The Fake Patient (fPatient) & Patient Engagement on Drug Companies’ Sites

Patient engagement: ePatients, meet fPatients

I wrote about ePatients on the blog a couple of months ago. The e-patient is supposed to be a patient who is engaged in electronic media (the internet) to learn about his/her medical condition. Perhaps she is doing research or reading about the experiences of other patients. Many of you might be considered ePatients for reading to this website.

Companies who sell medical care or medication make their presence known by advertising on websites that ePatients use. But some companies have looked longingly at such environments where patients may invest a lot of time and trust. Wouldn’t it be great if they could run the whole show?

Wouldn’t it be a dream-come-true for a company to have its own website and speak directly to patients on their own turf  – I mean terms? In the last few months, there have been two different ways in which their dream has come true. The first is by creating something some are calling the “fPatient.” The F is for “fake.”

If this is the first you’ve heard about the f-patient, you may want to have a look at the Facebook profile of Sara Baker  – I mean eSara. Sara is not a real person, but a persona that has been created by a company called Medseek for the purpose of engaging real patients everyone else. On a Facebook Fan page that looks a lot like mine, Sara talks about her twins and shows pictures of her honeymoon. But there is no real Sara. We have no idea who actually posts on that page.

You can read more of a discussion about fPatients in Phil Baumann’s article where I first heard about it and in Eileen O’Brien’s article.

Real patients filling role for patient engagement on drug company sites

The other approach to engaging patients uses real patients people. You can see it in the NewWayRA videos that are produced for the company which sells Remicade and Simponi, Centocor Ortho Biotech. The newest generation of videos even uses a real Sara – Sara Nash, a blogger – as a panelist. I discussed their videos last year on the blog in a post about their response to my argument with part of their script.

Another example of the use of real patients is a website which belongs to a company who sells medications for Multiple Sclerosis (MS), EMD Serono (Merck). It is called How I fight MS.com. They use five patient bloggers to discuss issues related to MS. They have a cool-looking setup with a red HELLO nametag and a sticky note and a cute coffee stain. It does look a lot like a blog – until you see the same cute coffee ring on every person’s page. There are video journals, “about” pages for each blogger, lots of casual photos of the patients and their pets, and a fake-link to their real blogs.

Is this what is meant by patient engagement?

I’m still thinking through this all of this. I’m at the questioning stage. And I have several questions.

  • Why do the companies require readers to surrender such an enormous amount of information about themselves in order to view the sites? What are they doing with the information and why don’t they disclose this?
  • Technically, there is disclosure on these websites of who runs the show, but is that the same thing as transparency? Do these sites make it clear enough what their purposes are?
  • Why is there no clear indication of how the featured patients are compensated? I only know Sara was paid because I read it on her blog.
  • Where is the engagement? Patient (visitor) participation consists of filling out detailed forms with personal information. There is no opportunity to respond or interact or comment.

What do you think?

If you happened upon these sites, would you have realized right away that they were professionally produced for drug companies just like a TV commercial? If you did, would it change the way you view the information presented? What is your reaction to fPatient Sara Baker? About half of the respondents in a Twitter poll approved of the Sara Baker thing.

Recommended reading:

Kelly Young

Kelly Young is an advocate providing ways for patients to be better informed and have a greater voice in their healthcare. She is the president of the Rheumatoid Patient Foundation. Kelly received national acknowledgement with the 2011 WebMD Health Hero award. Through her writing, speaking, and use of social media, she is building a more accurate awareness of Rheumatoid disease aka Rheumatoid Arthritis (RA) geared toward the public and medical community; creating ways to empower patients to advocate for improved diagnosis and treatment; and bringing recognition and visibility to the Rheumatoid patient journey. In 2009, Kelly created Rheumatoid Arthritis Warrior, a comprehensive website about RA of about 950 pages and writes periodically for other newsletters and websites. Kelly served on the Mayo Clinic Center for Social Media Advisory Board. There are over 42,000 connections of her highly interactive Facebook Fan page. She created the hashtag: #rheum. Kelly is the mother of five, a home-schooler, Bible teacher, NASA enthusiast, and NFL fan. You can also connect with Kelly by on Twitter or YouTube, or LinkedIn. She has lived over nine years with unrelenting Rheumatoid disease. See also http://www.rawarrior.com/kelly-young-press/

30 thoughts on “The Fake Patient (fPatient) & Patient Engagement on Drug Companies’ Sites

  • May 20, 2010 at 9:52 am
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    I like blogs like yours. I like reading you and knowing you’re here in the trenches with the rest of us, not being paid to hock some product. And eSara is creepy.

