How much trust would you place in

In April last year, when eminent historian Orlando Figes admitted to writing laudatory Amazon reviews of his own book while denigrating those of his rivals, I was shocked.

Not shocked because I couldn’t believe that anyone would do such a thing, but because I couldn’t believe anyone that clever could be so stupid.

Why? Because I too have logged onto Amazon with malice on my mind.

In November last year I set out to write a poor review of a newly published book by a university contemporary. It’s not that I thought the book was poor; I simply still carried a grudge from an argument in a bar sometime in the early ‘90s.

What I didn’t know then, and what astounded me about the stupidity of Orlando Figes, was that Amazon has one of the best barriers to anonymous commenting you’ll ever come across.

Not only do you need to register an email address before writing a review, you also need to have purchased from the site, which means you’ll need a credit card and an address associated with it.

Of course, this doesn’t mean that it’s impossible to create an untraceable review (either good or bad), but it does mean that this takes some planning. Certainly it takes more than the five minutes required to set up an anonymous email address.

The process of attempting to ensure personal accountability was on my mind this weekend when I read that TripAdvisor was facing a potential class action from hotel and B&B owners who believe that negative reviews have impacted their business.

TripAdvisor, for those of you who’ve never posted a review, simply requires that you have an account in order to post – and this just requires an email address.

And this got me thinking about reviews of medicines.

Earlier I referred to some data from Manhattan Research on the sources that patients turn to at the different stages of the condition lifecycle. One of these sources is “ratings and review” sites, used when researching a prescription by 9% of European patients 7% of Americans.

The example I’ve always used to demonstrate this trend is, operated as a “virtual clinical research community” by pharma services provider Quintiles.

It’s a great service, but iGuard goes no further than TripAdvisor – all it takes to game the service is five minutes to set up a fake email address. But iGuard or the likes of aren’t to medication what Amazon is to books, or TripAdvisor is to hotels.

WebMD, on the other hand is; and WebMD is growing its user generated content base rapidly.

Back in March, when Orlando Figes was anonymously slagging off his rivals’ work, WebMD was busy launching its health exchange communities. And lately, prominent in the site’s navigation, where once it just read “Find a Drug”, you’ll also find the call to action: “Find or review a Drug.”

And this is a reviewing process that doesn’t even want a screen-name, let alone an email address.

It seems WebMD wants to make things as easy as possible for its users to create content (perhaps even with a view to a “” positioning in the future), but should disgruntled patient groups want to flood the site with negative, exaggerated or entirely fictitious feedback then this process couldn’t be more painless.

Now, in terms of the implications for pharma, I don’t think we’ll be seeing TripAdvisor-style class action suits against drug review sites in the near future, but I do feel that the growth in this type of content should inform how the industry addresses the wider topic of social media.

For all the attention focused on what pharma should do “in” or “with” social media, there should be a greater focus on what pharma should do “about” social media to help its customers.

Rather than focusing on guidelines for internal staff to engage in online conversations, perhaps some of the industry’s patient-focused online budgets could be better put towards educational grants for developing guidelines that communicate what actually constitutes ‘trustworthy’ P2P drug information online? (There is of course a world of difference between the detail a patient will find in a community such as and that which they’ll garner from casual anonymous reviews).

Or perhaps the industry could work to develop an agreed process for submitting reviews which could prevent abuse and contribute to improved product safety measures?

In Europe, such standards could help fill the gap prior to the EU Pharmacovigilance Directive having a material impact,  and in the rest of the world they might help make clear to patients that not only are all user reviews not created equal, some might not even be created by real users at all.

(Luckily, btw, I didn’t need to write a malicious review of my resented college contemporary’s magnum opus. The real critics did it for me. If only Orlando Figes had been so lucky…)

Please note, the domain is owned by Interzoic Media. The use of this name in the headline of this post is not intended to reflect in any way on Interzoic’s business or any intended future use for this domain name – it’s simply there because I thought you’d click on it. And you did.

Duncan Arbour
Senior Consultant 
Blue Latitude

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