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Introduction by Pascal Beucler, SVP and Chief Strategy Officer at MSLGROUP: Key issues the healthcare industry is facing, key facts from the MSLGROUP EMEA Healthcare Practice project "You share, we care" and the Geneva conversation

A new ecosystem: Power to the patients

A new deal: The EU and governments are increasing pressure on companies

A new style of engagement: Towards a new advocacy

A new paradigm: The need for innovation

A new mindset: Healthcare reputation and corporate citizenship

How can we help you? Conclusion and presentation by Elisabetta Moroni, EMEA Healthcare Practice Leader at MSLGROUP:Next steps, the EMEA team and skills

Our team

Sharing is Caring.

Pascal BeuclerSVP & CSOMSLGROUP

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About seven years ago, I was heading a team of designers in charge of creating the visual identity for the soon-to-be-launched Institut National du Cancer (French National Institute for Cancer), sponsored by the then President of France, Jacques Chirac.

Prior to launching the Institute, Professor David Khayat, one of the most prominent oncologists in the country and chair of the new institution, was in his office at the Paris Pitié-Salpétrière hospital, outlining to us why he created the 'Charte de Paris' to better combat cancer.

Professor Khayat explained that all oncology departments in the world were invited to join, as long as they committed to putting people, not “just” pathologies, at the heart of their thinking.

“We need to put people first”, he said, not pills. People suffer from a lack oflistening, talking and sharing much more than they do from pain. Sick people desperately need to talk, to raise their voices, to express their views and experiences, and to share with their peers.”

While we were exchanging views on the matter, I saw a sculpture on the Professor's desk. It represented an individual helping another individual to stand up. I asked him what it was. He said that each hospital signing the Charte de Paris would receive the same sculpture, as a symbol of its commitment to a people-centric approach.

We left Professor Khayat's office with the sculpture in our hands. I remember thinking that this symbol was going to be inspiring for the creative team. And this is exactly what happened, as the re-interpretation of the sculpture won the pitch.

As we would say today: there was a story to tell, a story that mattered, and the symbol/sculpture within the logo told it very well – even if in a more abstract way.

This happened in 2005. Ages ago, in those ancient times when Facebook, Twitter and most of today's leading social networks didn't really exist, or matter. They do exist in 2012, and they have become central to everything we do.

Just a few weeks ago in Geneva, during a two-day “conversation” session organized by MSLGROUP's EMEA Healthcare Practice, one of those present from the pharma industry asked “Should we be talking about people instead of patients?” Yes, we definitely should, and the Social Shift is probably the biggest challenge many firms in the Healthcare sector are facing these days.

But as we discussed in Geneva, for many companies it is not an easy path to take.

Legal constraints are tougher than ever, and regulations are tighter too.But engaging with people and patients' communities is not an option. It is an absolute necessity.

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Our credo

Our vision

Firms in the Healthcare sector at large need to not only rediscover their social purpose, but to also put it at the core of their businesses, and to consider it when engaging with all stakeholders.

To stay relevant, these firms need to move from Corporate Social Responsibility (CSR) to Collaborative Social Innovation (CSI).

> From corporate to collaborative: defining a shared purpose that all stakeholders can collectively commit to, to help make the world a healthier place to live.

> From social to social squared: social as in benefiting society, but also social as in collaborating with all stakeholders in the sector.

> From responsibility to innovation: building platforms and programmes that enable innovative and sustainable solutions.

This is very much where the future of the Healthcare Industry lies and we are happy to help.

Pascal BeuclerSVP & CSO, MSLGROUP.

Furthermore, in a context where public trust in all institutions is down - while people are ever more empowered thanks to social networks - corporate and brand reputations can be very fragile.

The EU, national governments and their public bodies are financially at risk, given today's economic crisis. As a result, patients have to pay more and more, but they have less and less money to do so with.

From a mid-term perspective, much effort is needed to better educate people: health, nutrition and wellness are very much about prevention after all.

“The new engine of innovation driven by collaboration, openness, stewardship and the power of the social web gives all of us an opportunity to drive even more rapid, meaningful change across global institutions.” MICHAEL DELL, CEO and Chairman, Dell

There are millions of causes, but only few areas of opportunity that truly integrate business and social objectives, thus creating genuine shared value: environment, health and education.

