Let the Gamification Begin | American Marketing Association

Drug makers are investing in gamification to improve patient engagement and compliance. Is pharma gaming the new prescription for better health?

Could playing games actually be good for your health? That’s what many pharmaceutical marketers are aiming to show as they increasingly invest in gamification, which is the use of applying game-thinking and game mechanics in non-game contexts to engage audiences. In the near future, pharma marketers could be communicating important information to consumers and patients in more game-like ways—for example, floating avatars squishing abnormal cells until they vanish or a user-operated cartoon scientist running a virtual drug-development lab. Or even animated zombies that walk around a virtual maze, rewarding diabetic players with gold coins to unlock the next level of the game after checking their insulin levels. As pharma looks to find new ways to engage its audience, drug makers like Merck and Boehringer Ingelheim are investing their innovation dollars in developing complex, multi-tiered games that look more like something from the makers of Farmville than a pharma company.

“What I think we’re starting to see a critical mass of games for health,” says Paul Cummings, senior fellow at Fairfax, Va.,-based tech services firm ICF International and co-author of the report, “Gaming to Engage the Healthcare Consumer.” “What we’re starting to do is see a saturation of—or at least the use of—games for eliciting behavior changes across a variety of spectrums, and I think the pharma community is seeing the value. We’ve had years of games for health and research, and we’re now starting to see how we can apply those concepts to the pharma industry.”

The pharma industry wants to attract the attention of  tech-savvy millennials who’ve grown up immersed in apps and mobile technology. And with patients taking a more active role in their medical care and the industry’s move toward a value-based reimbursement model, the increase in gamification can be attributed to a rapidly changing health care space. According to John Bretz, vice president at ICF International, “The customer is very different and the marketplace has changed. One of the big drivers behind that is the Affordable Care Act, and this has really jump-started a lot of inertia and interest in innovation because organizations are struggling to communicate complex information to their key stakeholders—and there’s a lot of it.”

A Game a Day Keeps the Doctor Away

Big pharma hopes that by employing gamification it will help tackle one of the biggest problems in health care: patient adherence. Getting people to take better care of themselves means they should take their medications as prescribed, eat the right foods, get proper exercise and follow the doctor’s orders. One way gamification addresses this challenge is by creating a virtual environment that encourages the user to have fun and feel a sense of empowerment: winning points, badges or status and advancing through a hierarchy of different levels (think Angry Birds). By creating an enjoyable gaming experience, patients are more likely to engage and improve their self-care.

According to Michael Fergusson, CEO of Ayogo, a Vancouver-based startup that develops games and apps promoting wellness-related behavioral changes, “You can continue to build health care applications that are designed to be dreary on purpose or you can acknowledge psychology and say, ‘The best way to get somebody to do something is to get them to want to do it, to make it enjoyable or satisfying for them.’ The one thing that’s true about games is people engage with games because they enjoy them—because they’re satisfying in some really important way—and our job is to translate some of that understanding with how to do that in health care.”

Fergusson and his company have joined forces with Merck to create the drug maker’s Type 2 Travellers Project, a game for patients with Type 2 diabetes. Players pick an avatar and then compete in activities to win gold coins and advance to the next level while using tools to help manage their diabetes and learn why it’s important to stick to their prescribed regiment.

According to Fergusson, Ayogo also includes game-based achievements, but the awards in their games serve dual purposes: They are useful to the player for advancing to the next level of the game and they also represent a real accomplishment—and with that comes an emotional commitment. “In Type 2 Travellers, all of the modes of participation that a patient has with the system, all the ways in which they can interact with other people [and] the curriculum, earns them a currency. Then they can use that currency to do things that are fun and what we call ‘free play,’ ” Fergusson says. “Some of them are just intended to be fun, but some of them are supposed to be fun and useful. … There’s this currency arbitrage—your initial participation gives you access to something bigger.”

A Real Game Changer

John Pugh, global innovation team leader at Boehringer Ingelheim, began working on the pharma company’s first social game for Facebook, called Syrum, back in 2010. He initially launched a beta version of the game as a basic concept to test it with people just in the health care industry, seeking out their ideas and feedback. He was initially expecting to get between 500-1,000 people to play the game but ended up with 10,000 beta testers—and was “overwhelmed with ideas.”

