Critical Challenges for Medical-Pharmaceutical Meetings

Planners in the medical and pharmaceutical fields have faced their fair share of challenges in the past few years. As the meetings industry continues its economic recovery, what are the major concerns still facing these specialists? M&C spoke with a number of leading voices in this niche market to get their views. Here's what med/pharma planners are up against.

1. Keeping abreast of the rules.  One of the greatest ongoing challenges for planners of medical and pharmaceutical meetings is fully understanding the influence of regulatory codes, restrictions and legislation, notes Pat Schaumann, CMP, CSEP, DMCP, president of St. Louis-based Meeting I.Q. and U.S. director of its affiliate, China Connect. "It's just mounds of information, and trying to decipher the codes, and to understand the ramifications of the Sunshine Act and health-care reform, is a serious challenge," says Schaumann, who also is founder of the Inter­national Medical Meeting Professionals Association.

Self-regulatory industry codes of ethics, as well as both federal and state legislation, deal primarily with interactions with health-care professionals -- and how to avoid undue influence, or the perception thereof, over the prescription and medical-device decisions doctors make. The PhRMA Code on Interactions with Healthcare Professionals, specifically for the pharmaceutical industry, was updated in January 2009, while the latest iteration of the AdvaMed Code of Ethics on Interactions with Health Care Professionals (advamed.org/MemberPortal/About/code), for medical-device manufacturers, took effect the following July.

Both codes offer guidelines for companies within the respective industries; it's up to the companies to develop and enforce internal policies. As such, in an effort to ensure compliance -- or to avoid the public perception that undue spending or influence is occurring -- company policies could change more often than the codes themselves.

Last year's passage of U.S. federal health-care legislation, which included provisions of the long-debated Physician Payments Sunshine Act, requires companies to disclose payments made to health-care professionals -- essentially giving the codes more teeth, as well as adding federal government oversight to the equation. Adding to that complexity is legislation passed in many states over the past several years, much of which specifies payment limits.

In other words, if the code changes caused planners' heads to spin, government oversight should intimidate them into thinking straight. "What's become very clear to companies over the past year," says Schaumann, "is that audits can take place, and you have to be able to account for every penny."

Bringing international health-care professionals to an event further complicates matters, since pharma and ethical guidelines also vary by country.

"The last event we handled was for physicians from 10 different countries," says pharmaceutical-industry planner Christine Kelly, managing director of Cheshire, U.K.-based Gemini International. "And each country had different regulations in terms of the level of hospitality allowed, so we had to find a balance that was suitable for everyone. Particularly in the U.K., that's becoming more and more of an issue." Regulations are different even among countries within the European Union, Kelly adds.

While the pharmaceutical and device companies ultimately bear the responsibility of compliance, notes Schaumann, it is incumbent upon third-party planners, such as her company, to understand the requirements and aid in the process. "If you're planning a health-care meeting or working with health-care companies, you need to stay in the game," she insists. "There's too much on the table, and I think it's up to planners to stay on top of trends and changes." That's a big reason Schaumann founded IMMPA last year. "We're trying to help as much as we can to educate planners about the latest that's happening in the industry," she says.

Of course, understanding the regulations is only part of the challenge. The end result of all the legislation and industry regulation is that companies are being held accountable for their spending, and tracking those dollars is crucial. "On top of needing to keep up with the regulations and what you can and can't do," says Teresa Bria, SMMC, president of Oakland, Calif.-based Bria Events, "there's just the sheer volume, the sheer workload, that's being added to the responsibilities of the meeting planner. My staff probably spends two-thirds of their time dealing with paperwork, and one-third actually planning the meeting."

2. Getting busy people to attend. If the biggest challenge is understanding and complying with codes and regulations, explains Joe Lipman, CEO of Summit Management in Cedar Grove, N.J., a close second is calculating the time constraints of the health-care professionals you hope will attend. "Travel time, connections and downtime are all major considerations," says Lipman. "It's time in which that physician, who can earn as much as $4,000 a day, is out of the office."

Knowing where your expected attendees are traveling from is of paramount importance, Lipman explains. Can the attendees fly direct, or are there connections? How far is the meeting site from the airport? If you're expecting international attendees, can they fly directly to the host city?

"If you're bringing in 25 doctors from abroad," says Lipman, "and they have to clear customs in the arrival city, reboard, and take even a one-hour connecting flight, that can add about four hours onto the trip, each way. In total, that's an eight-hour day, no matter how you slice it. That's a solid argument for moving the meeting to the city with better international flight service."