Old Conversation Paradigm

DoctorPatient

Information Sources

Support

We now live in the conversation economy. Thanks to digital communication, we are facing a real democratic revolution: people (patients, families, doctors, journalists…) can talk to each other in real-time, and with ease.

A new ecosystem: power to the patients

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Managers attending the Geneva meeting in their own words…

As part of the “You share, we care!” initiative, MSLGROUP surveyed 70 managers in Europe asking the following: “Are you ready to handle this?” The same question was put to a group of top managers who spent two days with us in Geneva reviewing the survey results and debating the challenges of the healthcare sector. To facilitate as transparent and impactful a conversation as possible, we chose a closed-door event format, where no names and no specific companies would be revealed. Three panel discussions took place, ensuring representation across this complex industry: big consumer, big pharma, medical devices, biotech, generics and chemicals.

The purpose of this project was to provide food for thought, stimulating a debate among top healthcare managers: the EMEA survey and the two-day “conversation” session in Geneva have given MSLGROUP the opportunity to better understand the current and future trends in the European healthcare scenario.

The digital revolution has given power to C2C/peer-to-peer interaction. Millions of people are talking about drugs online without involving a doctor. Naturally, word of mouth has always been important in healthcare, but through social media it is undergoing a “massification” process.

“Traditional healthcare barriers are blurred and peer to peer is here”

Traditionally, it was politics and the media that shaped the environment in which healthcare companies operated. Today however there's another factor at play: thanks to their reach and clout, social networks are impacting the way the industry is perceived by stakeholders. The MSLGROUP survey “You share, we care!” outlines the views of 70 managers all over Europe. Managers who appear to be well aware of the impact digital communication is having on their industry, and who believe that companies need to become storytellers - creating contexts to explain to people what they do, and to highlight the company's social values. These managers want to become protagonists in the debate about Health:

Nearly 2/3 of the managers interviewed think that social media offers an opportunity, while only a little more than 1/3 think scientific meetings are important;

Moreover, the majority of them believe that the Web will be the channel to dominate healthcare conversations in the future;

Managers think that the social media revolution has occurred and therefore digital tools are an integral part of their communication campaigns (53 out of 70), although 34 out of 70 are worried by regulatory restrictions and approval processes;

For more than 2/3 of the managers, the peer to peer

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“…it is not clear to me what I am allowed to do with social media”

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revolution is real and the majority of those people believe that patients/patients’ groups can act as advocates on the Web;

Patients nowadays are behaving as actors in the healthcare environment and are key stakeholders in the healthcare ecosystem thanks to the digital revolution;

In this vein 61 managers out of 70 think that digital communication offers a great opportunity to help improve medical treatment/therapeutic adherence – in particular, Twitter can have a role in the dialogue between doctors and patients as it represents a tool for faster connections;

The majority of the managers also view blogs as important in healthcare communications, potentially impacting how influential doctors and key opinion leaders are on the Web.

It is clear from the survey that the patient’s role is changing and becoming more and more crucial: there are many patients' and consumer communities that are strong influencers on the Web and that could be strategic interlocutors.

Social media speeds up every process (acting as they do as facilitators) and therefore are an important means of communication, but companies do not really know how to go about using social media as a tool and do not feel ready to handle the resulting open dialogue among stakeholders (49 out of 70). Despite this, as a result of the

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“Should we be talking about people instead of patients?”

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debate that occurred in Geneva between healthcare managers, the digital revolution is seen not only as an issue, but as a greater opportunity for a mindset change in the industry's way of working: from a traditional top down communication approach to a co-creation of meaningful content.

This “new ecosystem” is valid not only for the pharma business but could also be extended to healthcare in a broader sense. For example this is an amazing opportunity for the agriculture industry; companies can start to interact directly and widely with consumers but they have to accept a genuine debate with the public.

Millions of people are also talking about food safety. Is the way in which food is produced impacting my health? The answer is Yes,

“The conversation cannot be controlled, and therefore we need to accept positive and negative opinions.”

according to conversations that consumers are having on the Web. The question is: are the Food and Chemical industries reassuring consumers by talking to them in a peer-to-peer way?

