-By Jim Edwards

Although a majority of marketers have embraced online social media and user-generated content efforts, one industry is conspicuously not taking advantage of the gold rush: pharmaceuticals.

Drug brand Web sites almost never carry the features that marketers usually are desperate to give their customers: bulletin boards, chat rooms, blogs and Web-page hosting.

The reason: Marketers fear that user-generated content will include complaints about injuries caused by their drugs' side effects. The law requires these "adverse events" to be reported to the FDA. The FDA's adverse-event databases are regularly combed by lawyers looking for potential class-action suits.

Thus, drug marketers have stuck with a decidedly Web 1.0 model, in which customer interaction is kept to an absolute minimum.

This head-in-the-sand approach may be about to change. A debate is raging in the drug business as to whether companies should adopt a Web 2.0 strategy. On one side are digital agencies telling companies that online customers generate far fewer adverse event reports than drug companies might expect.

On the other side are brand managers, whose every published word must survive a thicket of in-house lawyers, some of whom aren't Internet savvy.

Dori Stowe, chief digital strategist at Grey Healthcare Group, New York, recalls speaking with a pharma company's legal team about a campaign, "and somebody raised their hand and asked, 'What's Google?'" Stowe, whose clients include Boehringer Ingelheim, said that once brand managers are shown the full extent of what patients are doing online, they're keen to learn more.

When told that companies should embrace such activity, adverse event reporting becomes their immediate worry. "The legal departments will say it's just not an area we can play in," said Jason Rogers, vp/account services at Catapult Marketing, Westport Conn. His clients include Novartis and Pfizer.

Bill Drummy, CEO at Heartbeat Digital, New York, agreed: "We've talked about this with our clients for literally five years and in every case that has been shot down by regulatory and legal folks." His clients have included Abbott Labs and GlaxoSmithKline.

In many cases, clients agree with their agencies but nix projects anyway. "Part of this is understanding the brand manager caught in the middle, with agencies saying you have to do it and the regulatory group not understanding it," said James Pietz, vp/group director at MicroMass, Cary, N.C. His clients include Merck and Shire.

The pressure for drug companies to evolve is growing. "Drug companies need to begin embracing ways to look for adverse events instead of hoping they don't stumble across them," said Peter Pitts, an svp at Manning, Selvage & Lee, New York, who keeps a blog that champions the industry. "I think the attitude of 'there's safety in ignorance,' or active ignorance, is no longer actionable or responsible."

Bruce Grant, svp/business strategy at Digitas Health, Philadelphia, which has worked for Wyeth and Pfizer, thinks there may be a legal advantage in giving consumers more input into drug marketing. "Early warning signals that there may be a safety issue really puts the company in a stronger position in terms of potential exposure to product liability suits," he said.

Grant cites a survey from Nielsen BuzzMetrics, New York, of 500 messages on health-related Google and Yahoo! sites. Only one reportable adverse event was found, suggesting a "volume that is entirely manageable within companies' broader [adverse events] monitoring programs." (BuzzMetrics and Brandweek are divisions of Nielsen Co.) That is disputed by some, who believe the volume will be much higher and therefore more onerous and expensive.

One company is attempting to prove it either way: Johnson & Johnson, which in March acquired Childrenwithdiabetes.com, a community site for parents of kids with diabetes. The site has open bulletin boards and even takes ads from competing companies.

Joe Natale, vp-new media, said J&J monitors the site for adverse events and people who give incorrect medical advice, but aside from that anyone can post whatever they want. "The best way to destroy that community would be to in any way hamper or infringe upon the way they create content or share information. If [a company thinks] that every post for every user has to be reviewed and copy-cleared in advance, I will tell you not to waste your time."

Natale said the site gets 10,000 unique visitors a day, and the expense of monitoring for adverse events runs from $100,000 to $1 million, depending on the size of the site. So far he has encountered fewer adverse events than he expected. "There are enormous risks. I don't want to send the wrong message. It's extremely intimidating," he said. "Some companies will say, 'It will cost us money, cost us some investments.' But I think it will be worth it."