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P T. 2010 July; 35(7): 373, 416.
PMCID: PMC2912007

Pharma Twitters Cautiously Before Advertising Guidelines Are Released

Later this year, the FDA is expected to release draft regulations regarding the pharmaceutical industry’s use of social media to advertise. These much-anticipated guidelines, developed from public hearings, could have a huge impact on how prescription drug products are promoted online and how health advice and information are communicated to consumers through social networking sites.

Without formal FDA guidance, the pharmaceutical industry has been slow to warm to social networking. This has been the case especially with Twitter. But at some point recently, pharma decided that it wouldn’t stand on the sidelines any longer—it took the plunge into the twittersphere. Yes, despite dismissive predictions that pharma would stay away in droves from Twitter owing to fear of litigation or regulatory scrutiny, it has increasingly been joining the conversation.

At this time last year, only a handful of pharma companies, including AstraZeneca, Novartis, and Boehringer Ingelheim, had Twitter accounts.1 Today, all but a few of these firms are actively twittering, and many have managed to boost the number of their followers (those who choose to follow the company’s tweets) considerably.

Of course, creating and setting up a Twitter account is just the first step. Maintaining the site, providing valuable information, and devising new ways to engage the audience is the real challenge in achieving success with Twitter. A closer look at the actual Twitter activity of individual pharma companies shows a great variation in the level and depth of participation—from not twittering at all (or infrequently), to merely distributing truncated versions of their existing press releases, to engaging in daily interactive communications.

Twitter started out as a way to keep friends, family members, and coworkers up to date by answering the question, “What are you doing?” in 140 characters or less. Within a short time, however, the site has evolved into a worldwide cultural phenomenon. Today it is perhaps one of the most useful and powerful marketing and communication tools for businesses.

The pharmaceutical industry no doubt recognized Twitter’s potential and realized that it had to get on board if it didn’t want to become out of touch with customers and their needs or appear unwilling to be transparent and accessible. In addition, as many pharmaceutical companies are learning, Twitter is not only an effective way for companies to promote their brands; it is also a valuable opportunity to provide accurate information about their products to the public. Consumers have online access to a vast resource of health care information, but much of what they are finding is incorrect or out of date.

According to Katie Lubenow, Senior Manager of Corporate Communications for AstraZeneca:

“Health care companies have an obligation to responsibly engage in social media to help patients, caregivers, and prescribers make informed decisions about our medicines. It’s important for us because in our absence, consumers could turn to information sources that are not regulated and not always well informed.”

As one of the first major pharmaceutical companies to use Twitter, AstraZeneca has also been one of the most aggressive in pursuing followers. The company’s corporate account (@Astra Zeneca US) currently has more than 3,000 followers, up from just over 1,000 a year ago. According to the company, they range from patients, caregivers, health care providers, and patient advocacy organizations to employees, members of the media, shareholders, and others in the pharma industry. The site issues regular tweets of company news, perspectives on health issues, and links to information on Astra-Zeneca’s patient-assistance programs and other patient-support initiatives.

Johnson & Johnson (@JNJCOMM) and Pfizer (@Pfizer_ news) have also been investing a lot of effort and energy in twittering. What makes their Twitter profiles different from those of other pharma companies is that one identified person from the company serves as the voice of the account, giving the tweets a more personal, approachable, and authentic feel. The tweets are also more interactive than other pharma sites, sometimes responding publicly to followers’ tweets.

Although the pharmaceutical industry has definitely become more Twitter-savvy during this past year, companies have still not found a way to use their sites to engage in direct dialogue with customers. This is likely a result of a number of regulatory concerns, including what to do about adverse events that are reported through Twitter.

When the FDA held its public hearings on social media in November 2009, reporting adverse events was one of five specific areas addressed. During the two-day brainstorming session, the agency also sought input on the extent to which manufacturers are accountable for product information online; how fair and balanced information should be presented, given space limitations; the parameters for correcting in-accurate information on sites controlled by third parties; and the appropriate use of links. Pharmaceutical companies, along with consumers, caregivers, health care professionals, patient groups, Internet vendors, and advertising agencies, were invited to submit their opinions and recommendations on these five areas. Their submissions are available at

Twitter may be one of the social media tools especially targeted by the new FDA guidelines, given the challenge its 140-character-limit poses for pharma companies in communicating sensitive information on their products, such as drug risks. In fact, in an analysis from earlier this year, the communications company WCG found that compared with online user forms and blogs, tweets mentioning a specific drug, on average, tended to be more focused on benefits and less on risks.2

According to a few companies, when customers do reach out through Twitter about a specific product or problem, they are referred to individuals within the company already handling those issues. For instance, AstraZeneca uses a special Twitter account, @AZHelps, to respond to customers who twitter about its product Nexium (esomeprazole magnesium):

“Saw your tweet about access to Nexium®. AstraZeneca may be able to help. Call us @ 800-236-9933.”

But until the FDA implements its guidelines for social media use, most pharma companies are playing it safe and twittering primarily about breaking health care news and company updates, avoiding mention of specific products and other potential trouble zones.

“Online communication is still a new frontier for pharmaceutical companies,” says Ms. Lubenow of AstraZeneca.

“We continue to learn how important it will be for guidelines to be created to ensure we are able to appropriately communicate about our medicines.”


1. Reisman M. Will pharma twitter? P&T. 2009;34(8):421. [PMC free article] [PubMed]
2. WCG testimony to the FDA on social media. Submitted February 28, 2010. Accessed June 17, 2010. Available at:

Articles from Pharmacy and Therapeutics are provided here courtesy of MediMedia, USA