In conclusion, managers admit that companies still have difficulties in managing this revolution and in understanding which strategy to deploy. Nearly 100% of the sample believes in the peer-to-peer revolution, in which patients, as individual citizens or organized as part of associations, now represent a fundamental critical mass when it comes to fine-tuning corporate strategies. In terms of advocacy, online patients represent the main target (65/70).

“Lastly, the Web is alsofundamental not only in terms of talking with the public, but also in terms of listening to people with regard the issues they consider key”

New Conversation Paradigm

Patient

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The major challenge for companies in planning a digital communication strategy lies in their internal regulatory bodies and the restrictions imposed by health authorities.

As a result, companies are indeed facing what amounts to a double whammy: both internal and external restrictions on their communications. Making this situation even more difficult is the fact that there are no clear pan-European rules, while at the same time there is significant regulatory differentiation between individual countries. Equally, regulation around social media and communications doesn't yet exist at the European level. These challenges are also faced by Healthcare managers in the USA, where the picture is very similar.

Managers attending the Geneva conversations emphasized that within their company there is a long and winding road for a social media campaign to be approved - from the doors of Marketing to the halls of the Legal department. Despite this changing world, authorities don't really want companies to speak directly to patients. This lack of clarity has resulted in a culture of fear within organizations, which in turn has led to legal colleagues interpreting the law quite literally, and imposing rules that are even

“There are no rules in social media: companies are afraid because on the Web everything that goes out comes back.”

more constrictive than those that national health authorities impose.

Lastly, another major concern is that the flow of communication cannot be controlled on the Web.

In this regard, the GP's perspective is also very interesting: GPs are not particularly comfortable with the fact that the general public today often has its own clear opinion on treatment, when it's been highlighted that up to two-thirds of people are misinformed about drugs and their use in treatment. Here it's worth mentioning the "cyberchondria phenomena" – the unfounded escalation of concerns about common symptomology based on reviews of search results and literature online.

Companies should look to the internet as a tool to help enhance corporate social responsibility and as a relevant and meaningful opportunity to learn how to better communicate with patients. In short, any online approach should be education-oriented and not just product-oriented.

In conclusion, as online communication cannot be controlled, and companies are not able, or ready, to have face-to-face conversations with patients, they should start by supporting a balanced and growing dialogue between patients and GPs, which in turn can help increase adherence to therapy - and which doesn’t have to be regulated by institutions.

Better regulation: The crucial challenge

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The challenges posed by social media at the EU level are quite different from those in the USA. For a start, governing regulations in Europe and the US are different, as are the approaches towards and use of health services. One similarity however is that as in Europe, in the US the FDA is also currently failing to provide clear direction to our US colleagues.

But returning for a moment to the differences, let’s look at a simple example: while Europe lags behind on use of the internet for medical communication, it is ahead of the game in terms of mobile phone usage. In Europe almost everyone has a mobile – offering up a very direct way to reach patients, particularly as there are currently no rules restricting or controlling a doctor texting his patients.

“We cannot replicate the US, as we always did in the past. Consumers behave in a different way here.”

Today of course, people are increasingly ‘melting with the machine’: take the mobile phone, it’s never off and it’s in our hands all the time. This provides a huge communications opportunity of course – but there’s also a watch out: companies need to remember the need to create shared value with consumers, and particularly with mobile communications this means leveraging the channel to educate and engage rather than to simply promote drugs.

Evidently the power of mobile devices in any communications strategy cannot be overestimated and a holistic approach to their deployment, combining mobile devices and the web, is key.

Finally, it’s worth reminding ourselves that digital communication cannot revolutionize the healthcare landscape unless ethics, politics and legislation pave the way.

An EU approach to new media

Europe's welfare system was crafted at a time of economic growth. The environment has now changed and clearly the industry needs to adapt or face anunsustainable future. In short: there is a need for innovation.

A new deal: The EU and governments are increasing the pressure on healthcare companies

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“This can be seen as the paradox of modern times: healthcare systems were developed in times of prosperity and now we are facing financial ruin” was a common comment expressed at our event in Geneva. At the moment, governments “are just trying to plug the holes – but this won't solve the situation and will not leadto innovation”.

