Building a Diverse Content Strategy That Works | Marketing Vitals

Speaker A: M. Foreign.

Speaker B: You are listening to the global network of podcasters dedicated to the pharmacy profession. Welcome to the Pharmacy Podcast Network.

Speaker A: Has your business's marketing flatlined? Find your pulse again with Marketing Vitals, bringing you innovative and turnkey healthcare marketing solutions from industry experts who have developed a knack for solving problems. A co hosted publication from GRX Marketing and Finch Marketing, sister companies that are passionate and knowledgeable about healthcare marketing.

Speaker B: Hey, everyone. Welcome to another episode of Marketing Vitals podcast. Uh, I'm Nicole McClure, President of GRX and Finch Marketing, and so excited to be here today and talk to our guest. Uh, love to introduce, uh, Darshan Kulkani. He is a pharmacist, a regulatory and compliance attorney, a fellow podcaster. Um, I think I got everything. Darshan, welcome to the show. Did I miss something?

Speaker A: A. Ah, few things, but I'm sure they'll be okay. Um, I write various books. If you see the books behind me, I've written anywhere from one through six chapters in every single one of them. I teach, uh, at Drexel Law. I teach pharmaceutical marketing. Um, I also, uh, I speak all over the world on marketing and compliance and, uh, pharmacy, uh, related issues, if you will. I was. I just attended a conference, uh, last week in New York where I was presenting on it. I keynote various events. And, um, I'm sure there's more, but I forgot. Ready? Oh, I'm on board. I'm a board chair for multiple organizations.

Speaker B: Yeah, perfect. Well, so all of that experience definitely lends, um, you to be a great guest on our show today. So I wanted to talk to you about just marketing for pharmacies and compliance. I, um, feel like over the last couple years, from our perspective of working with a lot of independents, it's become much more complicated and challenging for them. Um, can you kind of talk about what you've seen on your side, um, as far as how it's become more challenging?

Speaker A: Oh, where do we start, Nicole? This.

Speaker B: This is.

Speaker A: This is sort of the multibillion dollar question right now, Right? Pharmacies don't quite appreciate how big an issue it is. Um, we can talk about a variety of different things at different levels. But, um, let's start with the first element, which is, um, marketing that's connected to, say, equipment manufacturers who are selling the equipment through pharmacies. A lot of those guys got in trouble because they were falsely billing Medicare and Medicaid. And essentially their marketing, the way they organized their marketing groups was set up in a way that these patients were receiving, uh, like, um, orthopedic stuff or um, devices that they really didn't need. It was more of a churning game to see if they can build Medicare and Medicaid for as much as they could. And it's one thing to do that if you're trying to help patients. It's another thing if it's basically just a route to bill Medicare and Medicaid. So um, if it's unnecessary you land up paying a bunch of money for it. Um, so if your pharmacy was involved in that process you can get people into trouble. The second element that I've seen is sort of pharmacists who are involved in clinical research and they were marketing um, their services in a way that um, it was less about the research and um, more about the sales process and dispensing products. Um, and that came in two different forms. We'll talk about one form now and we'll talk about another form later. But that first version landed up becoming um, something that's targeted. People have gone to jail over it. Um, you had pharmacy technicians and pharmacists go to jail over that. So that's number two. Then you had number three which was compounding pharmacies. Um, and that's a whole other beast. Um, and the reason you get mixed in this area is because compounding pharmacies are often doing a cash based system. Um, so the traditional uh, Medicare, Medicaid got defrauded. Doesn't work in that scenario. You may have some state laws that kick in, but not at the federal level. However patients are um, challenged uh, because there are other federal rules that kick in, for example on transparency on disclosure. So the FTC has something to say about it. The FDA could take the position they have that it is false and misleading. Um, the state boards have pulled it, have called it out multiple different times as um, the advertising tends to be uh, non compliant. Um, you also have uh, um, these pharmacies who would sort of say you can have any compounded medication you want as long as it's this one. So um, we used to see that a long time ago in the DEA world where pharmacists would compound specific medications and have pre printed um, prescription pads and the doctor would just check off the one they wanted. And that was very common and that was seen to be problematic because you're not saying that the doctor can customize anything, you're basically manufacturing and the doctor's choosing that medication. Well we're doing the exact same thing in this um, in the GLP one world. Um, and that's becoming Problematic because you're talking about drugs that are either, uh, unapproved, you're talking about drugs that are, um, approved. But, um, this is not on a shortage list anymore. So it's not, it's not something you're going through a 503B for, or it's a 503A and you're adding something to, quote, unquote, customize it, but it's a pre printed sheet and you're going to add like, I don't know, vitamin B12 in it. And it's practically not going to have any, any commercial effect, uh, any actual appreciable clinical effect. And that's come back to bite companies as well. Um, and then you have, uh, this other variety of pharmacists who are basically going out there and um, making medications. So, uh, tablets. And they're pre. They're making tablets of semaglutide or, uh, tiraspatide. I don't think I've seen the Tyra Zepatide version. I can't remember, to be honest, um, when they don't have any of the appropriate, um, filings for either a 505, um, or B2 with the FDA. So again, you're asking for all kinds of regulatory problems and consumer, uh, protection problems, um, from lawyers and from the regulatory agencies and then the state boards as well as. So and these are just some of the examples of.

