For a long time, the media debate around Alzheimer’s has been dominated by news of failed clinical trials – giants such as Merck, Eli Lilly and Pfizer, as well as lesser-known companies like Axovant and Prana Biotech, have all announced defeats in the last several years. As a consequence, pharma players haven’t developed a particular PR and communications playbook relating to one of medicine’s biggest challenges, and their messaging has been reduced to merely announcing disappointing results.

Like many other topics, Alzheimer’s stalled during the pandemic and didn’t enjoy that much interest at a time when every pharma article was about Covid. However, this changed in June 2021, when the conversation around Alzheimer’s was reinvigorated by The Food and Drug Administration’s approval of Biogen’s Alzheimer’s drug Aduhelm, the first new treatment approved in two decades.

It started as great news for Biogen, with headlines like Time’s “The First Treatment for Alzheimer’s Disease Is Here” and BBC’s “US approves first new Alzheimer’s drug in 20 years“. But the initial media euphoria quickly turned into crisis management for Biogen: in the nearly four months since the decision, a flood of articles started reporting on high-profile resignations by FDA advisers, a federal investigation and extraordinary pushback from a number of insurers and physicians. Aduhelm made headlines nearly every day.

To see how the recent Alzheimer’s discussion unfolded, we analysed 683 English-language articles published between 1 January-10 October 2021 in a set of pre-defined global publications. These comprised top mass media outlets like Reuters, the New York Times, Forbes and the Guardian, as well as leading industry publications such as British Medical Journal, Fierce Healthcare and Kaiser Health News.

We found that all the media stories around FDA’s controversial approval made Regulatory approvals and Clinical trials the largest topic in the debate:

Many media outlets reported FDA officials used a regulatory shortcut to gain approval in order to get the drug on the market sooner. Both pharma and mass media publications framed Aduhelm’s approval as controversial because clinical trials allegedly gave conflicting results, with criticisms including that the drug offers insufficient evidence of efficacy and that the US medicines regulator and the pharma company had collaborated too closely in the run-up to the approval.

NGOs such as Public Citizen and the Institute for Clinical and Economic Review criticised the approval, while some advocacy groups such as Alzheimer’s Association had lobbied for the drug because of its novel status.

Biogen tried to take control of the narrative by issuing a staunch defence of the science and approval process, saying that “misinformation” is fuelling criticism of the treatment. The company claimed the drug is the first to treat the causes of the debilitating disease, rather than just helping patients manage their symptoms.

The company’s main message was that there’s too much confusion, misinformation and controversy surrounding the data and the approval process. Biogen CEO Michel Vounatsos also added that although the company is facing some near-term challenges and everybody can see that, it continues to see a very high level of physician and patient interest and believes the mid-to-long-term opportunity remains significant.

Within the Pricing/insurance coverage topic, many articles reflected the criticism that Aduhelm’s high cost will adversely impact patient finances and Medicare budget. Drug treatment is estimated to cost $56,000 per year, and the company stated that they would maintain this price for at least four years, but Kaiser Family Foundation (KFF) researchers said that a conservative estimate of the cost to Medicare would be $29 billion in one year.

Meanwhile, other companies like Eisai, Eli Lilly and Roche took the opportunity to join the Alzheimer’s discussion by promoting their own treatments. Many saw FDA’s controversial approval as a boost to their chances to get approval for their own medicines that work similarly to Aduhelm (clearing amyloid plaques from the brain).

For example, Eli Lilly earned its influence in the conversation by saying mid-stage data it plans to submit to regulators for its donanemab showed that the drug more effectively cleared amyloid beta brain plaques than any other treatment. In early October, Roche joined the debate by announcing that its gantenerumab antibody, also designed to neutralise amyloid plaques, had received breakthrough therapy designation from the FDA.

What does this mean for PR and comms in the pharma sector?

  • Pharma crisis management became a bit trickier. The usual crisis scenario in the pharma industry involves product recalls. One of the best-known examples in the crisis management literature is Johnson & Johnson‘s successful recall of the pain relief product Tylenol after some fatal incidents. However, PR pros should now be aware that a crisis could arise when stakeholders challenge not only their own company’s work but also a regulator’s authority. In the case of Biogen, many critics called the approval to be one of the most controversial and publicly acrimonious decisions in FDA’s recent history, and the company could have done a better job at protecting the agency’s integrity.
  • Companies need to push their side of the story more effectively. Our analysis found that Biogen’s critics were given a large share of voice both in trade and mass media, while the company’s own spokespeople weren’t that influential. Although Biogen CEO Michel Vounatsos was the most influential pharma spokesperson in the debate, he wasn’t cited that often and his attempt at crisis management wasn’t reflected in many publications. This means that Biogen’s critics were more influential than its defenders, and the company couldn’t take hold of the media narrative.
  • Stakeholder segmentation got even more important. To understand the PR potential of a new Alzheimer’s treatment, and develop a compelling product brand, market researchers must take into account a wide range of stakeholders. They should have a clear view of how different government representatives, doctors, academics and payers have an impact on new product potential. For instance, certain segments of doctors expect a product with minimal safety concerns while others are more willing to trade off some risk for greater efficacy benefits. In Biogen’s case, those concerned about side effects were highly critical of Aduhelm, while those focused on efficacy tended to have a more favourable view of the treatment due to its breakthrough status. Mapping out such stakeholder segments at the start of every campaign is an invaluable stepping stone for every PR effort.
  • A focus on innovation and medical breakthroughs isn’t enough. As the narrative around the whole pharma industry continues to be innovation-driven, and the FDA approves more and more treatments, marketers face a far more complex product landscape. Medical breakthroughs need to stand out, not least because their categories are so complex and overwhelming. To achieve that, pharma players need to go beyond the innovation arch and invest in more properly communicated emotional brand strategies that explain the emotional benefit of the drug. Companies working on Alzheimer’s, including Biogen, still haven’t done much in this regard. For a notable recent example of an emotional brand campaign, take a look at our analysis of Pfizer’s Science Will Win.
  • Pharma should implement more CSR initiatives aimed at public awareness and destigmatisation. The smallest topic in the Alzheimer’s conversation, Awareness and campaigns, featured efforts to tackle the stigma around the neurodegenerative disease and support people affected by the condition. However, this topic mentioned primarily charities like the Alzheimer’s Society, meaning that there is a potential white space for pharma players to boost their CSR programmes by putting more PR muscle behind their public awareness campaigns. In this way, companies can break down the taboos about discussing dementia to connect with people emotionally and drive support.

For more insights into topics, key organisations and influencers, download our Alzheimer’s Influencer Network Analysis report.

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