“We use gaming as a way of learning, and a way of engaging with people is something that we wanted to learn more about,” Pugh says. “So I started thinking about, ‘Well, how do we go about building a game which is going to give us that experience and that learning?’ I spent about a year thinking about it and investigating it, and then we started working on Syrum back in 2010, and it’s taken that long for it to come about.” Pugh has been using those ideas and crowdsourcing even more to further develop the game.

The initial response was so great, in part, because Syrum is a social game on Facebook, a departure from pharma’s more traditional and conservative marketing strategies for increasing patient engagement. “I think it was the first time really that pharma had poked its head out from behind its corporate hideout and did something that was pretty different, and I think it was a pretty brave approach,” says Pugh. “If it hadn’t been for all of the work that happened beforehand, I’m not sure that Boehringer would have gone with it. I think it was unsuitably different enough to really catch people’s attention. … I could have built Syrum and put it onto a website somewhere, or I could have put it onto the biggest social platform in the galaxy, which is Facebook. That’s what I did—and that’s another reason why a lot of people found it attractive.”

Similar in nature to Zynga’s Farmville (except the farmland setting gets traded for a laboratory), Syrum allows players to create and run their own virtual pharmaceutical company by placing them in a virtual lab and challenging them to create and develop simulated medicines, run clinical trials and bring the newly formulated drugs to market in an effort to improve world health.

According to Pugh, Syrum positions Boehringer as a company that wants to understand new technologies and new communication channels. “It wants to engage with its customers and with its patients, and it wants to be seen as a company that is an attractive place to work for,” he says.

Syrum has already launched in Europe but will come to the U.S. this spring. “We launched it in Europe, but we didn’t launch it in the U.S., and the reason for that is I wanted to get it just right because it’s the biggest market,” Pugh says. “We’ve been spending the last several months redeveloping the game, making sure that it’s playable on the iPad—which wasn’t in the first scope—and putting into effect all the feedback that we got back from those 10,000 testers. 

Pugh is most excited about the social elements within Syrum, which give users the opportunity to collaborate and build products together. He’s interested in how U.S. consumers will  receive the story. According to Pugh, games such as Grand Theft Auto are successful because of their compelling story lines—users are eager to get to the next level. “[Syrum] isn’t your normal kind of story,” Pugh says. “It’s pretty far out and a little bit strange, and then there are some other things we’ve been discussing recently that are really exciting. Perhaps the ability to pay to get further ahead in the game or to buy certain elements in the game using real money, and then having that money go to charity or something like that. If we can build those things in the future, that would make it not just a game that helps explain some of the processes in the pharma industry, but [a game that] actually does good as well by donating money.” 


Up Close: Does Gamification Improve ROI?

Gamification aims to bolster patient engagement and health outcomes, but a big question remains: Does it really help improve ROI? And can you measure the impact of gamification?

A Spoonful of Metrics Helps the Gamification Go Down

According to Bretz at ICF International, organizations are engaging in gamification not only to boost engagement and quality care, but also because they anticipate ROI for their efforts. Health care organizations have plenty of options for spending their innovation dollars, so measurable ROI in gamification is important. The key to proving a return, he says, requires identifying the right metrics. “If you don’t know what [the metrics] are and you don’t know how to find them, you’re going to have a disconnect. … You know the old saying, ‘If you can’t measure it, you can’t manage it.’ You have to have the appropriate metrics set up at the end of the day so that you can evaluate how the overall experience was received.”

Understanding the Players

Before you can report the ROI, however, marketers must make sure to have a strong grasp on their gamification strategy—which will factor into the overall metrics. Cummings from ICF International says, “I say this to everybody who develops games: ‘The important takeaway is that you really need to understand what it means to do it right, and doing it right really takes a lot of knowledge outside of technology. It takes an understanding of the community, strong subject matter experts, people who understand communications. … Sometimes validation might come in the form of engagement, but, ultimately, you’re trying to create behavior change then show behavior change through research.”


This was originally published in the Spring 2014 issue of Marketing Health Services.