The point is to find a way to positive public health intervention because “as Europeans, we have a social welfare model in our DNA, we all believe and think within a paradigm in which everyone has the right to the best possible treatment”. People expect to be cured, and these expectations must be met.

“We must re-think the EMEA healthcare model and work together with institutions”

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The Healthcare system is now a major concern for European governments and the pressure on institutions is high. While today people in Europe are more worried about the economy (27%) and rising prices (45%) than the healthcare system (17%), they need to be aware that the two issues are interrelated: the healthcare system is no longer sustainable precisely because national public debt is high. As life-expectancy increases, so healthcare costs will jump dramatically in the future,reaching as much as 10% of the EU's GDP in 2060. That compares to the 7% of GDP healthcare costs represent today.

The increasing role of the EU and the growing interdependence between European policy direction and national authorities is forcing the healthcare industry to balance its public affairs strategy in a different way. Healthcare remains a national responsibility but the situation is changing, and there are horizontal issues that impact directly or indirectly on health at a European level and need an EU

approach: new economic governance, market competition, market access, patient protection, data privacy, workforce and skills gap.

We have to balance the need toprovide universal health care andlong-term care with increasingdemands in the coming years associated with an ageingpopulation, technologicaldevelopment and growing patientexpectations.

Europe's ageing population, cost increases, and the economic crisis all combined are endangering the Healthcare System which has characterized Europe so far. It is increasingly evident that the sustainability of the whole system will be a key issue in the future. Industry should re-negotiate a new model with governments to share risks where reimbursement is concerned, and to ensure that the reimbursement model is reviewed and subject to innovation.

“Healthy aging is not about old people, it is about us”

Turbulent times and the need to revise today'scost-cutting approach

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Any reimbursement model must be sustainable, and this involves change, plain and simple, because:

• Governments, who are concerned about the cost of healthcare, don’t choose or use various medicines, yet have to foot the bill for them;

• Practitioners, whose major concern is effectiveness, are making choices about the type of medication, but do not pay or indeed use those medications as patients themselves;

• Patients are the recipients of treatment, yet don't have a say in the choice of medication and often don’t pay for the drug either.

At this time of dramatic change in healthcare systems across the EU, the healthcare industry needs to become an active player in a way it has never been before. To move from being passive to proactive. Success will depend on whether or not companies can interact with

national and European institutions to create new approaches, ones that take into account the bigger global picture, versus everyday business matters only.

What is the EU proposing? The body has an ambitious health programme that will impact national healthcare systems and which represents a major opportunity for the healthcare industry to be part of the process - to help define a strategy that sits well with them, while also satisfying EU needs at the same time. The main objectives of the EU's health programme are:

• To create innovative and sustainable health systems (48% of the allocated budget)

• To increase access to better and safer healthcare (22%)

• To prevent diseases and promote good health (21%)

• To protect people from crossborder health threats (9%)

The need to break up today's 'exclusive triangle' and instead establish a win-win strategy for all

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Currently, governments perceive healthcare companies as effectively presenting them with financial challenges, rather than potential solutions – through innovation, for example. And this must change if a true win-win strategy is to be achieved. On the other hand, the demand for transparency on the part of institutions, and the lack of clear regulations at the European level, creates confusion at the national level. According to the MSLGROUP survey “You share, we care!” 52% of European healthcare managers interviewed agree (or strongly agree) that European governments will need to find a way to improve the collection of and transparency in health data in order to prioritize investment decisions.

One important area of cooperation between stakeholders is the prevention of diseases, so as to save costs in the long term. Today’s healthcare system is sick-care: instead we need to focus on prevention, with an holistic approach, in order to become economically sustainable in the future. To do this, it is fundamentally important that people are fully aware of the importance of a healthy lifestyle. If EU state members and pharma companies play their part in supporting and promoting public information campaigns, everyone’s common interest in reducing overall healthcare costs will be achieved (a good example of this can be seen in the case of vaccines.)

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Towards a united healthcare industry

ready to engage in that open dialogue yet (49 out of 70 respondees confirmed this).

In order to work with Institutions and civil society, healthcare companies need to challenge perceptions so as to help build trust and become true partners. In particular, companies are well aware that thanks to the peer to peer revolution and social media, patients and civil society more broadly are gaining in strength and influence.

