Who Has Actually Played BI's SYRUM Game? The Silence is Deafening!

During today's #hcsmeu chat session (see archive here) I asked "Truthfully - has any of my EU colleagues actually played SYRUM?"

There's been a lot of hype about Syrum previous to its launch by Boehringer Ingelheim (BI) in the EU (see here), but I've heard nothing post launch from anyone who has actually spent time playing the "game" (I'm told that it's not a form of "gamification").

"Who's the EU 'pharmaguy' who will take on this task and report back?", I asked.

Turns out that one person (Maria Öst, Sweden, aka @mariaatomaca) admitted she signed on to a beta account, but she didn't actually play the game. By signing on, Maria gave Syrum (and BI) permission to "post on [her] behalf" and "read [her] checkins" even if she does not play the game (see here).

According to @fision (Kai Gait, UK) Syrum opens "lots of potential opportunity in the future by accessing the interest graph of players" -- even if they don't actually play the game ("If a user doesn’t ‘disconnect’ the game, they [BI] still have access to data in theory," said @fision).

Felix Jackson (@felixjackson, UK, founder of medDigital) actually has played the game and said "I ... enjoyed it! I liked the way it showed me drug development." I thank Felix for taking the time to give me a live tour of the Syrum via Skype during which I saw a few peculiar things such as a masked avatar that looked like an Al Qaeda terrorist! I guess it was supposed to be a surgical mask. I've worked in a lab and I never saw anyone wear a mask. Maybe drug development labs are different.

One of the features of the game is that you can see friends on Facebook who have also signed on to play the game. You can "recruit" these friends to be members of your drug development team or you can collaborate with them. Unfortunately, none of Felix's FB friends -- including BI's John Pugh -- were able to collaborate with Felix because they didn't have any molecules under development (ie, they currently are not playing the game).

Meanwhile, Helen Harrison (@harrassedmom) alerted me to this "walk through" on YouTube:



By the time you read this, one or two other people I know on Twitter may tell me that they also have played Syrum. These people, however, are mostly like me -- not representative of Syrum's target audience, which is the general public. We won't know very much about how many of those people have signed on to play, how long they have played, etc., unless BI shares that information with us. That make take another 3 years -- I'll wait :-)

"Gamification" (eg, Syrum) is Just Another Way for Pharma to Mine Our Personal Data and Wisdom

Everyone I know in Pharma Twitterdom is enamored by the launch of Boehringer Ingelheim's SYRUM FaceBook game, which is available ONLY to European FB users. BI says the game is "educational" for physicians and the public:

"The research driven pharmaceutical industry is immersed in education - whether aimed at medical or pharmaceutical professionals or providing information directly to the public," says John Pugh, Director of Digital at Boehringer Ingelheim. "Gaming is an experimental way for Boehringer Ingelheim to do this. The challenge is to do this in a truly engaging, educational and entertaining way that immerses the player."

Syrum allows players to create and run their own pharmaceutical company, using a virtual laboratory to discover and develop imaginary medicines to improve the health of the world.

But "educating" the public may be a minor goal of Syrum. It surely is not something that can be measured as a key performance indicator (KPI) to justify the years and money invested in developing this "game."

So how does BI justify investing all this time and money to develop a game if it cannot measure how better educated the public is about drug development?

I believe that Syrum is designed to educate BI and NOT to educate us. It's much easier for BI to measure how much better educated IT has become due to Syrum than to measure how much better I have become from playing the game.

What do I mean by BI being "educated" due to Syrum?

Firstly, BI requires everyone who plays the game to open up their FB information for access by the company.

I was able to access the game while in Spain recently. Before I could play the game, however, I had to agree to allow BI to gain access to practically everything I do on Facebook (see screen shot below).

This stopped me dead in my tracks. Perhaps this is a normal permission request for all FB apps, but I was loathe to "allow" this kind of access for a pharma company app. It seems that BI wants to do some market research about the people who opt in to play Syrum. This kind of data could be a valuable KPI for Syrum.

I must admit that I am mystified by FB. For example, what does "Post on my behalf" mean? Whatever it is, it doesn't sound good. "Reading my checkins" also does not sit well with me. 

