March 2007 VIEW on Advertising Advertising and Promotion • Detail aids • Journal Advertising • Patient education • Direct-to-Consumer Advertising • Market Research • Online Promotion Back to Basics and Beyond By Taren Grom, Editor Increasingly stiffer competition, combined with enormous market pressures shortening brand timelines, make achieving a drug’s full sales potential much more difficult in today’s environment, according to analysts at Cutting Edge Information. These same experts say brand leaders must be finely attuned to their brands’ unique strengths and weaknesses, including the realities of markets, clinical profiles, and their own companies’ capacity to support effective promotion, if they hope to help their products reach their potential. According to industry experts, brand teams need to examine the basics properties of their products and then develop a strategic marketing mix that will be the most effective for their brands and support the strategy with the appropriate resources. Creating Success Marketers are embracing a number of best practices to ensure an advertising campaign’s success. Little. Halozyme. We’ve had great success using humor in a campaign for our Cumulase product. Finding the levity in what is perceived as a serious industry can be a great asset if done with care and sensitivity. Our product is a replacement for a bovine testes derived extract and that was a fun angle to take advantage of. The slogan was “safer, purer, no bull,” and the visual image of a cartoon bull was really well-received. We carried the imagery through in our exhibition booth and even in our giveaways; it was a risk that paid off. We never want to belittle the seriousness of science or whatever the condition is that a product aims to address but there is something refreshing about a less serious approach on occasion — of course always maintaining fair balance. del Rio. Daiichi Sankyo. It’s important for marketers and advertising executives to think outside of the box — to always strive to be innovative. They shouldn’t be afraid of exploring different approaches. It’s also important to have a good historical perspective; know what has been executed in the past; did it succeed, and why did it fail. Marketers need to learn from the past as they develop new strategies. We should always ask the question: Does this campaign add value to the customer and does it inform? Allen. Bayer. We aim to develop campaigns that are unique compared with our competition. We keep a close eye on what’s happening in our area of the market. We want to have campaigns that have stopping power for our readers. We want to do things that are different; we want to create campaigns that cause our customers to stop and really read the advertisements. We also want to provide a call to action, which enables them to not only read the advertisement but to take action, whether it’s a phone number, a business reply card, and so on. We also make sure executions are tested by our readers — focus groups — in advance. Addressing the Audience In this day and age of having to appeal to multiple stakeholders, focus groups remain an important component in the design of an advertising campaign. Allen. Bayer. Focus groups are very important for us. We recently developed a new advertising campaign, which was launched last month. And focus group feedback drove the development and execution of the whole campaign. We had five potential concepts that were leading us in a similar direction, but one clearly stood out with the focus groups we conducted at a national convention. This feedback gave us confidence that the patient community would respond to the campaign. From our perspective, it’s critical to hear directly from our customers. In this recent example, we integrated feedback from the focus groups directly into the advertising campaign. When we develop a new campaign we do market research at several different points. At the start, we want to learn what the key issues are for customers and we want to know how we can match our messages with what’s most important to them. Down the road, when we have four or five different concepts is when we test them with focus groups to get a sense of what will work in the marketplace. Little. Halozyme. If time and budget permit, focus groups are certainly an important asset especially for DTC campaigns. In the world of life sciences, however, those two commodities tend to be a rarity. We typically take a more informal approach to focus groups and seek input from employees not intimately involved in the particular product or we take the concept to customers who we have a close relationship with and who we trust to provide insightful feedback. del rio. Daiichi Sankyo. It is imperative that we know our customers as well as we know ourselves. We need to understand who they are; how they make decisions; what their unmet needs are; how our products answer those needs; and how to communicate these answers in a manner that resonates and drives behavior. Well-targeted market research is one key to success, but at the end of the day it never fully answers all of the questions. multichannel Media Addressing audiences via multiple mediums is more important than ever. And multichannel advertising campaigns are becoming the norm rather than the exception. del Rio. Daiichi Sankyo. New communication channels allow us to reach, and communicate with, customers in the way that they desire, and