Speaker B: Right, right.

Speaker A: Yeah.

Speaker B: Do you see then? Um, because I know with GLP1s, you know, at first there was, yeah, some litigation or just threats, um, against pharmacies that were compounding. And um, now that it's, you know, not as popular as far as, um, it is more commercially available, but pharmacies are still doing it. Do you still see that action that the fda, other government groups are coming after pharmacies for those that are continuing to compound it, then.

Speaker A: Yes. So we're seeing that right now. We're seeing that with, uh, large companies as well, because the government is looking for a scapegoat, someone that they are going to go after and make an example out of. Um, I can't remember whether it was Roe or hims in my memory. I'm sure we could double check that.

Speaker B: I think it was hims.

Speaker A: Yeah, I think it was hims as well. Um, where they are being referred to the Department of Justice for the claims that they were making. Um, but again we have to double check which company it was. And that's an example of, um, the government taking it very, very seriously. Um, but as you pointed out, this isn't the end. Um, I think pharmacies have been fighting back and pharmacies are saying why can't we make it? And the answer is very simple because you didn't go through the approval process. If you want to go through the approval process, go ahead and sell it. Um, but that's a different beast. I think that the next step is going to be peptides and I think that's going to raise all kinds of new havoc that we simply don't know how to deal with. I was again at that conference last week and people are still trying to figure out what to do with peptides because they're known to be unapproved products. So how do you make a compounded version of something whose API itself was never approved? Um, and that's going to be problematic going forward. So we had some ideas and we'll see if anything lands out of them, but we'll see.

Speaker B: Yeah. And the independent pharmacies that we work with, I mean especially on GLP1's compounding marketing, I mean the biggest issue we see is they want to try to make false claims. And I think there's this bit of conception that um, well, we're a small pharmacy, like you know, FDA is not going to find out or we're not going to get in trouble, that sort of thing. But um, I think it's just a slippery slope that they're trying to go down. Um, you know, as this just continues to be an issue,

Speaker A: so few different questions, concerns with this. So number one, in the end what you're really going is we have a highway with a bunch of cars speeding on it. How many people can the cop stop?

Speaker B: Mhm.

Speaker A: I don't know if I really want to find. Yeah, um, and yes, theoretically the cop could only stop one company at a time. Except the FDA is not as understaffed as you think. Uh, the fda, last time I checked and we're going back several years at this point the FDA had like 77,000 employees out of that if I remember correctly. A thousand are in um, advertising and promotion, just cdr. So that's opdp. That's not counting the Office of Unapproved Drugs, that's not counting Applebee, that's not counting cdrh. But it's not an insignificant number. You then add on the um, you add on the ftc, you add on the State Attorney Generals, you add on uh, uh, uh, State Board of Pharmacy, you add on lawyers who are now going, you know what, maybe a small pharmacy, someone I could ignore. But I can go after hims, I can go after roots, more of those guys. And once you do the hims and the rows and you succeed and you've got these multi billion dollar companies, you're going to go after smaller pharmacies as well.

Speaker B: Yeah. You've set a precedent.

Speaker A: So do you really want to be in a position where you're just a target? You know, you're a target and you're going to be targeted and you're just waiting for that right moment? Because I would also argue that I don't know if your insurance will cover you. So you've spent a lot of time as a pharmacy owner, building your business, protecting your children, growing your pharmacy, and you're risking it now for what? For an extra, I don't know, $10,000 this, this year, $100,000 this year, I don't know. But the point being, I don't know if it's worth it. I don't. For me personally, it wasn't. I wouldn't risk my pharmacy license for that.

Speaker B: Right, right. What are you seeing as far as um, like AI and compliance with pharmacy marketing? So, you know, we, uh, of course have a lot of clients that are like, we'll send us something and clearly you can tell it's been run through AI. And I think AI has its purpose, but I have found in healthcare it's inaccurate a lot. And so, but it's just like we're taking this gold standard around it that, well, you know, AI told me, so it has to be 100% true. But from a compliance standpoint, I guess, kind of. What are you seeing on that side?