“We shouldn’t be afraid to take risks, and to share in a common project as an industry.”

Clearly, if companies want to become real players in the conversation around the future of the healthcare industry, they have to do something about reimbursement and also begin dialogue with European institutions. Importantly, they need to do this collaboratively, although an approach to advocacy at the European level is difficult to foresee at the moment (as the MSLGROUP survey highlights) simply because there is currently so much differentiation when it comes to national legislation.

Nonetheless, it is evidently time for companies to begin a dialogue with all key stakeholders: from patients to HCPs and governments - this despite the fact that as the MSLGROUP survey showed, healthcare companies do not feel

Looking forward to prevention

How can money be channeled into prevention? Companies and institutions have a major role inensuring that society extends and improves healthcare support. For example, think of the majorchanges brought about by the introduction of toothpaste and its accompanying public awarenesscampaign.

Prevention in the 1960's was all about vaccinations – today we need to turn to nutrition. Preventing ill-health through nutrition has a lot to

“First, we need a paradigm shift where we see the focus moving to prevention”

do with education, and we need to start targeting schools - and medical schools - as well as NGO's, doing all of which will have a positive impact on healthcare costs. Furthermore, according to most of the managers who were interviewed (46 out of 70), today’s global economic outlook means that society as a whole needs to work together to find solutions in the field of healthcare. Findings from the survey highlighted the increasingly strategic future role of family physicians as gatekeepers of a nation’s health system, working with governments to create a ‘prevention mindset’ via the promotion of a culture of well-being that is seen as an asset for each individual.

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A fresh style of engagement: Towards a new advocacy

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Companies need to build new advocacy strategies, given that not only patients but often even physicians no longer see value in a healthcare company’s very existence. Those companies are today afraid and have remained silent for too long as a result – yet this silence in turn impacts their reputation.

How can the industry change from being part of the problem to being part of the solution? Healthcare companies need to think practically; the European situation is critical and they must engage in improving lives and health conditions at the EU level. Who is going to convince people to get ready to embrace healthier habits? The general public is not yet aware of the amount of money that pharma companies and the healthcare system are currently investing to develop and make available medicines that can help improve lives.

According to MSLGROUP’s survey “You share, we care!” 52% of the top healthcare managers in the industry in Europe agree (or

strongly agree) that “more effective preventive measures and fundamental lifestyle changes need to be promoted to encourage overall healthy behaviour.”

The capacity to articulate a more holistic approach in external communication strategy,integrating pan-European public affairs foresight will be decisive. In terms of prevention, nutrition as we have just seen should become a key topic for European agendas. This dialogue needs to happen - governments are thinking short term. An example of this can be seen in Germany, which - despite having the strongest European economy - still provides the worstnutrition in hospitals.

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Healthcare companies should envisage a multi-layer advocacy approach that combines Pan-European and local policy orientations. The local level does have an important role, as it is there that industry associations will be enforced, strengthening the linkwith patients and speaking

alongside institutions. Much can still be done at the local level, where balances of power are shifting, and where a new model is becoming increasingly popular: the PPI (Public Private Initiatives) – a model which probably holds the answers for the future of the healthcare sector.

“I need to establish European guidelines in my company.”

The importance of partnerships

As is the case for other actors within the healthcare industry, agriculture too needs to develop a new partnership approach - partnering both within the industry and with external scientific and/or institutional partners. This could be a real opportunity for the industry to communicate in an effective and differentiating way: putting agricultural issues into a wider context, and improving the image of healthcare companies.

In Geneva, a “concrete advocacy example” was brought up: the Italian Association of Crop Protection Products’ Producers who launched a journalistic prize in cooperation with a respected scientific foundation and the National Association of Scientific Journalists. The purpose of the prize is to provide an incentive to Italian journalists to talk about innovation in agriculture in a scientific way. The partnership and the initiative are truly innovative in the agribusiness scenario. The first

step is to reinforce the unity of the agriculture industry as a whole, overcoming national or market differences.

Naturally, the road is still long, as nowadays it is very difficult for healthcare companies to find an accountable counterpart.