    Reply
    • May 20, 2010 at 11:05 am
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      I wonder if eSara is a man? Did they even hire a woman? Is she blonde? Come on.
      Someone say “Well we know these FB pages are not real…” – I said, “Hey, mine is

      Reply
  • May 20, 2010 at 11:02 am
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    I know I won’t be filling out all that information just to watch one of their videos.

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    • May 20, 2010 at 11:58 am
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      I assume a lot of the info will be fake. Maybe what they deserve. ?

      Reply
  • May 20, 2010 at 12:01 pm
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    To me it sucks. Drug companies want to get their act together and listen to us the REAL patient for a change… Love your pages Kelly because we are all in it together so to speak and it’s great to be able to interact together to support each other. Not be another statistic on the balance sheet with some phoney block writing in the back ground….

    Reply
  • May 20, 2010 at 3:17 pm
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    Thank you so much for continuing to be such an advocate for people who live with chronic illness and rheumatoid arthritis. I personally have enjoyed reading your blog and your posts so much. you tend to write about a lot of the topics I would like to write about if only I had more time. Somehow, you always seem to sound so eloquent! Keep up the great work and thank you for pointing these kinds of things out to us. I just tweeted it and put it on Facebook to about 5000 people.

    Reply
  • May 20, 2010 at 3:54 pm
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    I don’t uderstand why they would need to have a fake patient when there are so many REAL patients out there who could give them REAL information. Unless they do not want REAL information, and if that is the case then they aren’t very reputable!!
    I think we all know or at least think that the people in the RA drug commercials are fake patients because I know I have never met anyone with RA who feels like doing any of the stuff in the commercials nor do I. I wish I could! They need to get REAL, this is our lives our health and our emotions they are playing with!

    Reply
    • May 20, 2010 at 7:05 pm
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      Cindy, good points – real patients, real information. I would like to see real patients in commercials with real stories and real pain. I hate the commercials as much as you do. Did you see this yet? Click here

      Reply
  • May 20, 2010 at 5:25 pm
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    fPatient sites and marketing-sites-disguised-as-information-sites are exploitative and just plain creepy.

    What I find here at RA Warrior is everything those sites wish they could imitate (they can’t): Honesty, solid facts, transparency, genuine caring and empathy, realistic, practical, hope, and humor.

    The fPatient sites and marketing sites are not REAL. They are manufactured and sculpted to lead a reader to follow their profit-based agenda and that is just plain wrong. Why do they try to appear as something false? If they had full disclosure at the top of their opening pages (instead of buried in some hard-to-reach “about us” disclosure page), that would ruin their illusion.

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    • May 20, 2010 at 7:04 pm
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      Caysea, Real is always better than Fake. I like the use of real patients if they want to try to show a patient viewpoint. There are some problems for them with real patients such as liability and credibility issues. What I would like to see is more transparency from them. I know it is complicated, but the amount of information they insist upon before letting people view the site is ridiculous. The RA one took some sleuthing to figure out last year. Their new pages have the drug company name at the bottom of the front page which is better. But still it does not say why they exist to collect all this information from patients & what they are doing with it. We can only guess.

      Reply
  • May 20, 2010 at 6:05 pm
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    Hi Kelly
    I want to respond (esp since you were sent these on Twitter, rt’ed from a tweet based on a comment I left at whydotpharma. However I’m still hooked to iv at hospital and my iPhone is not easy to for typing lengthy comments. Thought I’d be home now but not likely until after 9pm.

    You know I respect your opinion. And I’m involved with the latter project mentioned. I’m dif not a fake blogger, blogger, patient,advocate, or writer. Look for more later. Btw the howifightms bloggers started our own facebook where folks can communicate with us ORany readers simply go directly to our blogs to interact. Also I always tell it like it is no matter where I write and I’ve never been censored on the sponsered site.

    Reply
    • May 20, 2010 at 6:51 pm
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      Hi Lisa, I look forward to hearing more from you. Just to let you know, my post had nothing to do with the whydotpharma comment which I did not see until after this blog was published today. I did reply on Phil’s blog (linked in the post) on the first or second day – April 26th – which was a couple of weeks before I was asked about this in a Tweet this week. I’ve been involved & following some discussions of the fPatient issue since then. I’ve been commenting privately & publically on the NewWayRA thing from the beginning. Like I said in the post, I’m still at the questioning stage. When you get to a more comfortable position, I hope you will read my second comment on Phil’s blog. I suggested to him a scenerio similar to the one at the MS site, which I had not yet seen. There are still some sticking points, but real people like you are hands down what is preferred by patients over the Fake Sara!

      Reply
      • May 20, 2010 at 10:18 pm
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        Hi Kelly,

        I’m finally home. Oh boy, my comment above reads very disjointedly. Sorry for that. Lots of people have written about the eSara/MedSeek stupidity. I think I was practicing enroute to Europe when Phil/Eileen first posted. Silja asked me to comment on her post as we have a good working relationship and share ideas frequently.

        I criticized MedSeek’s effort, but did mention NewWayRA and HowIFightMS within my comment. That’s where @andrewspong saw it and tweeted those urls with a ‘patient engagement’ mention. He was RT’d a number of times and then @SharingStrength asked for your opinion. Ok now.

        Last year I ignored NewWayRA because it looked to be just about as phoney as the superslick, sucky inspiration, junk which several MS ‘support’ sites have. Can you tell I have not believed these ‘shows’ to be real? Well, maybe I should rethink that position.

        It was only when I saw Sara Nash (who is becoming quite the celebrity apparently) was involved that I took a second look. This time around Centocor/J&J make it very clear that certain persons including Sara were compensated for travel and preparation time. That’s fair.

        It’s unfortunate that they don’t clearly say that Centocor makes Remicade and Simponi (which was only approved just last April, the same month the url NewWayRA was registered by J&J). The reason is that this is a ‘unbranded’ or ‘nonbranded’ website designed to provide some sort of service to patients…..and to collect contact information for future marketing of newly-approved drugs (ie Simponi). This is ‘hidden’ in the agreement information with something like – you give Centocor permission to contact you regarding RA treatments and other stuff.”

        Only because Sara was involved will I give this website a 2nd look. It was good that I read about the compensation on the website before I ever read Sara mention it. However, there wasn’t much time between the two occurrences.

        Regarding HowIFightMS, when I was first contacted about a project “to inspire the MS community”, I ignored it as spammy email drivel. The PR rep didn’t give up too easily. I was quick to ask if “a pharma company who happens to have a new oral MS drug coming out in the next year” was the sponsor. I just didn’t know if it was EMD Serono or Novartis until later.

        Even before getting an actual contract I had spent several hours speaking with folks from the PR company. One conversation where I was asked about many different MS-related topics by their medical personal lasted hours itself. The initial posts during several months came from topics discussed during that phone interview. Then we’ve gone beyond those topics and I’ve come up with things which the medical guy (not being an actual MS patient) had not thought to ask about. An example, the connection between menstrual cycles and MS symptoms. That video has yet to air.

        Oh, and yes, we are compensated for vlogs/blogs/playlists. I’d have to dig my contract out to see if the amount is classified. (I talked about this on my blog). It seems comparable to other freelance writing I do online. We each wrote our own “about me” pages and submitted at least 5 photos to include. The only thing they didn’t include was a photo I have of Sicko crew members at my house after an interview they filmed. I didn’t want to go through the trouble of getting necessary permissions. I submitted something else instead.

        The coffee stains are cute. A nice template really, but not much different then some of the cool blog skins and templates which folks often use in the blogosphere. I was surprised that they used the goofy vlog of me talking about my cat, Musette, as the first video of mine you see (free of the login). But I am proud that over time, I’ve gotten better at finding better angles and times of day to tape. And the only editing they have done of any of my pieces is to add a disclaimer to consult your physician if you want to start doing yoga or any other exercise endeavour – it made me laugh.

        HowIFightMS is an unbranded site, and yes EMD Serono has submitted cladribine for approval with the FDA. Beyond them getting email addresses for MS patients, I truly hope that the website provides a useful services to other patients. I, too, am tired of people who don’t have a clue talking about our disease (or about our activities online) instead of having the patients speak for themselves.

        In fact, many patients have contacted me directly after they found my blogs from my “about” page on the website. Too bad they didn’t make the links live, but I think that would have required a “leaving this site” disclaimer.

        Jen, one of the bloggers, started a Facebook page for us and readers to interact. It’s not too busy because we talk so much elsewhere….and it’s not advertised at all. The same blogger has been talking with the PR company (to talk with EMD Serono) about putting many of our posts together into a book which could be freely given patients and whose proceeds would go to supporting NMSS. Don’t know if this will go anywhere.

        Ironically, the only time I’ve been ‘censored’ was just this past week when I presented a series of questions to a community on a website I wrote for. The portion which was edited addressed the topic of whether it matters who the sponsor of a website/project/initiative/forum/etc is.

        There is so much to be discussed surrounding the different examples you have presented here. I could go on and on…

        Reply
        • May 21, 2010 at 11:36 am
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          Thanks for all the info, Lisa. I appreciate hearing your opinions on these things. We are certainly in new territory w/ new media & new relationships w/ pharma, etc. I hope the new treatment helps you.

          Reply
        • June 1, 2010 at 8:14 pm
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          I have never heard of the eSara campaign, but I have to admit that I am a. not surprised, but b. completely freaked out by it, especially since she shares my name and spelling of my name. That’s creepy and misleading.

          I think that you and Lisa are bringing up lots of good points, and even though I am now a blogger who has partnered with a pharma company, I am also still working out a lot of my own thoughts to what it all means to be involved with a pharma company. I’m glad that people are talking about it, too, because there isn’t really a manual out there for those of us who are blogging and are interested in becoming more involved as an advocate/spokesperson- I am figuring it out as I go along, as are most of us.

          One of my hesitations in doing New Way RA initially was that I wasn’t sure what the reaction would be in the blogging community- would it affect my credibility, would I be seen as ‘selling out’, etc. I suppose the verdict is still out on that one, but nothing ventured, nothing gained.

          I also knew that being on the program would take up a considerable amount of my time and energy, two things I value highly, and that as a ‘real’ blogger, I was bringing a certain amount of cache (or perceived cache) to their program. I felt I should be compensated for my time and my experience, even though I knew that could potentially alter my status as a patient blogger further.

          One reason I felt ok about doing the program, and ultimately decided to give this it a go, was that I don’t take any of the drugs Centicor makes. If Amgen & Wyeth had approached me about getting involved, I’m not sure that I would have said yes, even if everything else had been exactly the same. For me, knowing that I don’t personally use any of the drugs Centicor makes (or profits on) felt like a way to preserve a personal boundary. And, to reiterate, I was never asked to write anything about New Way RA, have not received any payment for anything I have chosen to write about New Way RA, nor did they have any editorial say in what I wrote (nor do they now), so my words and opinions remain exactly that.

          Ultimately, I’m interested in helping get more information out there about RA and putting a non-stereotypical face on RA, and I felt like the potential for good outweighed the murky, complicated issues in this instance.

          I will say I didn’t realize (and perhaps should have done better homework) that in order to see the videos for New Way RA, one would have to give as much information as you do and consent to receive emails from Centicor….though there are ways around that, which I posted in the comment thread on my blog about it. I do believe that the team I worked with on New Way RA does sincerely want to create a platform for people to learn more about RA and become better advocates for their own health. I feel good about my involvement with the program, but am definitely interested to see how these issues continue to develop, what questions arise both personally and in the greater blogosphere, etc., even though I realize there could potentially be a backlash of sorts again me or my blog.

          Thanks for raising the issues in such an organized and thoughtful post. I hope more people will discuss so that these complex issues and relationships can begin to be sorted out.

          Reply
          • June 1, 2010 at 9:12 pm
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            Hi Sara, Thank you for posting. It’s good to hear from you. As I think I told you last year, I agree that you ought to be paid for your work. Yes, trailblazing means we figure it out as we go.

            Hopefully, the fake Sara / real Sara contrast did make you laugh. There is a world of difference, of course. :heart:

  • May 20, 2010 at 6:07 pm
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    I think this is terrible.And I feel really stupid – i just signed up to newwayRA and added their info to my blog. It will be deleted as soon as I finish this. I so hate the RA Medication commercials on the TV. If I could do one tenth of what they can I’d be happy. After having it for 26 years with no successful treatment I have been told by my doctor there is no point to try any new meds as all joints are totally damaged and am reduced to pain management only. I agree, there are plenty of us out here they don’t need to invent RA patients. Thank you Kelly for the info.

    Reply
    • May 20, 2010 at 7:14 pm
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      Hi Cindy, Don’t feel stupid. If you like the videos, I think it’s fine to put them on your site. But it is a free ad for them, so even though they would like me to do that, I’m not posting them on my site. It’s just my editorial choice – I think they should have to pay for ad space. They are much better off than I am – I work as a volunteer…

      Reply
  • May 20, 2010 at 9:52 pm
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    I imagine a world where all the fake patients of the world can “friend ” all the other fake patients in the world:)

    Reply
  • May 21, 2010 at 12:38 am
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    Control

    It is to me at least, all about control of site content. Fpatients are packaged, every thing about them conceived by committee, and even if there is a seed of a “real” person, well it just doesn’t matter. Let that “real” person even try and write something not agreed or approved by the committee or Corporation, they would be squashed. There are not being paid to think. They are there to present the party line, and keep in step with the Corporation.

    The Corporations would like to treat patients like sheep. The best way to do that is to control content of website, and do it stealthly reminds me of a political process used to control people — Propaganda.

    Reply
    • May 21, 2010 at 11:45 am
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      I hear you. Hopefully, not all of them. They certainly need to better represent themselves, though.

      Reply
  • May 21, 2010 at 4:29 am
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    That is just creepy, I just looked at the ESara on Facebook, why don’t they just put the real person or person’s doing that. And the poor 77 fans she has who follow that whole fake thing.. Thank you for taking the time to find out about these things and also all the helpful information that your site actually gives. Cathy

    Reply
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  • May 21, 2010 at 2:18 pm
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    ESara kinda reminds me of the movie “The Stepford Wives”.

    Reply
    • May 21, 2010 at 2:29 pm
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      I love that movie – the old version. I don’t know whether it’s a political statement or whatever, but I love the point that making us all into a mold is a horror. 😛

      Reply
  • October 19, 2011 at 6:49 pm
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    I think that the fake eSara is deplorable. Any company who fails to disclose the WHOLE TRUTH about who they are by:
    1. Lying about who they are (i.e., presenting themselves as
    a “real” person who does not really exist);
    2. Lying about the purpose or intent of the blog/website;
    3. Being untruthful by “omission” (failure to mention or
    disclose either their identity or the purpose/intent of
    the website/blog or what they do with the information
    you give them)
    4. Doesn’t allow one to reply or comment or ask questions
    is a dishonest company, and in my opinion, they forfeit their right to be trusted in ANY way, shape or form. As in any “crime,” you are a suspect of criminal activity or intent if you lie or fail to disclose information. In the same way, I would “suspect” a lying or dishonest company of either straight-out criminal acts or intent, or “immoral” or “unethical” practices. In my eyes, when people feel they have to resort to lying or being dishonest in other ways, it’s because they are “hiding” something or otherwise up to no-good.
    If a company wants to host a blog or interactive website, they ought to be 100% honest and forthcoming with who they are (not “priming” by using fake people), what the intent and/or purpose of the blog/website is, and what they will do with any information provided by guests. Further, they MUST allow guests to CHOOSE what they want to answer and what they don’t (without being penalized or denied access), and MUST allow guests to leave comments and/or ask questions. Anything less is criminal (or at least should be).

    Reply
  • October 19, 2011 at 7:06 pm
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    P.S. – Kelly – Thank you for your website. I don’t think this site is dishonest or fraudulent in any way – and you allow people to comment and ask questions. Thank you for the time you spend on here. My RA diagnosis is fairly new – so I’m only in the beginning stages, I would imagine. But I have been trying to arm myself with information – and almost all of it has been from this site! Lately, I’ve just been praying a lot, that God would just heal me and I won’t have to go through anymore pain or suffering! And yes, I send up a prayer for all the people I read about on here, as well as you, Kelly. Again, thank you for your time and desire to share what you learn and what you go through. Your honesty and unselfishness is greatly appreciated. We need more people like you on the web ….

    Reply

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