Speaker A: So a couple of different things. So I think the first thing is, um, there was actually a manufacturer very recently who used an AI as their compliance tool chest. And, um, the FDA came in and they were like, what are you guys doing? And why don't you have this documentation filled out? And the guy literally said, because I told me to. And why didn't you fill out this one? Because I told me to. And the FDA went, no, that's not how any of this works. You don't get to blame AI for this. You need to have systems in place. Those systems need to work. AI can help you, but it does not eliminate the need for the systems. On top of that, the doj, the Department of Justice, has already come out and said that in the end, fraud using AI is still fraud.

Speaker B: Right.

Speaker A: So, um, and then there's the actual. And um, you say this as a marketer, I can only imagine what you see, that's being generated, ah, by AI Because I can tell you the vast majority of stuff that I see. Number one, it's incredibly clocky as AI.

Speaker B: Right.

Speaker A: And you're just going, no. I mean, maybe about five years ago this was glossy and cool, but now it just looks like something someone's just going to scroll over. Because I know if I see something from AI, I don't want to read it anymore. Um, if I even believe or think, and I could be wrong, that it was written by AI, I don't want to read it anymore. I sometimes have to use AI as an initial generation point and then clean it up and then honestly, m even make some mistakes in there. I may know that it's a mistake. And when I say mistake in terms of formatting, um, not in terms of content, um, but the idea being that people want to read something human. And that's just purely from a marketing standpoint, from a compliance standpoint, you're still responsible for what it says, the fines and penalties. I have a friend, um, and you probably know him. Um, he's working at a pharma company. And, uh, he informed me that, um, he's surprised how long approval takes in a pharma company compared to a pharmacy. He's like, oh, my God, it takes three weeks to get a document approved just so I can share it. I don't understand why. And I had to explain the concept of MLR to him, of medical, legal, regulatory review. Because if you're going to put something out and people are going to believe you, the fines and penalties that go along with it are significantly more. If you're a pharmacy and you were going, no one's going to notice that anymore. Well, guess what, you're operating in one of the most profitable systems there is. M. And yeah, it's very much an area that people care about and you might get sued for that. So compliance is very much an issue. I see mistakes. I can't think of an AI document or write up I've seen that has had no mistakes. And this is going back now four or five years. Like you always. It either has something off about the tone, the information itself. Like, it's like, understood the information, but not quite. And that was my experience with it. Like, you got to like, you'd get a solid C minus, but I can get you to a C yet.

Speaker B: Right. Well. And I think the irony with, you know, independence especially is you're trying to come across as like, this personable.

Speaker A: Yeah.

Speaker B: You know, in the community that sort of Thing. And then the content that you're putting out on your website, social media, is that messaging is not matching when you're using AI so you're just losing people, like you said, just scrolling past.

Speaker A: Uh, I'll give you, uh, I've never seen this version, but this is an example of the type of mistakes you'd see. Come to your local pharmacy at the corner of Erie and Fenton, and we'll give you blah, blah, blah. Except there's no Erie and Fenton in your neighborhood. I would totally be gaslit going, I don't know where Erie and Fenton is. Maybe I just don't live here. Or maybe it's an area I haven't been to. Except AI generated that. And, um, anyone who's not looking is going to. That, uh, seems okay, right? But it feels like AI seems to gaslight you more than it should. But that's just my take.

Speaker B: Yeah. It also just seems like an easy avenue for kind of back to these lawsuits, you know, for lawyers just to start perusing websites for, you know, copyrighted photos that people are using. That AI was like, use this one, it's okay. Or, you know, pulling content from websites without sourcing. It, um, just seems like a dangerous road to go down for any business pharmacies, you know, especially.

Speaker A: I think 100 agree with you. I think the, the way it works and most people haven't read the terms of service. I actually tried to. This is going back probably about three years. I haven't re reviewed. I should probably do that at some point. But, um, I tried to look at what each tool gives you. Uh, and I'm going to get the order of these mixed up and who goes with what. I might get mixed up, but the general thrust remains the same, which is, I want to say OpenAI says that you own what I own. So whatever. If you put in a prompt, you own what I own. So this way you can have control of that. Except what they don't tell you is that OpenAI got sued because they don't own anything.

Speaker B: Right.

Speaker A: They stole it.

Speaker B: Yeah.

Speaker A: Okay, then I want to say anthropic says you own the right to the prompts. Well, no shit, I own the right to the prompts. I'm the one who put it in. I want the everything else that I

Speaker B: hope I own those at least.

Speaker A: And then there's the third one. Uh, and this is again going back a few years, but Google Gemini, I think, said, um, it was just silent on it. It didn't say who owned anything. So my point is these Companies are being staffed by very, very expensive, very, very good lawyers. They're not taking the liability. So guess who is? You are. So keep that in mind as you continue as well.