Advocates have different opinions in different countries; they often do not agree with each other and are sometimes against companies on principle. The stronger activists are probably young people and patient groups. In order to target them we must find new tools and have clear strategies on what we want to achieve from them. Once again digital PR can be of help: monitoring opponents, neutral players and possible advocates. A concrete example of partnership is the forthcoming world exhibition EXPO 2015 which will be focused on the theme “Feeding the Planet. Energy for Life” and will take place in Milan, Italy.

Covering the topics from a global perspective, Expo 2015 will be a universal event that will provide an opportunity to demonstrate how innovation is going to reshape our lives in the near future, in the fields of both health and food. The event will be global in every sense: from focusing on the differences between the North and the South, to the increasing pressure on welfare budgets in the developed world.

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A new paradigm: The need for innovation

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Innovation is relevant across the healthcaresystem, from pharmacology to the system's very organization.

Pharma is not just making “white pills”: this industry has an impact on society, economy, and the wellness of populations. Innovation is the fil rouge of this process. For smaller companies delivering innovation is more of a challenge, and indeed expensive - so it's important those smaller companies form partnerships with entities that co-finance research and studies.

It is also necessary to reinforce communication around the social utility of companies’ actions: social engagement is the key to changing the perception that institutions now have of the healthcare industry.

The next proposal for greater transparency in the healthcare industry, for example, could be an opportunity for member states and pharma to cooperate in order to build reimbursement criteria that

are increasingly objective and verifiable, and therefore more efficient. The integration of new economic and social expectations in companies’ business models and communication strategies is becoming the main trend.

Governments are more focused on reducing healthcare costs, as well as on spending better, optimizing resources and investing in education and prevention. The healthcare industry can be a great partner. It is important that companies also stimulate debate using social media, instead of only relying on one-on-one dialogue with institutions. It is also essential to explain to citizens and patients that companies are ready to adopt new “win-win” models.

Healthcare companies have to explain to institutions how innovation creates benefits for

society: saving and improving people’s lives, reducing costs within the healthcare system (directly and indirectly), financing R&D, and creating thousands of jobs.

When pharmaceutical companiesdevelop and offer drugs that are particularly innovative in terms of effectiveness, governments fear that patients using them will live longer, and that this in turn will lead to greater spending. This reality reminds us innovation is needed not only in terms of increased therapeutic efficacy, but also interms of improved long-term financial sustainability. Companies need to approach the whole question of innovation with this thinking in mind.

Today's new communications platforms and social media represent a significant opportunity to tune in to stakeholders. That said, there are of course challenges due to specific legal restrictions that often vary between countries.

a) Rare diseaseIt is also fundamentally important that new solutions and technologies are developed, with regard rare diseases. Because they concern only a small percentage of the population, authorities have a real need to clarify their strategy in terms of allocating significant portions of a budget to treat such a small group of patients. Rare diseases represent 1% of the total healthcare budget spent by European institutions, despite a high rate of innovation. Therefore

“We need to re-discover our purpose and share it with our stakeholders.”

Two possible examples

institutions need a "creating shared value" approach, one that not only validates the price of the drug but also takes into account the impact on people's lives, be they patients or their families.

At the same time, industries - referring to common drugs - should be able to accept the criteria that reimbursement has to be subject to real innovation.

b) Food safety and healthUntil a few years ago, healthcare and agriculture had never influenced each other, as human health and food production weren't generally conceived as an holistic issue. In recent years however, economic and social development, along with great strides made by scientists, have changed this scenario.

Agriculture is today facing one of the most complex challenges of our times: the need to dramatically increase food production over the coming years – the result of global population growth, the rapid development of countries including India and China, and the scarcity of resources such as water and soil. Just think that today there are seven billion people on earth, and by 2050 this will have grown to nine billion – a staggering extra two billion people added in just 40 years.

In Geneva, some managers representing this industry highlighted that “only innovation can assure safe and sufficient food for the whole population at an affordable price. These themes are being discussed by the media more and more, even if consumers are not really conscious of this dramatic situation yet.”

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Consumer perception: innovation is scary

The vast majority of consumers have always lived in urban centers and do not know what agriculture really is or how the food production process really works. People buy food in supermarkets and are used to seeing abundant, cheap, clean and safe produce available all the year round. In other words, consumers are unable to fully understand the food transformation process, and indeed have an urgent need for greater information provision. This is something that the food production industry must manage.

Despite the food safety that innovation has promised over recent decades, eliminating starvation in Western countries, “consumers are scared by innovation” - especially chemical science - as they instinctively think that what is natural is good and what is artificial is dangerous.

So we need to promote innovation in research and technology along the entire food supply chain to improve the nutritional value, conservation, and distribution of foods. We further need to promote a higher awareness of the benefit of innovation for consumers.

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A new mindset: Healthcare reputation and corporate citizenship

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Winning trust, increasing authenticity and building reputation

In this difficult healthcare scenario, it is time for companies to stand up, to become the interlocutors of institutions and partners of patients, otherwise somebody else will take the space companies are leaving empty. In order to become trusted partners, companies must work firstly on corporate reputation to change the way civil society and institutions perceive them.

This industry must work jointly in order to plan a common reputation management project because patients, while becoming more and more influential, are losing trust in pharma companies.

Healthcare companies still face reputation issues and a common effort to improve performance should be initiated. It is about creating shared value in a world

“Healthcare is becoming patient- centric and patients do not rely on the pharmaceutical world.”

where the relationship between business and society has changed and calls for a deeper level of collaborative social innovation.

Companies should no longer be seen as the creators of problems, but instead the providers of solutions. From the MSLGROUP survey it is clear that managers think that disease awareness is relevant and HCPs are a priority in their communication strategies, but two thirds of respondents think that reputation management is important and is becoming more and more crucial.

Moreover, it is time for companies to enhance how they communicate about the social impact of their actions, and to reinforce how they engage socially, so as to shift how society currently perceives given industries. Indeed, the MSLGROUP survey shows that “45 managers out of 70 believe that CSR is an integral part of their communication

strategy”, yet the public may not be fully aware the industry holds that view. In order to strengthen their commitment, companies have to move from philanthropy to purpose, as a company's purpose must be placed at the core of their actions and activities.

In recent years, people have become more and more sensitive to the value behind a brand and therefore companies need to increase their reputation management strategies. In order to help companies communicate their value, MSLGROUP has recently launched a new approach: PurPle, a global offer helping business leaders drive positive change by catalyzing collaborative social innovation and grassroots change movements.

At the moment, the loss of trust is critical; some examples of this are:

• Food health claims have decreased, potentially precisely because public authorities no longer believe their veracity. At the same time, we've seen a rise in food scandals and this has inevitably led to heightened fears about food-related diseases.

• Sometimes, companies invest in CSR and education, but the general public does not recognize this effort. They simply think that it is easy for large pharma companies to do this because they have a lot of money.

Managers who took part in the Geneva healthcare conversation debated the future. In order to gain

“People are looking for value”

trust, companies should be very transparent, clear and authentic: they should not hide that they are business-oriented.

It is important to work on evidence-based communication. There is also a need to define what evidence is and how to prove and demonstrate innovation.

On the agribiz side, public opinion is focused increasingly on environmental sustainability, and agriculture is one of the most closely-watched industries. The public is also concerned about the impact of food production on health (e.g. water pollution, air pollution, etc.)

In recent years, the agriculture industry (especially its chemical arm) has come under increasing attack, accused of damaging the environment and people's health. At the same time, the industry has sometimes failed to correct false information, or indeed highlight the real benefits of chemical science in agriculture.

Consequently, many consumers lack confidence in - or at least are suspicious of the industry, making it even more important that the agriculture industry change its communications approach in order to become a trusted interlocutor. Today companies “don’t have to be afraid any more” of adding scientific fact to their arguments when addressing civil society, even if it is hard to translate technical terms into everyday language.

“We should shift from late cure to prevention, but how do you put money into prevention? How do you make it tangible?”

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“The challenge is to transform scientific content into something easy and appealing.

A new communication mindset is required with regard farmers and consumers. In order to achieve that, companies have to define some key messages to use in communication and try to explain them in an effective way. Since B2B communication is not sufficient, B2C meets the need to voice the sustainability of this industry explaining how evolution improved people’s lives in recent decades.