that cuts through the noise. In general, I think people appreciate creativity. They appreciate a pleasant surprise, a clever approach. Getting customers’ attention is the first step, getting them to change behavior is the ultimate goal. Without obtaining the first, it’s impossible to get to the second. Little. Halozyme. I think the sense of continuity delivered by a comprehensive campaign is essential to brand recognition. We spend a lot of time at conferences and tradeshows and the repeated imagery and brand identity that a potential customer sees in a print ad, and then on a booth, and then in a corporate brochure or an annual report provides a sense of consistency in branding. I think consistency delivers, on some level, the message that we as a company have a vision and a clear direction of where we are headed. Allen. Bayer. It’s very important to have an integrated campaign; it’s something we automatically do now. We develop all of our campaigns to incorporate print advertising, direct mail, Website advertising, HTML e-mails — based on a customer list of patients and families who have opted in — convention presence, public relations, and so on. Everything has the same messages across the board so the campaign really is integrated. An advertisement alone won’t do anything anymore. The more consistently our patient community hears the messages the more they sink in. In our market, patients are key decision makers so finding different ways to communicate with them is critical. On the cutting edge New technologies continue to rule when it comes to innovative approaches to developing pharmaceutical advertising campaigns. del Rio. Daiichi Sankyo. I believe that the technologies and techniques being used today in commercials generally also can be applied by pharma. We have much to learn from other industries. There is no rule that prevents us from informing our customers in a manner that entertains and educates. Being memorable is not a sin. Allen. Bayer. E-mail communications are a leading-edge tactic, but even hotter than that is in-depth customer segmentation, which would allow us to deliver targeted messages to patients to an opt-in customer list. For example, unique messaging platforms can be created for different customer groups based on responses to a survey. These messages can address what patients are looking for, what they hope to gain from using the product, or how we at Bayer can help them. Little. Halozyme. Certainly for the last several years the pharmaceutical trend has been about direct-to-consumer advertising as consumers have become better educated about their health and are more aware of the various drug choices available to them. Within the business trades, I would say because the technology or science being promoted is often so difficult to express, there is a trend toward visual expression of a company’s core competencies or technology. Companies are trying to deliver a higher-level message rather than delving into the intricacies that are better explained verbally or in supporting materials than in a one-page ad. PharmaLinx LLC, publisher of the VIEW, welcomes comments about this article. E-mail us at [email protected]. Decision-Support Activities Influence Pharma Brand Success EARLY investments in market research are critical to help companies reveal a brand’s true market potential. If market research can identify a distinct unmet need in a market, for example, a company has a better chance of adapting its brand to fulfill these unmet needs and have more success in the marketplace. Cutting Edge Information has analyzed spending for six drug brands in Phase IIIa, Phase IIIb, and their launch year. During Phase IIIa, profiled brands, on average, spent 17% of their launch year budgets on market research. During Phase IIIb, market research spending slightly increased to an average of 18% of the launch year budget. This market research work revealed crucial information about diverse subgroups of patients, doctors, nurses, caregivers, and payer organizations. Two brand teams invested between $2 million and $3 million each on early market research and competitive intelligence. This early investment was wise because both teams discovered that there was a great market opportunity to address patients’ unmet needs. One brand discovered that its market exhibited a strong need for improved dosage convenience while the other brand noticed that its competitors did not offer a delivery system that addressed patients’ unique requests. Both these teams used this information to develop their delivery systems in ways that differentiated their products in already crowded markets. “Investing in decision-support activities early in product development and certainly during Phase III can be instrumental in helping the brand team identify key market drivers that are unique to their product,” says David Richardson, senior analyst for Cutting Edge Information. “A brand’s success then rests on the brand team’s ability to capitalize on these opportunities.” Thought Leaders Robin Allen. Deputy Director of Marketing, Bayer HealthCare, West Haven, Conn.; Bayer HealthCare, a subsidiary of Bayer AG, is one of the world’s leading, innovative companies in the healthcare and medical products industry. For more information, visit bayerhealth.com. Jose del Rio. Senior Marketing Manager, Atherothrombosis, Daiichi Sankyo Inc., Parsippany, N.J.; Daiichi Sankyo, the U.S. subsidiary of Japanese pharmaceutical company Daiichi Sankyo Co. Ltd., has a strategic focus on cardiovascular diseases and is researching and developing new therapies focused in the areas of glucose metabolic disorders, infectious diseases, cancer, immunology, and bone and joint diseases. For more information, visit dsus.com. John Kamp. Executive Director, Coalition for Healthcare Communication, New York; the Coalition for Healthcare Communication defends the right of health professionals and consumers to receive truthful information regarding pharmaceuticals and medical products, as safeguarded by the constitution of the United States; founded in 1991, the Coalition represents organizations, rather than individuals, dedicated to assuring the free exchange of scientific information without undue government interference. For more information, visit cohealthcom.org. Robert J. Little. VP and Chief Commercial Officer, Halozyme Therapeutics Inc., San Diego; Halozyme is a biopharmaceutical company developing and commercializing recombinant human enzymes for the drug-delivery, palliative care, oncology, and infertility markets. For more information, visit halozyme.com. Robin Allen Bayer HealthCare From our perspective, it’s critical to hear directly from our customers. When we develop a new campaign we do market research at several different points. PharmaVOICE Reader Survey Agency Strategies Extremely Very Fairly Minimally Not Important Important Important Important Important N/A Creative 56% 38% 6% 0% 0% 1% Strategy 56% 35% 7% 1% 1% 1% Reputation 24% 34% 35% 6% 0% 1% Relevant Experience 33% 51% 15% 0% 0% 1% Organizational Structure 5% 13% 44% 24% 12% 2% Past Success in Similar Campaigns 15% 48% 27% 6% 2% 1% Technological Sophistication 21% 37% 30% 9% 2% 1% Advertising to Seniors: Medicare How does Medicare Part D affect the pharmaceutical industry’s advertising to seniors? No effect 5.4% Minor effect 11.6% Moderate effect 40.8% Major effect 27.9% No opinion 14.3% What target audience is most important with the launch of Part D? Promoting the brand to plan committees is more important 27.2% Promoting the brand to consumers is more important 8.2% They are equally important 47.6% No opinion 17% Budgets Journal Advertising In the next 12 months, do you expect your advertising budget for professional/journal advertising to: Increase by 10% 18.6% Increase by 20% 4.7% Increase by more than 20% 4.7% Decrease by 10% 3.9% Decrease by 20% 3.1% Decrease by more than 20% 0.8% Stay the same 32.6% Not applicable 31.8% DTC Advertising In the next 12 months, do you expect your advertising budget for direct-to-consumer (DTC) advertising to: Increase by 10% 10.1% Increase by 20% 8.5% Increase by more than 20% 3.1% Decrease by 10% 5.4% Decrease by 20% 1.6% Decrease by more than 20% 1.6% Stay the same 20.9% Not applicable 48.8% ONLINE Advertising In the next 12 months, do you expect your advertising budget for Internet promotion to: Increase by 10% 17.1% Increase by 20% 17.1% Increase by more than 20% 12.4% Pharmaceutical Patient Education Shifts Emphasis From Ads Smart pharmaceutical companies do more to reach consumers than just run ads during prime time TV hours — they launch patient education programs to teach people about their health, their specific medical conditions, and the treatment options available to them. New Cutting Edge Information findings show that companies are pouring more money and time into patient programs that reach individual consumers with clear information — and a minimum of promotional distractions. Drug makers have traditionally struggled to reach the very consumers who ultimately use their products. At the same time, patients and physicians alike clamor for educational content that provides useful, unbiased content about critical health issues. Drug companies are well-positioned to provide this type of information, and some organizations fill the need better than others. The Cutting Edge report — Patient Education and Direct-to-Patient Communication — finds that the companies most effective at educating patients stick to five straightforward guidelines: Support patient education with tools and resource levels equal to program objectives. Drug makers spend millions of dollars on the Websites and brochures that make up good education campaigns. Coordinate content disseminated to both patient and professional audiences. Consumers encounter drug information on TV, online, at the supermarket, and in the doctor’s office. Coordination keeps confusion to a minimum. Use market research to effectively communicate with patient subgroups. All patients are not the same. Market knowledge allows companies to reach consumers on the patients’ own terms. Balance branded and unbranded content to provide unbiased information without sacrificing comme cial goals. Few doctors feel comfortable handing out brochures filled with logos and sales messages, and patients don’t trust such content. Good education materials are unbiased, accessible, and scientifically trustworthy. Establish win-win relationships with advocacy and patient groups. Organizations have the credibility and reach to push patient-education programs over the top. Source: Cutting Edge Information, Research Triangle Park, N.C. For more information, visit cuttingedgeinfo.com. Decrease by 10% 0.8% Decrease by 20% 0% Decrease by more than 20% 0% Stay the same 22.5% Not applicable 30.2% Source: PharmaVOICE, Titusville, N.J. For more information, visit pharmavoice.com. Jose del Rio Daiichi Sankyo In general, I think people appreciate creativity. They appreciate a pleasant surprise, a clever approach. Getting customers’ attention is the first step, getting them to change behavior is the ultimate goal. Coalition Responds to DTC Study The january/february 2007 edition of the Annals of Family Medicine contains a report on a DTC research study and an accompanying editorial co-authored by former FDA Commissioner David Kessler questioning whether the industry is acting for the public benefit with DTC. Although the FDA needs to ground its DTC policy on the science of consumer behavior, the study and the editorial would lead policy makers in the wrong direction. Either editorialists didn’t read the study carefully or chose to ignore its limits. Nothing in the research supports their opinions and conclusions that more stringent DTC rules are needed. Further, the research authors largely ignore the significant body of studies on the effects of advertising on consumer beliefs and behaviors, including the FDA’s own studies, that demonstrate that exposure to advertising leads to more and better doctor-patient conversations. The authors of the study recognize its limitations, but not their own bias. They note at the end of their introduction that the study uses “content analysis,” which as they say “is a well-established method of inquiry for generating research questions and hypotheses for future experimental and observational studies that examine the effects of advertising on consumers beliefs and behaviors.” What they don’t appear to recognize is that the study of DTC advertising has largely eclipsed any need for such rudimentary research. Mainline social science researchers have largely abandoned content analysis because it does little to illuminate consumer behavior and can easily mislead lay readers, policymakers, and even academic leaders. Worse, the authors of the research appear to have designed it to confuse rather than enlighten. The authors’ choice of what to code and how to interpret it, as well as their conclusions in the discussion section, could easily lead the casual reader to believe that the ads somehow “failed” academic scrutiny and thus need to be more highly regulated. We hope policymakers read the study critically and respect its limits, rather than use it recklessly to support calls for more restrictive DTC policy. The entire issue of DTC advertising, as well as the regulation of it by the FDA, calls for more and better social science. The Coalition for Healthcare Communication has petitioned the FDA asking the agency to develop a communication advisory committee that could bring better social science to the regulation of consumer advertising. This study would not meet any test of scientific rigor that Dr. Kessler correctly championed during his tenure at FDA. In fact, the scientific studies by the FDA to date have been much more scholarly, granular, precise, and useful than this. Clearly, the FDA already is well ahead of these researchers in both technique and interpretation. Unfortunately, the study denigrates emotional appeals and calls for more fact-based advertising. Facts are fine and DTC advertising provides great facts and information, particularly since the industry adopted the PhRMA DTC self-regulation principles in 2005. Meanwhile, emotions are a fact of life. Emotions drive much human behavior, including our eagerness to follow our doctors’ instructions. Without emotion, much advertising would be wasted, and great opportunities to advance patient care would be squandered. Good DTC advertising policy demands respect for a clear understanding of consumer behavior, how patients think and act, and what drives them to take the medicines that often enable longer and healthier lives. Sophisticated social scientists know this and can help the FDA use this knowledge to inform good public policy choices. Doctors choose medications for their patients largely based on the science of medicine and the experience of other patients, making it appropriate to focus professional advertising on those facts. Patients respond to different facts and appeals. Good policy requires focus on the information needs of patients, rather than the needs of prescribers. Today, partially because of exposure to advertising, patients are empowered to have more informed conversations with their doctors about drugs that might be useful for them. Doctors still control the prescribing decision, but look to patients as active participants in decisions and for better adherence to their instructions. DTC advertising plays an increasingly valuable role in this process. The authors observe that advertising is not a perfect or complete communication tool. No such tool exists, including drug labels, brief summaries, doctor/patient discussions, extensive continuing education programs, and the like. If we had such a magic wand, we would all wave it and our research on DTC could end. In reality, each communication tool has a place, but none can carry the load by itself. So, let’s not allow the pursuit of the authors’ implied perfect model for communication impede the beneficial use of advertising. Although interesting, this study is far from a definitive work and certainly not a basis for more stringent FDA regulation of DTC advertising. John Kamp Coalition for Healthcare Communication

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