun social media campaign.

There are 3 components to this campaign;

1)      a FaceBook fan page with over 800 fans within 3 months and most importantly a high level of engagement by the fans,

2)      a Twitter account which has grown in popularity since their existence on Twitter as of September 2009, and

3)      a very popular  ‘Athlete of the Year’ video which can be customized with your name, or that of a friend.  The video was launched on November 19th and as of December 4, has already been viewed over 28,000 times (Source:  Data on file, Afexa Life Sciences).

If you look through the FaceBook and Twitter posts by Afexa, you will notice that there is no mention of the brand Cold-FX.  All of the posts by Afexa are related to their Olympics Trivia game.

Moreover, the ‘Athlete of the Year’ video has only a minimal amount of branding as well, as shown in the photo below.

Cold-FX 'Athlete of the Year' viral video

(… and for the record, the only way that I could be recognized for any athletic skills whatsoever would be if running after a 2-year old while talking on the phone with a client and taking notes of our discussion were a sport … thank goodness I have the most understanding and wonderful clients in the world  …)


On Friday December 4th, I had an opportunity to speak with Justin Jones (Director Digital Strategy) and Hardeep Gosal (Online Community Manager) of Afexa Life Sciences to discuss their Cold-FX social media campaign.  Here are a few highlights of our discussion:

  • New to social media:  The Cold-FX campaign is the first social media campaign for the company.
  • Taking small steps at a time:  They started by monitoring to find out where their consumers were online, what they were saying about the brand, the sentiments of their comments and the reach of forwarded messages.
  • Deliberately being conservative: The main objective of the campaign is to build relationships with the consumers, therefore messages are kept neutral and non-branded to give the consumers an opportunity to get to know the company and feel comfortable to communicate with them.

The snapshot below was taken of the Cold-FX Twitter profile at the end of the day on December 7 2009.  It demonstrates the neutral, non-branded messages being posted by the company.  As for the design of the Twitter profile, the only branding consists of the “Cold-FX” name found on the left and the right side of the screens.

Cold-FX Twitter profile

  • Selling the idea to senior management:  1) Showed them the analysis of a full year’s worth of social media monitoring, and 2) presented a variety of real cases.
  • Building up a follower-base is a long process but well worth the time and effort.
  • Company wide initiative:
    • Approximately 16 months prior to the launch of the social media campaign, all employees had an opportunity to discuss their feelings, knowledge and comfort level with social media.  Justin captured the corporation’s learning culture by stating that:  “The more we educate our employees about visual technologies, internet, mobile technology, social media, the more internal support we are likely to gain in the months ahead for our social media campaign.”
    • Training then took place to educate our employees on the use of social media.
    • Firewalls do not block employees from logging onto social media networks at work, although there is a social media policy in place to avoid abuse.
    • As part of their social media policy, Afexa Life Sciences’ employees are encouraged to not talk about product or anything financial.
    • Followers’ engagement with the company via social networks is creating a lot of positive energy and excitement in the organization, and employees are motivated by this.
  • Biggest challenge in managing a social media campaign:  Being new to social media, the organization expects to make mistakes and learn from them.  However, the social networks frequently change the landscape, rules and regulations.  To work through these changes, the organization is partnering with suppliers who maintain a close pulse on upcoming changes within the various social networks in order to help predict and manage upcoming changes.

The FaceBook fan page “wall” snapshot below describes the quick change that the Afexa Life Sciences team needed to implement to stay within FaceBook’s revised contest policy:

Afexa reacted quickly by launching a FaceBook application on December 9 2009, which now allows them to continue their trivia contest on FaceBook while staying within the FaceBook policies.  Just check out the ‘Trivia Contest’ tab on their FaceBook page and you will be brought to the new application.

  • Measuring ROI:  Be clear on your objective for implementing a social media tactic and determine ROI measurements based on that information.  Afexa’s main objective for the Cold-FX social media campaign is not financial.  Instead, the main objective is to build relationships with consumers.  Some of the measurements for this campaign consist of;
    • Number of followers
    • Frequency of engagement
    • Sentiments of consumer communications online
    • Click-through to the Cold-FX website
  • 5 Key Learnings from Afexa Life Sciences:
  1. Leverage monitoring tools to see what people are saying about your brand and the general sentiment of their communications, as well as identify demographics of the consumers who are talking about your brand online and what platforms they are using.
  2. Stay focused on 1 or 2 social media platforms rather than all of them.  Go through the experience with the selected platforms, learn from it, and then scale onto other platforms if your objectives direct you that way.
  3. Leverage partners who are dealing with some of the social networks that your brand is involved with.  Dealing with a company that has an idea of upcoming policies will save you a lot of time and a lot of money.
  4. From an internal organizational perspective, take the time to carefully draft a social media policy and respect everybody’s level of comfort with social media when presenting internally.
  5. Embrace social media.  Social media is here whether we like it or agree with it.  Google Sidewiki is a perfect example; people can comment on your brands or organization whether you give them the platform to do so or not.

Hardeep summed it up nicely with the following comment:

“The conversation is already happening with your product, so why not get involved.  Companies are often afraid of negative feedback, but we have found that brand advocates balance the conversation with positive comments.  Brand advocates -see who they are and develop relationships with them.”

Regulatory considerations for the Cold-FX social media campaign: Cold-FX is approved in Canada as a Natural Health Product, therefore it has more flexibility than a prescription product in terms of regulatory guidelines in its promotions.  I asked Ray Chepesiuk, the PAAB Commissioner, for his regulatory insights with regards to this campaign.  Here was his response;

“The Cold-FX social media campaign is brilliant and appears to be well within the regulatory guidelines.  You can do a lot more with consumers with an NPN product from a regulatory perspective because you can actually advertise with claims.  You can talk about your drug, but the only caution is to make sure that fair balance is included and indications stated correctly in accordance with the product’s license.  It appears that Afexa Life Sciences have respected the linkage policies of Health Canada in this campaign.  If there is promotion, they must follow section 9(1) of the Health Canada’s Food and Drugs Act.”

Kudos to Afexa Life Sciences for taking on this initiative with passion and enthusiasm, and for giving a chance to their consumers to have so much fun with the campaign.

GIVEAWAY: Afexa Life Sciences has kindly offered to give away 5 COLD-FX Vancouver 2010 Olympic Winter Games Hockey 3-Pin Sets to those who write comments about this post.  For those who decide to write a comment, I will be in touch with you to gather your shipping information (so please do not include that information as part of the comment).  If more than 5 people write comments, then we’ll have to make it a draw in which case everybody who writes a comment will be given a number (ie. the 1st to write a post is assigned the number ‘1’, and so on) and then will be randomly selected with the use of the random number generator Random.orgDeadline is Wednesday December 16th, 11:59 pm.  Draw (if required depending on number of comments) will take place on Thursday December 17th (to give us enough time to ship you the pin-sets in time for the holidays if you plan on giving as a gift).

DISCLOSURE: Afexa Life Sciences has not paid me to write this article, is not a client and has not requested a business pitch from me.

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Highlights from “Social Media Marketing in Pharma: What Works in Canada”

The Pharmaceutical Advertising Advisory Board (PAAB) recently held 3 sessions of a workshop called “Social Media Marketing in Pharma: What Works in Canada”.  Originally, only one session in each Montreal (September 29 2009) and Toronto (September 30 2009) was planned, but due to popular demand, a 3rd session took place in Toronto this week (November 9 2009).  In total, there were 250 Canadian pharma marketers (client and agency side) who registered for these sessions.

PAAB social media workshop audience - Toronto September 30 2009

The panel members for this workshop are listed below.  I was quite humbled to be included as part of this stellar cast;

Ray Chepesiuk, PAAB Commissioner

Patrick Massad, Chief Review Officer (CRO), PAAB

Ann Sztuke-Fournier, Manager, Regulatory Advertising and Risk Communications/ Therapeutic Effectiveness and Policy Bureau, Marketed Health Products Directorate, Health Canada

Henry Anderson, Interactive Marketing – The Americas, Novartis Consumer Health, Inc.