I'm not the only one who doesn't use apps due to privacy concerns. More than half of mobile application users have uninstalled or avoided certain apps due to concerns about the way personal information is shared or collected by the app, according to a nationally representative telephone survey conducted by the Pew Research Center’s Internet & American Life Project (see "Privacy and Data Management on Mobile Devices"). What applies to mobile apps also applies to FB apps - maybe even more so given FB's bad rep viz-a-viz privacy (see for example: "How Facebook Plans On Using Your Prescription Drug Purchase History, And How To Stop Them").

Another way that Syrum can educate BI rather than educating us is by allowing BI to cash in on "crowdsourcing" WITHOUT financially compensating the crowd!

BI says it has steered clear of therapeutic areas it is involved with as potential areas of interest in the Syrum game, although it has left the door open to change that. Perhaps BI's objective is to test the social aspects of the game and access the "wisdom of the crowd" to help it develop new drugs.

The pharma industry seems ready -- even desperate -- for help from the crowd to develop new drugs. Ten top U.S. and European drugmakers -- including BI -- started a nonprofit organization, called TransCelerate BioPharma, to collaborate on the problem of developing new drugs (see here).

Meanahile, Lilly's Clinical Open Innovation believes that crowdsouring can help fix drug development, which it claims is "broken." Lilly believes that "Open Innovation models – focused on clinical drug development – can result in transformational gains in value-to-patients and efficiency. We also believe that open data, linked, crowdsourced, consumed and curated by experts outside (as well as inside) the walls of pharma will bring innovative insights and wisdom. And that open communities will set and meet objectives to reduce costs and improve outcomes" (see "OMG, LCOI! Open Source Pharma: Creative Commons Coming To Pharma").

Perhaps Syrum is a precursor to that kind of "collaboration" - what I call "semi-open access" drug research. This could be of tremendous educational as well as FINANCIAL benefit to BI. And all it costs is the price of developing a game with very little payback to the crowd other than "fun" and "engagement!" P.S. On KPI I forget to mention was ROI on PR. BI recently retweeted this tweet from the PM Society: "RT @PMSociety: How is PR ROI for Syrum being measured? 50 pieces of press just from launch party. Value in positioning of @Boehringer". 50 easy "pieces of press" -- some kind of "POP"!

Mirror Mirror on the Wall, Who's the Most Innovative of Them All? Pharma, Social Media Wise, That Is.

The pharmaceutical industry has consistently promoted itself as an "innovative industry" by which it means it discovers new, innovative drugs through research. No one ever claimed the drug industry was very innovative in marketing in general or in its use of social media. However, consultant and strategist Andrew Spong, just came close to doing that in a post titled "Innovation: the name of the game for Boehringer."

"By dint of the sheer weight of evidence that has accrued over the past three years alone," says Spong, "Boehringer Ingelheim may reasonably be identified as the pharma company that sets the pace for the industry in digital environments...Boehringer merits recognition as the digital leader in the pharma industry not because of what it has achieved, but because of what its activities say about the cultural evolution that has taken place within the company."

Spong and many others are lauding Boehringer's Facebook Syrum game based solely on hearsay evidence -- Syrum won't be officially released until September 13, 2012 (see "BI to Launch Beta Version of its Syrum FaceBook Game on September 13, 2012"). The "weight of evidence" comes almost exclusively from tweets, blog posts, and press releases written by BI PR people and John Pugh, BI's Director of Digital.

I doubt if Spong or any other laudatory commentator has actually played the game. If they did, I am sure they would have mentioned it and actually written something new about it.

I am not sure what kind of "cultural evolution" is going in within BI, but I know that the company has exhibited some PR and marketing behavior that regulatory agencies have frowned upon (see, for example, "BI Masters the Art of WOM through Its 'Parrots,' er, Spokespersons"). This is not indicative of a cultural evolution in pharmaland.

Spong also mentions BI's "experiments with outré humour" and links to this "Famously Unpronounceable" YouTube video as an example.



Spong neglected to mention that the above video is NOT found on the official BI YouTube site, which no longer hosts the video in question. BI yanked it because of negative comments from industry commentators such as myself who are “slow to acknowledge its transformation” (see “BI’s Famously Unpronounceable Video Lives On!”).