You have to consider, too, in which direction most attendees will be flying, and at what times the majority of those flights will depart. "Just by shifting the start time and end time of a two-day meeting," says Lipman, "you can save overnight hotel costs."

It isn't just the doctors' time that is of concern; if the meeting host is covering travel, every penny spent is a physician payment that must be disclosed and counted toward limits. "How much you spend on transfers, breakfast, lunch and dinner, and the hotel room rate -- everything must be compliant," Lipman underscores.

Because of all of the restrictions, it is harder for industry suppliers to get face-to-face meetings with physicians in general, adds Fred Criniti, who serves as chief marketing officer for industry education provider Medical Exchange, based in Weston, Mass. For that reason, he says, we should expect to see new models emerging at medical conferences that make the most of such opportunities and increase the efficiency of one-on-one meetings.

At Medical Exchange's new CollaborativeCARE Conference (C3), set to debut this November in Long Beach, Calif., organizers will gather information from exhibitors and attendees to arrange meetings in advance, by using an automated platform that will match physicians and product reps based on interests and needs. "It's like a speed-dating software package," describes Criniti.

3. The growing role of procurement. The event industry overall has become gradually more procurement-driven in recent years -- and particularly so in the pharmaceutical sector, notes Gemini International's Christine Kelly. Working with procurement can pose a number of challenges to planners, depending on their positions within a company -- or relationships to their clients, if they are third-party planners.

"My situation has been affected quite dramatically, both positively and negatively, by procurement," says Kelly, whose planning company must participate in procurement bidding and scoring processes to win business from major pharmaceutical clients. "For a company of our size, even though we have the experience of working with world-class clients on a world-class level, in some cases now it's very difficult to compete with very large agencies that have the physical size and resources and physical presence in many countries."

Kelly worked on the client side for many years for a major pharmaceutical company, and has an additional 20 years of experience specializing in pharma events with her agency, but she says that this kind of background sometimes isn't enough to counteract the weighted scoring that procurement analyses might give to larger, more global companies, particularly when consolidation of vendors is a primary motive.

"We've been through a lot of procurement processes," Kelly notes, "and with some we've been successful, and with some others we've spent an awful lot of time to find that we've come in a close second for the job." Such an investment of time and resources leads many smaller, specialized planning companies to consider some difficult questions. "We're all having to decide whether or not it's actually economically viable to actually go through those processes," admits Kelly, "or to focus on smaller, niche projects that are more service-oriented."

Adding to the difficulty is that participating in such a bid doesn't always guarantee work; sometimes it only earns the planning company a place on a roster of preferred vendors.

Kelly believes that procurement's motives of increasing volume and lowering margins too often commodifies the high level of service offered by planners. "Companies say they're looking for quality and added value, and I'm sure they are, but I think that they may risk losing some of that when they're trying to cut costs and to consolidate," she says. "I'm not convinced that it's the right way forward with event management -- to just use one agency to do everything. I think having a range of specialist providers, and some degree of competition, is a good thing."

In-house planners face similar issues stemming from procurement's involvement. It can be both a major challenge and excellent opportunity to convince procurement -- and executives and marketers, for that matter -- to leverage planners' expertise and allow them a hand in more strategic meetings development. In some cases, says Pat Schaumann, planners have been put in the position of having to educate their procurement departments about the industry codes and policies. "That's a whole new element for planners," she  says, "and to make procurement understand can be a challenge." (For advice, see "A Procurement Primer for Meeting Managers," online at mcmag.com/webexclusives.aspx.)

4. Ever-tightening budgets. Many planners still are seeing budget cuts, whether they are related to physician-spend regulations, the still smarting economy or an unfortunate combination of the two. "That's our biggest challenge," says Teresa Bria, "continuing to stay within food-and-beverage and hotel-spend guidelines, when every year the cost of goods is going up." The amount her clients can spend, however, continues to decrease, creating the need for more intense negotiations with her vendors.

"When does it start to affect the quality of the program?" Bria asks. "I think the pendulum has swung too far. The limits are now starting to impact quality."

Vendors, too, are feeling the pinch. Omar Mejias, director of business development for communication-services provider EarthColor Pharmaceutical, a Parsippany, N.J., marketing firm serving the pharmaceutical and biotech industries, sees the trend continuing through the coming year. "It's going to present meeting planners with a very significant hurdle in some cases," he says. "Location, premiums, dinner events -- even the pre-meeting packets and registration processes are impacted as a direct result of the cost-cutting."

One increasingly common solution, notes Mejias, is to substitute a smaller, multi-site meeting approach for larger events. "This is an excellent way to cut the overall cost," he acknowledges, "but it can bring in much larger issues around the logistics of the meeting, from multiple registration processes to getting the printed materials in the proper quantities to the different locations when needed."

5. Using social media wisely. The growing use of social media presents a challenge newer than the others -- and one that still isn't really being addressed. This concerns IMMPA founder Pat Schaumann. "We're learning about the advantages, of course, of expanding the learning network through social media, and we're all using it," she explains. "We're using it for communication and marketing. But without any internal social media policy, there could be a real potential for information and privacy risks."

It's a concern that should be considered by all event managers, of course, but the ramifications of social media misuse could be particularly significant in the med/pharma world. "We're a regulated industry," notes Schaumann, "which means there are people watching; there is accountability to consider."

Legally speaking, there is little precedent for social media use gone wrong at events. "The whole thing is a wide-open area and really something that we have to watch," says Jonathan Howe, Esq., M&C legal expert and founding partner of Chicago-based Howe and Hutton Ltd. With respect to publicizing sensitive information, says Howe, there are some accepted rules in place: "If people are disclosing secrets at meetings, they might be in violation of their employment agreements. There's also the issue of industrial espionage if someone is doing this illicitly."

And then there's the matter of intellectual property. Copyright infringement, notes Howe, might be difficult to prove from a 140-character tweet; on the other hand, using copyrighted material without permission in blog posts has become an area of growing concern.  

Some planners have amped up their efforts to minimize such infringement. "We've always cautioned about putting a disclaimer on the opening slides of a presentation to protect your intellectual property," says Schaumann. But with the speed with which information can be dispersed from a show, she doesn't think that's enough anymore. "People could come into a conference late and miss that first slide. Now we're telling speakers to put it at the bottom of every single slide and every single handout. They don't have to talk about it, but put it up there, just to protect everything."

Beyond the meeting planning realm, companies should be cautioning their employees on what information should or shouldn't be posted, adds Schaumann. "At every conference today, it seems, there's a seminar about how to use social media, about the benefits, the positive side of it. No one is really paying attention to the negative side. I don't know that companies are addressing this in their policies and compliances internally. I can tell you I'm not seeing it in any risk-management plans in working with clients."

6. The perception factor. It's an issue most planners have battled during the past few years, but public perception is a particularly potent problem for medical and pharmaceutical meeting planners.

"Perception of the meeting is very important," says Joe Lipman of Summit Management Services. "Where doctors can or cannot go, and where they can or cannot stay, is constrained by compliance," he notes, but such choices are driven just as much by public perception as they are by strict adherence to the specifics of a code.

Lipman rattles off a laundry list of medical meeting requirements: a property shouldn't have the words beach, resort, golf or spa in the name; a coastal city may be fine, but a beachfront property is not; islands with good weather and towns known for skiing are out; the hotel should be four-star (not five) and, depending on the city, preferably close to the airport. He names a handful of popular convention cities that have built-in obstacles, merely based on location or reputation.

Which isn't to say medical and pharmaceutical meetings don't happen in these locations, but it behooves a planner to know how to handle the situation. What if the site does border the beach, for instance? "You have to be sensitive and professional about presenting it," Lipman explains. "Our job, when we're hired, is to try to help the individual who might not know this. That person might be thinking 'Gee, we want the doctors to come to a place they're going to enjoy.' We have to bring them a great program, at the correct amount of money, and stay at the correct type of hotel, without drawing attention to the fact that it's a medical meeting being held in that location."

The issue of perception is of particular concern to pharmaceutical companies, which seem to face an uphill battle in maintaining a favorable public image. Incentive trips pose a unique challenge. "Companies continue to organize events to incentivize their staff," notes Christine Kelly. "But now they give something back as well."

Kelly knows of one pharmaceutical company, involved in the area of HIV and AIDS, that rewarded its highest achievers by taking them to South Africa. After an adventurous few days of touring, participants spent the last half of their trip volunteering in an HIV clinic. "So they were actually seeing how their drugs were used and giving something back, and having a meaningful trip, rather than just having a lighthearted incentive or reward," Kelly says.

Gemini planned a similar trip to South Africa for a client that raises funds for a U.K. charity, in which a few days of white-water rafting and trekking were followed by volunteering in an orphanage. Participants worked with the children and staff to renovate a dormitory. In both of the above cases, says Kelly, participants found the latter parts of the trips to be the most memorable "because it was so meaningful and, sometimes, life-changing for them."