Christian Roy (Montréal Session), Vice President, Marketing, Primary Care Business Unit, Pfizer Canada

Pat Forsythe (Toronto Session), Neuroscience Business Director, Allergan Canada

and me, Natalie Bourré, Medical Marketing and Social Media Consultant, Marketing 4 Health Inc.

Here is a summary of some of the key takeaways from the workshop.  Keep in mind that my expertise is medical marketing and social media, and not regulations and guidelines.  Therefore I must disclaim that what you will read in the following statements are my interpretations of how the Canadian regulatory guidelines impact the use of social media in the Canadian pharmaceutical marketing environment.  Furthermore, guidelines may change over time.  This post is considering regulatory guidelines as they exist as of November 2009.

If you would like to brainstorm and strategize ideas about the use of social media as part of your medical marketing, then please contact me at marketing4health@yahoo.ca .  But if you already have an idea of what you want to do and just need to determine if your plans are within the Canadian pharmaceutical regulatory guidelines, then I would advise that you contact CRO Patrick Massad at the PAAB directly (http://www.paab.ca).

Before looking at some examples that were discussed during the workshop, the following statements need to be reviewed because these comments were mentioned over and over again during the workshops;

1. Every situation is evaluated on a case-by-case basis. As the PAAB looks at a promotional campaign in its entirety, it is difficult to give a clear-cut answer without knowing all the facts.  For example, your social media program may be non-branded and acceptable as is because it is informational and not advertising.  However, if it is somehow tied to an advertising piece, then it is considered advertising and must be reviewed by PAAB.

2. The intent of the campaign often determines if it is considered promotional or informational. To help you determine if your campaign is considered to be advertising (thus requiring PAAB review), take a look at the 7 questions provided by Health Canada’s policy on the “Distinction Between Advertising and Other Activities” (link to: http://www.hc-sc.gc.ca/dhp-mps/advert-publicit/pol/actv_promo_vs_info-eng.php) .

In fact, this point supports the 1st, as Health Canada states that it is only after having determined that the primary purpose of a message is advertising that an assessment can be made regarding compliance with the regulations pertaining to drug advertising.” Get to know these questions because they apply to all promotional campaigns related to the pharmaceutical industry, not just social media.

3. Canadian guidelines are different than American guidelines. This post is not meant to go into details about these differences.  However, it is important to note that direct-to-consumer (DTC) advertisement is highly restricted in Canada, where only the brand name, price and quantity can be mentioned while staying within our Canadian guidelines.  So if the promotion’s intent is targeted to consumers in general and is considered to be promotional in intent (see point #2), it is not allowed in Canada.  If the promotion is considered to be information only (no product focus), then it might be allowed in Canada.  If you are unsure if your campaign is promotional or informational, contact The PAAB for guidance.

Keep in mind that DTC is not the same as direct-to-patient (DTP) information.  DTP information distributed through health professionals is allowed in Canada as long as it is consistent with part 3 of the Product Monograph. It should be reviewed and approved by the PAAB with respect to section 6.4 of the PAAB Code of Advertising Acceptance.  The difference between the two is that the target market for DTP are patients who have received a prescription for the drug in question and for DTC it is the general public.


Here are just a few samples of the discussions that took place during the workshops.  Each discussion point mentioned below is meant as a stand-alone and does not necessarily have anything to do with the discussion point(s) mentioned prior to it;

Discussion 1:  Assuming that a social network is developed for patients who have received a prescription for a drug (DTP), does the company have any responsibility with regards to any off-label comments made by a patient who is a member of the network?

Yes.  As the owner of the network, the pharmaceutical company holds responsibility for ALL comments that are posted on the network, and these comments become part of the network, therefore they become part of the promotional campaign.  As such, all comments made which are visible to other members must comply with the PAAB guidelines.  Therefore, any off-label comments made by patients must be removed.

Discussion 2:  The point of social media is to allow discussions to take place.  What will patients think if pharmaceutical companies start removing or editing comments?

Regulators understand that comments enrich the discussions on social networks.  However, as a highly regulated industry, we must abide by the guidelines.  One remedy to the situation is to ensure that all members are made aware of certain requirements for posting comments right from the beginning.  For example, let the network members know that any comments that mention prescription products will be removed or edited in order to comply with the industry’s guidelines.