With regard to the Syrum game, BI has been milking that for almost a year making it one of the more spectacular examples of “vaporware” I have ever seen (again not culturally evolved). BI, IMHO, would have been much better off sticking with real world exhibits (see “'A Drug is Developed:' Easier than Launching an Educational Facebook Game about Drug Development?").

Before you label me solely as a negative commentator, I offer you this: “Boehringer Ingelheim Shows How to Support Patients via Twitter and Beyond”.

Just like every pharma company, BI has its social media triumphs and failures – or “Trials & Tribulations” as I like to call them. See my latest Slideshare presentation on that here.

FDA Caught Speeding. Puts Public Safety at Risk.

"An FDA effort to speed approval of new medicines allowed drugs for stroke prevention, cancer and multiple sclerosis onto the market without proper safety analysis, according to two drug-safety experts," reports the Wall Street Journal in a review (here) of a "viewpoint" recently published in JAMA.

Peter Pitts of Drug Wonks says: "As usual, Janet Woodcock [Director of the Center for Drug Evaluation and Research at FDA] places the matter in the appropriate perspective. 'I'd like to stress that where there are unmet medical needs, the public has told us they are willing to accept greater risks,' Dr. Woodcock said. "The cancer community in particular says we haven't used accelerated approvals enough.'" Pitts adds this zinger:

"Here’s the truth -- there is no such thing as a 'safe' drug. It's the patient who must understand the risks required to achieve the benefit. That’s why the patient voice must be heard during all phases of the regulatory review process."

Unfortunately, I don't think Pitts actually read the piece in JAMA. The drug safety expert authors of that piece (Thomas J. Moore and Curt D. Furberg) did not claim that drugs approved by the FDA should be "safe." They made the argument that accelerated approval by FDA of several powerful drugs with UNKNOWN safety issues were no better at improving outcomes than drugs currently on the market whose safety issues are well-known.

"Although enabling new drugs with a favorable benefit-to-harm balance to become available to patients more rapidly is a laudable goal," said Moore and Furberg, "the underlying question is what public health risks are taken when drugs are approved for widespread use while important safety questions remain unanswered."

The authors cite several specific drugs that were fast-tracked for approval without adequate safety information available. I'd like to focus on one: Dabigatran for prevention of stroke. Dabigatran is marketed as Pradaxa by Boehringer Ingelheim (BI).

According to Moore and Furberg, Pradaxa benefited from "3 different FDA policies promoting innovation. This drug received both Fast Track and Priority Reviews and was studied in a single large phase 3 trial rather than in at least 2 pivotal trials, as normally required...Within less than a year of approval, 1 survey showed that dabigatran accounted for more serious adverse drug events reported to the FDA during the second quarter of 2011 than any other regularly monitored drug. Risk of hemorrhage was prominent in older patients (median age, 80 years), a subgroup for whom declining kidney function or other factors may have increased bleeding risk. Both a manufacturer package insert revision and the European Medicines Agency have called for closer monitoring of kidney function, a needed step because even moderate kidney impairment increases dabigatran levels more than 2-fold. In addition, unlike warfarin, no antidote is available for use in bleeding emergencies related to dabigatran. Evidence was beginning to emerge that dabigatran-related bleeding— whether from trauma or as an adverse effect—may be more difficult to treat than warfarin-related bleeding."

Couple this safety issue with the promotion of Pradaxa in the media as a "super pill" and a "revolutionary drug" (see "Bad Journalism or Bad Pharma?") and you end up with a real public safety issue that patients should be concerned about. BI itself stoked this Pradaxa-mania (read, for example, "BI Masters the Art of WOM through Its 'Parrots,' er, Spokespersons" and "Full BOEHR(inger) Social Media Reporting of RELY Trial Results").

Sadly, Woodcock may have heard from "patient advocates" paid by pharma companies to testify before the FDA, but who advocates for the patients harmed by drugs like Pradaxa? Their stories are locked in the FDA's adverse event database, which is not generally cited during drug approval Hearings at the FDA.

Not to mention the impact of DTC advertising on the public's willingness to accept greater risk: