Elon Musk’s official takeover of Twitter has led to large-scale uncertainty for industries that have come to depend on the platform, and pharma hasn’t been immune — consider the infamous 48-character tweet impersonating insulin-maker Eli Lilly that sent the company’s stock plummeting in November.
Prior to Musk’s ownership, pharma companies relied on Twitter to foster relationships with healthcare practitioners sharing research under hashtags like #MedTwitter and frequented the platform to communicate during conferences. The social media platform was also a mainstay of pharma advertising, with industry marketing efforts growing 160% on the site this year, according to a report by Trinity Partners.
“Twitter is the only social network that's used for professional purposes as a vehicle for scientific exchange amongst pharma companies, HCPs (and) medical affairs physician societies,” Matt Titus, chief commercial officer and vice president at Epocrates, a clinical reference provider owned by Athena Health, said, noting that most conferences now funnel into Twitter.
But continued upheaval on the platform, including the termination of its COVID-19 disinformation policy and the recently relaunched Twitter Blue subscription service allowing users to buy “verified” status, has created even more apprehension in the scientific community that uses the social media site.
As Twitter’s new policies pose potential reputational risks for companies, questions swirl over whether to maintain the status quo on the platform.
Impact on pharma
Many pharma companies are taking a silent approach for the time being. The official Eli Lilly page @LillyPad has not tweeted since a parody account cost it millions with a tweet announcing the company was giving away free insulin. And most large pharmas, including Pfizer, AbbVie, Novartis and Merck and Co., temporarily ceased advertising spending on the platform after the incident, according to advertising database Pathmatics.
“If I'm a pharma brand marketer, right now … I can't be in a place where there's a lot of spam going around, or false information or hate speech,” Titus said. “So, I'm probably doubling down on my known entities with verified audiences that have clinically relevant information.”
As for practitioners, many are looking for alternative platforms, such as Mastadon and Post, to communicate about the latest research, threatening fewer opportunities for pharma companies to connect with them.
“You'll see that a lot of HCPs have said, ‘Hey, I'm not going to be posting on Twitter anymore,’” Titus said. “Pharma has less of a view into what HCPs are thinking, what data is being shared, that scientific exchange.”
Dr. Nick Mark, a pulmonary and critical care physician at Swedish Medical Center Seattle who is active on #MedTwitter, created a Mastodon server in late October as a backup option for the HCP community.
“Think of #medmastodon as a small town (and) #MedTwitter as a neighborhood in a big city. In a small town it’s easier to have laws that reflect the values of the community. For example, prohibiting hate speech (and) blatant health misinformation. Self-moderation may be more responsive,” he tweeted about his decision to create the new space for scientific connection.
"I think throughout the pandemic pharmas started to learn you need to have a plan A, but then also plan B and plan C and be able to pivot quickly. We can’t forget that lesson."
CCO, VP, Epocrates
So far, nearly 10,000 users have joined the server, Mark said. He’s also seen a notable uptick in the last few days since Musk attacked Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases and chief medical adviser to President Biden, in a tweet.
Like many physicians, however, Mark continues to post on Twitter, in addition to Mastodon.
“I'm holding out hope that they can right the ship and that none of those existential threats (on the platform) will happen. Because I think there are still a lot of good things about Twitter,” he said. “I think it's also a great platform to communicate medical information to other professionals or to the public and none of that has changed.”
A report by ZoomRx published in mid-November found that he’s not alone — over 90% of HCPs had still remained active on Twitter.
For the physicians who are disengaging with the platform, Mark said he believes it is more a result of increased hate speech and harassment by people who spread disinformation and who target physicians, rather than the disinformation itself.
Where does that leave pharma?
That puts pharmas in a tight spot of trying to decide whether to continue using the platform to both advertise and communicate with HCPs. There’s no one right way for the life sciences industry to approach the platform, Titus said. It’s about creating a flexible strategy.
“I think throughout the pandemic pharmas started to learn you need to have a plan A, but then also plan B and plan C and be able to pivot quickly. We can't forget that lesson,” he said.
For instance, companies should approach paid ad content on the site differently than they might on their brand’s account page. When a company pays for a sponsored post, they do not know where on someone’s feed it might land, including whether it could show up next to hate speech or medical disinformation. That makes spending ad dollars on the site risky for pharma companies, Titus said, especially with reports showing hate speech rising under Musk’s leadership.
Timeline of changes at Twitter post-Musk takeover
Elon Musk completes $44 billion purchase of Twitter.
A fake Eli Lilly account tweets "We are excited to announced insulin is free now." The company's share price drops more than 6%.
Twitter temporarily suspends its verification subscription service.
Previously suspended users are allowed back on the social media site.
The company announces it will no longer enforce its COVID-19 misinformation policy.
Twitter disbands its Trust and Safety Council.
The paid verification service, Twitter Blue, relaunches.
Musk tweets “My pronouns are Prosecute/Fauci.”
With the new Twitter Blue verification system, it also may be more difficult for pharma companies to discern whether they are communicating with credible HCPs, or whether the information being circulated is factual.
“Historically, Twitter has kind of policed itself. If a clinician came on and was spreading a lot of disinformation, you would see five or six (key opinion leaders) jump on them and be like ‘That's not true. Stop,’” Titus said. “But when you introduce others that have blue checks that may or may not be who they (say they) are … you introduce a lot of risk.”
However, that doesn’t mean companies should abandon the site completely, he added.
“It's still important to have a seat at the table,” Titus said, but pharmas should consider using Twitter to “do more monitoring than active promotion.”
And as companies look to divert those resources toward other channels, he suggests going back to basics. While sites like Mastodon and Post might hold potential for the future, they are risky in the short term because they’re largely untested. Similarly, other social platforms like Instagram and TikTok hold promise for direct-to-consumer advertising but are likely not the path forward for HCP communications, Titus said.
"There's a lot of value added even going from the 500-word abstract to a 200 character tweet, where somebody who knows the subject area is summarizing it."
Dr. Nick Mark
Pulmonary and critical care physician, Swedish Medical Center Seattle
"You’ve got to be a lot more guarded — if you really alienate half of your targeted audience, and there's only 15,000 prescribers for your drug, that's going to be a big problem,” he said. Playing it safe and sticking to tried-and-true platforms with verified users is key to maintaining and growing relationships with physicians through virtual channels.
In the long term, however, he suggests the industry needs to find a better way to communicate to replace the infrastructure Twitter created and foster relationships with physicians.
“We're kind of going back in time,” Titus said. “We said digital is a great thing because clinicians in the same specialty can have meaningful conversations across the world. And then we're kind of saying, well, you should go back to emailing your colleagues (because) that space is eroding a little bit, which is a danger.”
But for physicians like Mark, Twitter provides a valuable space where they can quickly see major insights from recent research and educate themselves about updates in medicine.
“There's a lot of value added even going from the 500-word abstract to a 200 character tweet, where somebody who knows the subject area is summarizing it. That definitely lets you read more and internalize more,” Mark said.
Preserving that will be a key challenge for the life sciences industry if the turmoil on Twitter continues, Titus argued.
“We need to build tools and resources and places where physicians can come get information quickly, do their jobs, be the best clinician that they can, and learn the new information that they need to know to be relevant,” he said.