How your company will decide to manage these situations will depend on your company’s level of risk aversion.  To be entirely safe, your network may not allow any comments to be made at all.  Perhaps your network will allow members to “like” certain information (ie. As in FaceBook), but will not allow written comments.  Or perhaps your company will accept comments and will assign a person or preferably a team to monitor the comments and make changes as appropriate.  Keep in mind that when you start a social network, it may evolve with time.  You may wish to test the water at first by allowing members to “like” comments and then take the plunge to allow comments.  Go at your company’s comfort pace.  It is easier to add functionality than remove it later on.

If your company is comfortable with allowing comments, here are a couple of things to consider as part of your planning process;

i)                    Identify who in your company will be responsible for monitoring and making appropriate changes.  If your network becomes very popular, this could become a very time-consuming task.  Consider the personnel workload and costs that will be involved.

ii)                   Develop an SOP before initiating the process.  In this SOP, consider as many scenarios as possible.  In fact, you will probably have to demonstrate to the PAAB how you will deal with certain scenarios before they will approve your social network anyway (this is just my opinion – it is not something that PAAB stated).

Discussion 3:  If a company has not set up a social media network themselves, but they are monitoring their product mentions throughout multiple social network sites, are they responsible for reporting adverse events?

Yes, but only if all 4 criteria that define an adverse event are met (drug, patient, reporter, event).  Here is the link to the Health Canada guidance for ADR reporting:  http://www.hc-sc.gc.ca/dhp-mps/pubs/medeff/_guide/2009-guidance-directrice_reporting-notification/index-eng.php

Of course adverse events are a concern in our industry.  It would be irresponsible for any one of us to dismiss the possibility of adverse events being reported online.  Adverse events do get reported on social networks, but according to a recent study, this is a rare occurrence.  In August 2008, Nielson Online published an article called “Listening to Consumer in a Highly Regulated Environment”.  The article states that of 500 product reports that they looked at, and only 1 actually met all 4 adverse event criteria.  Please remember that this study identified cases that included all four criteria and in real life you may have to follow up to get more information that would be available. At the moment, this is the only data that I am aware of that quantified adverse events reported online.  If I find any others, I will be sure to blog about it.  If you know of others, please let us know via the comments section.

Discussion 4:  If a pharmaceutical company sponsors an online health professional journal, can that company include a reminder ad with a link to the full Product Monograph?

If the journal can be accessed by the general public, then linking to a product monograph for a prescription drug would not be acceptable.  This would contravene the Canadian DTC restrictions which only allow drug name, price and quantity to be promoted to consumers.

If the journal is gated and is only accessible to healthcare professionals (HCP), then linking to a product monograph for a prescription drug would be acceptable.

This discussion generated comments that there is a discrepancy in how the regulators are viewing online journals versus printed journals.  Printed journals for HCPs may contain approved drug ads, and the product label can be found at the end of the journal.  Some HCPs leave their printed journals in their patient waiting rooms, thus giving access to patients to the ads within the journal.  How is this different than a consumer having access to a link to a product monograph in an online journal?  The answer is “intent”.  With printed journals targeted to HCPs as seen by the name and address label, the intent is to advertise to the HCPs.  HCPs leaving the journals in their waiting room is not under the pharmaceutical company’s control.

Discussion 5: Assume that a company sales rep posts comments on Twitter about a new study regarding a product that he or she promotes for your organization, and that the study is off-label.  Should this be allowed since it was done during off-business hours?

No.  This type of information should be removed and corporate policy should clearly dictate internal actions.  An organization would not allow any of its employees to discuss upcoming strategies or prices with other individuals, whether it be during or outside of business hours.  This should be considered as a breach of the company’s policies.  Don’t have such a policy or SOP?  It might be time to put together a team to start working on them.  Looking for some social media policy guidelines from other companies?  Take a look at Dave Fleet’s e-book on developing social media policies;   http://davefleet.com/downloads/social-media-policies-ebook.pdf

I hope this helps clarify some questions, and I’m sure it has generated a whole bunch of new ones.  Let’s keep the discussion alive.  Send me your comments and feedback.

Stay in touch,


Marketing 4 Health Inc.




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