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Based on both public and proprietary research, it is clear that the Internet is proving to be an effective tool for engaging actual and potential prescribers for a given brand or class of drugs in an intellectual dialog that can change prescribing behavior dramatically. FRED FOARD HAS WATCHED THE EVOLUTION OF THE I NTERNET W I TH I N THE PHARMACEUTICAL INDUSTRY WITHA CLOSE EYE. Through his intimate involvement in the medium, as a mediaplan ning executive with Communications Media Inc., which delivers nonpersonal promotion to professional healthcare audiences, Mr. Foard has identified four reasons why the industry has not taken to “the Net” with the same reckless aban don as the consumer goods industry. “While there are arguably more reasons, I’d like to discuss four,” Mr. Foard says. “These all derive from `translation’ issues. They are prob lems inherent in adapting a consumeroriented medium to healthprofessional targets and to ROI expectations. I call these `retardant’ factors: the inability to discriminate professional from lay Internet surfers; the lack of standardized ter minology; the inability to target specific medi cal specialities; and the inability to measure advertising effectiveness on the Internet.” The Prescriber In the pharmaceutical industry, branded drugs — not diagnostics or other nondrug items — make up more than 90% of the business. “In 2000, pharma spent $2.5 bil lion — a 35% increase over 1999 — in DTC promotion,” he says. “The figures for 2001 are not yet in, but I’ve seen one projection of $3 billion — a more modest 20% growth. I suspect one reason for the less aggres sive investment is that after several years of heavy DTC spending, phar ma is beginning to examine the ROI. DTC has been successful in building brand awareness and in generating interest. But prescrip tions don’t come from consumers.” Indeed, while pharma has increas ingly spent wildly on consumer advertising, advertising to profes sional audiences has declined dramatically. Unlike consumer goods industries, the con sumer cannot take direct Internet action to acquire a product. “The potential key Internet audience for pharma is therefore the prescriber,” he says. “This fact leads to the first retardant fac tor: the inability to precisely discriminate pro fessional from lay Internet surfers.” Of all of the medicaloriented Websites, only a handful can distinguish, and then veri fy, healthprofessional traffic from layperson traffic and therefore there is no good way to assess exposure potential. TheTerminology “Even if one could distinguish health pro fessional traffic from layperson traffic, there IN AN EXCLUSIVE INTERVIEW WITH PHARMAVOICE,FRED FOARD,EXECUTIVE VP, COMMUNICATIONS MEDIA INC., DISCUSSES FOUR SPECIFIC PROBLEMS INHERENT IN ADAPTING THE INTERNET FOR HEALTHCARE PROMOTION. FRED FOARD WHENGOINGTO the Net VIEW on Internet advertising remains a second barrier: the lack of standard ized terminology and measurement tools,” Mr. Foard says. “This is a particularly frustrating problem given that the Internet potentially provides the capability for precise and imme diate tracking of all activity.” Mr. Foard says, “The problem is that there’s no universal approach for tallying each instance that an ad is viewed. What are `visits,’ `ad impressions,’ `pageviews,’ and `clicks’? And, is there a uniform metric that applies to each? Furthermore, are there reliable sources for obtaining these data in a manner that are inter changeable or, at least, related?” Mr. Foard says the answer to these critical questions is a qualified “Yes.” Recently, the Interactive Advertising Bureau published a set of definitions (see box on this page). “It will take some time for all parties (Web site purveyors, audit houses, media planners/buyers) to fully incorporate these uni form definitions,” he says. The Specialty Target “Even if an advertiser could tell when a message was exposed to a health professional as opposed to a layperson, and there were uniform metrics to track Web activity and compare exposure potential between Website alterna tives, the advertiser is still faced with the third retardant factor: targeting medical specialties,” Mr. Foard says. “For most of the hightraffic health Websites, even those with qualified `professional’ sections, advertisers cannot directly target a specific medical specialty.” There are some passwordprotected sites that can tell how many physicians of a given special ty are “registered users.” With prodding, they can probably tell an advertis er how many times in a month a physician in a spe cialty has logged on. Although they can, Mr. Foard says they don’t provide this data as an ongoing service. “We are left with mak ing some assumptions about whether and how a given professionaloriented Website can deliver `eye balls on the (ad) page’ for targeted specialty audi ences,” he says. “We would not buy space in a medical journal that could not demonstrate specific reader ship numbers for a given specialty. For the Internet, we must settle for a good guess.” The Measurement According to Mr. Foard, the fourth retar dant factor is the inability to measure adver tising effectiveness on the Internet. “In my business of media planning for pro fessional healthcare advertising, we know that advertising generally cannot be relied on to deliver prescriptions,” he says. “Research shows that advertising as an adjunct to other promo tional forms (primarily personal selling) is asso ciated with incremental prescribing behavior. Perhaps it would be useful if we could tag unique visitors to medical Websites and track their pre and postexposure prescribing. I know of no medical Website purveyor who offers this service and I am unaware of pre scription audit firms providing this service.” In contrast, Mr. Foard points to consumer goods advertisers who can calculate “conver sion rates” and “referral rates” for relating Internet activity to purchase or inquiry behav ior. For prescriptiondrug advertisers, there is currently no way to tell whether a banner ad or interstitial touting a branded drug stimulated any action on the part of the viewer to make any move in the direction of selecting that brand for his/her next appropriate patient. The “TakeHome”Message Given these four factors, Mr. Foard says it’s no wonder that the pharma industry has been slow to adopt the medium. “It doesn’t help that there are few people with Internet advertising expertise who really understand pharmaceutical promotion to pro fessionals or people who really understand phar maceutical promotion to professionals who have Internet mediaplanning, buying, manage ment, and assessment experience,” he says. Mr. Foard suggests the industry should focus on the Internet’s successes — winning friends and influencing enemies through self directed education. “Edetailing, esymposia, and Webcasts that allow interaction with experts and realtime selftesting, are setting records in participation,” he says. All of these vehicles for targeted interactiv ity with health professionals not only help form favorable clinical opinions but also create a pos itive relationship between the sponsoring drug marketer and the participant. Through educa tion, the clinical message that is behind the advertising message is delivered at a time, place, and pace chosen by the target. “I’ll take that any day over a 5second view of a banner ad on a medical Website page clut tered with competing information and dis tracting popup ads,” Mr. Foard says. “But that’s just one man’s opinion.”# PharmaVoice welcomes comments about this article. Email us at firstname.lastname@example.org. 52 M a r c h 200 2 PharmaVOICE Defining Internet Activity Measurement Metrics AD IMPRESSION — A measurement of responses from an addelivery system to an ad request from the user’s browser, which is filtered from robotic activity and recorded at a point as late as possible in the process of delivery of the creative material to the user’s brows er — therefore closest to being an actual opportunity for the user to see an ad. CLICK — There are three types of click — clickthrough, inunit click, and mouseover. Clickthroughs are measurements of userinitiated actions of clicking on an ad element, causing a redirect to another Web location. Inunit clicks and mouseovers do result in serv er log events and new content being served but may not necessarily include a redirect to another Website. PAGE IMPRESSION — A measurement of responses from a Webserver to a page request from the user browser, which is filtered to remove robotic activity and error codes before reporting,and is recorded as close as possible to the user’s opportunity to see the page. VISIT — One or more text and/or graphics downloads from a site qualifying as at least one page,without 30 consecutive minutes of inactivity, which can be reasonably attributed to a single browser for a single session. For a complete list of definitions, log onto IAB’s Website at www.iab.net.