President Trump’s drug pricing speech made Friday, May 11th the day with the most online drug pricing posts in 2018. Rational 360 analyzed the online conversation around the speech, including tweets, online news articles, blog posts, forums, reddit posts, and online comments, to develop the following insights. Here are the things you need to know:

Biggest Drug Pricing Moment of 2018. With nearly 48,000 posts, Friday, May 11th was the single biggest day of the year in the online drug pricing conversation. It wasn’t close. By contrast, the three-day period around President Trump’s speech represented a nearly five-fold increase over the second-biggest moment (President Trump’s drug pricing mention during the State of the Union address) and a roughly seven-fold increase over the next biggest (FDA Commissioner Gottlieb’s drug pricing remarks at a March AHIP event).

 

Moments in conversations around drug pricing in 2018.

Overall Sentiment of Posts Remained Consistent. Although the volume of drug pricing posts increased significantly in connection with the speech, there was no statistically significant difference in the sentiment of the posts – that is, posts were no more negative on Friday than they had previously been in 2018. (Approx. 4% positive, 62% neutral, 34% negative).

President Trump Expanded Beyond Healthcare Audiences and Reached His Base. The audience for the Trump drug pricing speech changed significantly from the audience that usually talks about drug pricing online. While key demographics remained similar (92% >35 years old, 52/48 male/female), audience interests diverged wildly. Typically, the people who talk about drug pricing are more than 20x as likely as the average Twitter user to be interested in specific health care issues, such as clinical trials, HIPAA and genomics. People talking about drug pricing on Friday were no more likely to be interested in health care issues but were instead 20x more likely to be interested in Donald Trump, conservative politics and Fox News.

 

Gender break down of audience for the speech. 

Age break down of audience for the speech. 

Drug Pricing Speech White House’s Message of the Day, But Moved Off Quickly Unlike Other Priorities: The White House Twitter account posted 10 tweets or retweets on May 11 on drug pricing. That was the most posts on a single topic on the 11th, but there have been no posts about drug pricing since from that account. For context, the same @WhiteHouse account consistently tweeted 15 times between May 8 and May 12 about Gina Haspel’s nomination for CIA. Also none of the White House posts used a hashtag. While the #AmericanPatientsFirst hashtag, which seemed to originate with the Administration was included in more than 370 tweets, it fell short of usage of hashtags like #drugprices, #ABetterDeal, #FoxNews, #Trump and #MAGA. If the Administration’s communication strategy going forward remains light touch, it is increasingly unlikely there will be Administration-driven shifts in perception around drug pricing, PBMs and pharmaceutical companies.

Speech Didn’t Register with Patient Advocacy Organizations Online.* Rational maintains a database of 200+ national patient advocacy organizations. Only 5 percent of the groups acknowledged the speech on social media, with two organizations tweeting that they were present at the speech, and three others tweeting links to neutral news articles. This was actually a slight uptick in the frequency with which patient advocacy groups normally talk about drug pricing. 

States With Drug Pricing Legislation Paid More Attention. Six of the top 10 states with the most posts per capita on drug pricing Friday had pharmaceutical price bills before their state legislators in 2018 (OR, NY, MA, WA, VT and CO), including drug price transparency, price gouging or rate-setting bills. However, although these states fielded larger audiences, there is no evidence that users were connecting the President’s speech to local legislation.

 

Heat map of posts mentioning drug pricing on day of speech. 

DC Influencers Posted More Often and More Negatively, But the Weekend Killed Interest. Rational’s list of 1,000+ DC influencers – including every Member of Congress, cabinet officials, members of the media, and political pundits – posted 158 times about drug pricing on Friday, which would have accounted for roughly a quarter of all 2018 drug pricing posts prior to Friday. Although influencer posts have been primarily negative all year, negative sentiment trackable posts increased from 69 percent to 86 percent. Conversation in DC tapered off on Saturday even more than among the general population. 

Post volume per hour the day of the speech. 

Drug Price Advertisement Disclosure Proposal Did Not Get Social Traction. Although the President’s proposal to require pharmaceutical companies to disclose drug prices in advertisements garnered significant traditional media coverage as one of the President’s concrete proposals, only 2 percent of all online posts about drug pricing on the day of the speech mentioned the proposal.  

Pharma Companies Mentioned More Than PBMs on Day of Speech. Mentions of individual players in pricing like pharmaceutical companies and PBMs decreased during the speech, as the conversation focused on the overall pricing environment. 10.45 percent of posts relating to pricing on the day of the speech relate to big pharma and pharmaceutical companies. That is almost three percentage points fewer than how many pricing posts throughout 2018 related to big pharma -- 13.13 percent.  Mentions around PBMs dropped even more. In 2018, PBMs were mentioned in 16.03 percent of posts about drug pricing. During the speech, only 7.47 percent of posts mentioned PBMs.

Top Hashtags in Friday Drug Pricing Conversation.

  1. #MAGA 1,300+
  2. #Trump 970+
  3. #FoxNews 670+
  4. #ABetterDeal 610+
  5. #drugprices 410+
  6. #AmericanPatientsFirst 370+
  7. #DRUG 370+
  8. #FridayFeeling 370+
  9. #Medicare 340+
  10. #Pharma 330+

*Rational 360 maintains an exclusive list of approximately 200 patient groups and monitors their social media posts throughout the year. This list is made up of groups that are U.S.-based patient organizations and whose primary missions involve health. They are patient (not provider) groups. Individuals, including group leaders and surrogates, are not included.

**Rational 360 maintains a list of more than 1,000 DC influencers including members of Congress, Cabinet officials, media figures, and strategists and pundits on both sides of the aisle.