To succeed in communication with consumers (and with the public in general), the agriculture industry has to also change the language it uses, undertaking a process of “emotionalization”. This means that the messages should be presented in an easier, conversational language that captures people’s attention and directly involves them in such key themes. Agriculture is too

important for the collectivity to remain only in a technical context and the agriculture industry has to face the challenge of extending the discussion to the whole of society.

The lack of science-based information over recent years has, in fact, provoked a “polarization” of the debate, and we are now seeing a strong contraposition between people who accept innovation in agriculture and people who reject it (e.g. organic vs. traditional cultivation, GMOs debate, etc.). This discussion, often not based on science, is not positive for industry and consumers. Companies have to be more proactive in the debate, explaining that the solution lies at the heart of the two approaches = sustainable technology.

“We need to open a real dialogue: from a defensive attitude we need to move to being more proactive”

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Elisabetta MoroniEMEA Healthcare Practice Leader MSLGROUP

How we can help you? Conclusions by Elisabetta Moroni, EMEA HC practice leader

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Managing the survey in EMEA and talking to healthcare managers for two days in Geneva allowed our team to shape a new picture of this industry.

The “You share, we care” project involved Great Britain, France, Germany, Italy, Poland, Scandinavia, Spain and Switzerland and focused specifically on market access, advocacy and digital communication.

There is a profound transformation going on.

In these increasingly digital times, the peer-to-peer revolution represents a change in trust, patients are becoming advocates, and sometimes we put more trust in those who are close to us rather than the traditional KOL or stakeholder, even if they might be more knowledgeable. This can be right or wrong but is it a fact.

In EMEA, the definition of guidelines could help companies roll out better campaigns and

initiatives. This revolution is often incorrectly interpreted by decision-makers, who show great resistance to change. In this context, the role of the consultant is crucial in order to offer rational mapping of the effects of the digital revolution on healthcare on a global and local level, and to advise companies to find the right balance between creativity and realistic execution.

A good healthcare campaign should include a social media component: according to the EMEA framework and local application, every target - patients, people, GP, media - must be approached differently, keeping in mind what the campaign is trying to get from each of them, as well as risks and opportunities.

Innovation must be the cornerstone of a new relationship between

pharma companies and institutions. The EU itself is pushing in this direction, so a win-win strategy could be the new paradigm for this industry. Innovation will play a key role in the EU strategy and companies have to be part of the process.

Convergence between nutrition, wellness, chronic disease prevention and innovative therapies is growing: we need a new mindset to embrace the meaning of health and the future of medicine.

With population numbers growing worldwide, only science can assure safe and sufficient food forhumankind; food production is part of the new healthcare game and the agriculture industry has to change its communication approach.

At MSLGROUP we believe our role is to work alongside companies to

deal with this fluid scenario. It is time that companies rediscover their purpose and innovate their social engagement model.With the “You share, we care” project, we at MSLGROUP choose to act as an independent “catalyst” of opinions and a generator of conversations and projects in the healthcare sector: an “always on” network of companies and professionals who can share information, visions and actions in order to innovate the sector in a tangible way, getting as close as possible to the needs of citizens and institutions.

Geneva was the kick-off of the project.

I would like to thank our Chairman Pascal Beucler, SVP and Chief Strategist Officer MSLGROUP, whose guidance made this project possible.

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Special thanks to Anders Kempe, CEO MSLGROUP EMEA, Bronwen Andrews, Director, European Business Development, Trudi Harris, CCO MSLGROUP and Mike Ward, Editor-in-Chief, Scrip Intelligence, who supported the project.

Our thanks to PublicisLive for hosting the healthcare meeting.

CHAIRMAN

MSLGROUP HC EMEAADVISORY BOARD

MSLGROUP HC EMEA EDITORIAL COMMITTEE

Our Team

EMEA HC Task Force: Where We Are

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Netherlands

France

Brussels, Belgium

Nordics

GermanySpain

Italy

UKPoland

Switzerland

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Pascal Beucler, SVP and Chief Strategy Officer

Stefanie Clemen, Leonardo Sforza, Elisabetta Moroni, Erin Ortiz, Florian Wastl

Roberto Adriani, Thomas Balanzoni, Delia Ciccarelli, Alice Corinaldi, Alessandro Paoletti

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