Drug marketers will need to target messages at regular consumers of their medicines, and not wait for doctors and pharmacists to recommend their products as in the past.

This industry-wide consensus has been gathered after changes announced late last month to the Ontario Drug Benefit Program that has seen 106 non-prescription medicines and slightly more than 200 over-the-counter drugs de-listed.

Under the drug benefit plan, drug costs have been covered by the Ontario health care system when provided to about two million provincial residents aged 65 and older, people on social assistance or those living in long-term care facilities.

Non-prescription and over-the-counter drugs listed on the Ontario Drug Benefit Program formulary represent a protected market for pharmaceutical companies worth more than $1 billion in annual sales, or 6% of Ontario’s health care budget.

But changes to the plan mean regular users of the de-listed medicines must now choose between paying for brand products out of their own pocket or having their doctor recommend alternatives.

Drug company heads are reluctant to unveil marketing adjustments so soon after the drug benefit program changes. But the word is, marketing departments will do more to ensure drug consumers stay loyal to a brand and do not end up with cheaper alternatives.

Mehbs Remtula, head of Toronto-based agency Remtula Associates, argues that the drug benefit program changes mean drug makers will increasingly rely on consumers making their own decisions on buying products, rather than on recommendations from doctors.

So Remtula expects marketers will make more approaches at the consumer level to pharmacists, urging them to help consumers make informed decisions about their drug purchases.

For example, one of Remtula’s clients, Allergan Pharmaceuticals of Toronto, has seen its non-prescription artificial tears product for elderly patients, Lacrilube, de-listed.

Remtula says Allergan will still benefit from doctors’ recommendations. But the loss of drug benefit program protection for Lacrilube means an over-the-counter recommendation from pharmacists will be more important than ever.

So, while Allergan’s consumer ad budget will hardly balloon, the company’s sales force will do more to inform pharmacists about Lacrilube and other company products.

Likewise, Frank W. Horner, the Montreal-based drug company, has seen Gravol, its popular anti-nausea drug, fall from protection.

The drug benefit program rules that Gravol was useful in treating motion sickness, but indicated no benefit when treating vomiting from serious illness.

Ron Sawatzky, vice-president of marketing at Horner, expects Gravol users will choose to pay the difference between the brand product and its generic at their pharmacy, increasing over-the-counter sales of the product.

Besides considering a letter to doctors explaining its product’s benefits when compared with the drug benefit program’s recommended alternative – Stematile, made by rival Phizer – Horner is understood to have discussed marketing approaches to Gravol consumers.

Big losers from the drug benefit program changes include sunscreen products, now considered personal care products like toothpaste and shampoo, and which have all been de-isted.

Marketing efforts for sunscreens will likely be stepped up. Sales of sun care products have taken off in recent years as public concern about the harmful effects of ultraviolet radiation grows.

The drug benefit program also took aim at antihistamines, effective in treating seasonal allergies. The program has concluded it can save $12 million annually by de-isting all antihistamines without risking life-threatening diseases among its regular users.

That has unsettled Merck Frosst Canada.

Based in Montreal, the drug company has seen its own antihistamine product, Periactin, de-listed. And eight of its prescription drugs have been struck off, owing to competition from generic products.

Says Sylvain Clermont, marketing manager at Merck Frosst:

‘We have good products, but we cannot compete with generics.’

The drug benefit program approached Merck about dropping its price for Periactin, but the company said no, pointing to its one-price policy for all drugs sold across Canada.

Besides considering marketing approaches to consumers, Clermont says Merck will continue print ad campaigns urging Ottawa to extend patents on drugs protected from generic competition.