Speaker B: I'm just going to cut that little snippet and just have it as a bite for when we get stuff from clients or like. No, this is why we say no.

Speaker A: It's. Yeah.

Speaker B: Um, any other kind of common mistakes that you, you know, when working with pharmacies, you see that they're making for us. It's like just, you know, not adding the proper disclaimers, trying to make claims that aren't accurate. Um, but I guess anything else that kind of sticks out to you that people should be aware of, that they should probably already be aware of, but maybe aren't paying attention to?

Speaker A: Um, I can think of several. Um, one is a disclaimer doesn't let you. It's not a get out of jail free card.

Speaker B: Right.

Speaker A: So if you are a pharmacy that's using disclaimers, you'll see this often. And I've seen that, um, you make this fantastic claim. This drug is. I'm making this up. Or maybe I'm not. You might see compounded medications that are, um, that have these fantastic claims along with it. It's completely unapproved. Um, and you think you're going to get away with it because why not? Except that might come back to bite you. And you can't just go, oh, this has not been approved by the fda. Well, no shit it has. Excuse my language, but no crap, it's not been approved by the fda. Um, so number one, keep track of those off label may be appropriate in very specific situations. This is not that situation. Um, talk to your lawyer. Fine. I'm not your lawyer. This is not legal advice. Keep track of what applies. Another one that pops in mind is privacy. Um, um, in the context of, uh, privacy there is. How are you coming up with the data? For example, are you putting the data into AI? I see that happen every so often as well. That's a violation of multiple, multiple laws. Um, then there is the actual, um, following can spam laws, TCPA laws. If you're texting people, uh, following, um, the do not call list track of that. TCPA is probably the most litigated lawsuits in the world right now.

Speaker B: So with texting and stuff.

Speaker A: Yeah, with texting and stuff.

Speaker B: Yeah.

Speaker A: And people don't know that they're supposed to register, get it all done. And um, it's hugely problematic. So I think there are loads of areas that pharmacists need to comply with. And everyone seems to operate with the. I'm just going to be the. I'm going to be the Ford Fiesta driving on the highway that I know there's a Mercedes driving on as well. So I hope they catch the Mercedes and not the Ford Fiesta. But you know what? Every so often, the Mercedes is still far behind. They can still catch the Ford Fiesta as well. God, I hope there's a version called a Ford Fiesta. Yeah,

Speaker B: it's a little car. Yeah, yeah. Um, no, those are all great points. And I mean something. So with websites and social media specifically, like a recent development of, um, ADA changes and making sure, you know, your stuff is compliant, and we're still seeing some of that where, you know, pharmacies don't want to pay to add the widget to the website. And kind of going back to what you were saying with GLP1s, it's like, what's your comfort level? You know, this little widget is like 50 bucks a month. If you happen to get sued, it's going to be, you know, thousands of dollars that you're going to have to potentially pay out. So, um, sometimes I think it's hard for them to just want to take that step. Either they're paying for it or making sure everything is on the up and up.

Speaker A: I think another area that I think both of us would probably end up advising a lot of these clients about is make sure that your insurance has appropriate coverage for this stuff. You might find out that your insurance doesn't cover you or that the limits are very, very low. And go talk to your insurance provider, uh, and make sure they're covering you properly. And don't let them sell you the cheapest thing in the world, because the cheapest thing doesn't protect you. Look for the one that's right for you. So I have nothing to do with insurance. I'm happy to refer you if you want, but it has nothing to do with me, but I tell this to all my clients. Whether it's pharma, pharmaceutical companies, medical device companies, or pharmacies, the goal of insurance is always to protect you. And if you don't have the right coverage, you're not being covered. And that's problematic.

Speaker B: Yeah, excellent point. Well, anything else to share with our listeners before we, uh, wrap it up?

Speaker A: No, I think we covered a lot of ground. If people like what we're saying, they can come back, talk to me, talk to you. Um, and I'm sure they'll get some more information and, uh, if you need to reach me, you can reach me at, uh, Darshan D A R S h a n@kulkarnilawfirm.com. that's K U L K A R N I Law firm dot com. Um, or you can reach Nicole. And, you know, she's very, very approachable and obviously very, very smart. So you should, you should reach out to her as well.

Speaker B: Well, thank you for being a guest on the show. It was great to chat with you.

Speaker A: Thank you again, Nicole. I appreciate it.

Speaker B: And if you need to reach me, you can find me at grxmarketing.com or finchmarketingsolutions.com thanks for joining us for another episode of Marketing Vitals Podcast, part of the Pharmacy Podcast Network.