Pharmaceuticals get wired

'TV is not the way to go' - marketers apply proven methods for reaching doctors to the consumer market

In the past, ‘pharmaceutical marketing’ meant friendly sales reps visiting doctors who would then write prescriptions to hapless patients. But marketing has evolved along with technology. Pharmaceutical marketers increasingly rely on complex online programs designed to streamline doctor education while boosting brand awareness. Now, drug companies are bringing their Web savvy to the consumer market.

‘A medium like the Web, in my mind, is absolutely made for the pharmaceutical market,’ says Mehbs Remtulla, chairman and CEO of Euro RSCG Life Canada in Toronto, which handles work for a number of pharmaceutical companies including Bayer, Abbott Laboratories and Bristol-Myers Squibb.

‘TV is not the way to go. We don’t need to reach 30 million households in this country. Mass media is not the way to go. In the age of permission marketing, and one-on-one marketing, the Internet is way, way underutilized by pharmaceutical marketers.’

Cynthia Hastings-James, director of interactive services for Toronto medical advertising firm Medicus Group, agrees. ‘A few years ago, the Internet was viewed as an alternative way of communicating with health-care professionals and patients. Pharmaceutical companies thought doctors didn’t have the time to use the Internet and [consumers] didn’t think the information was credible. As it becomes more widely accepted and used more and more by consumers and health-care professionals, it’s become a very attractive marketing vehicle for the pharmaceutical manufacturers specifically.’

One of the reasons is that consumer Web savvy is on the rise. Last year, Ipsos Reid reported that two-thirds of all Canadians have visited a health Web site, up from 55% in 2000. More Canadians have spent time looking for online health information than any other single activity. Sixty-six per cent of those who have visited a health site do so on a monthly basis, and 22% browse health sites weekly.

Evidence is mounting that, in some situations, consumers reach for the keyboard before they reach for the phone. A recent TV ad from Toronto’s MacLaren McCann for Johnson & Johnson’s painkiller brand Motrin (an over-the-counter drug not subject to Health Canada regulations) offers viewers a 1-800 number and a Web address. So far, the Web site has pulled more people than the telephone number.

Of course, Canadian pharmaceutical marketers know that there’s a catch. Hastings-James puts it best: ‘The regulations in Canada restrict direct-to-consumer advertising, so what ends up happening is when patients go looking for this information online, nine times out of 10 they end up on a U.S.-based product site.

‘The plus side is that Canadian marketers are stepping up and really looking at the Web as a great opportunity to educate and communicate with consumers. While the rules in Canada for communicating to patients directly haven’t changed, the unrestricted nature of the Web creates a new dynamic.’

The first task for marketers is to ensure that reliable, robust Web sites exist for consumers. Earlier this year Johnson & Johnson’s McNeil Consumer Healthcare launched an online joint venture with Bell Globemedia. The result is, a consumer Web site that offers ‘Strategies for living well.’ The site reads like a magazine and includes information on topics like healthy eating, exercise and relationships. Visitors can also use tools to count calories online or determine their body mass index.

Content for the site comes from Bell Globemedia properties Canadian Living and CTV’s Balance TV. Johnson & Johnson maintains the rights as the exclusive advertiser in the consumer healthcare category. The company is currently running banner ads for Tylenol, Imodium, Acuvue contact lenses and LifeScan glucose monitoring products for diabetics.

The idea is to ‘create a real health destination,’ says Christine Saunders, account manager for Toronto-based MacLaren McCann. ‘No one’s going to go to Johnson & Johnson to learn about Tylenol. They want to learn about pain states, or how to avoid pulling a muscle.’

Prescription drug makers are also having success with branded sites that don’t offer any information on the drug or its effects. In 2001, Wyeth Ayerst Canada launched an online promotion for the birth control pill Alesse. Branded TV and transit spots drove traffic to a microsite on The branded site hosted a contest where young women (mainly 18-to-25) were asked to submit their advice on ‘lessons learned’ in exchange for the opportunity to win a $300 gift certificate from HMV. The year-long promotion got an average of 400 submissions weekly, and Wyeth plans to do it again with new campaign executions later this year.

Another tactic is search engine optimization. Optimizing Web sites to make them easier for search engines to find is relatively easy and very cheap. Increasingly, pharmaceutical companies are also buying keywords so that users who search those words will see a sponsored link appear on the side of the page. ‘That’s a pay-per-click scenario,’ says Hastings-James. ‘You only have to pay when someone clicks on that ad. It’s terrific ROI and Canadian pharmaceutical companies are getting more and more interested.’

Other companies partner with associations, such as the Canadian Cancer Society or the Heart and Stroke Foundation, to run co-marketing programs with branded online content. Companies can produce their own condition-based Web sites, and Hastings-James says that many do, but Canadian regulations forbidding the inclusion of specific drug names make it difficult to provide brand value.

A bigger growth area is likely to be compliance-based sites, or sites that offer tips and information to patients who have already been prescribed medication. These sites ask consumers for a drug identification number before they can access password-protected information. (Abbott Laboratories tried this tactic for its anti-obesity drug Meridia. See ‘Doctor tested, patient approved,’ p.16.)

‘It’s a huge issue for most products,’ Hastings-James says. ‘Half [of patients] will fill the prescription, and very few will stay on the drug long-term. If it’s a chronic condition, that’s an area where pharmaceutical companies can see a huge return.’

Implementation costs for customer relationship management software is driving the trend towards customized, password-protected sites. ‘You can justify a $50,000 investment in software when you’re seeing hundreds of thousands of dollars in return – as well as the relationship side of it.’

In fact, Tom Kouri, president and creative director of Montreal-based Internet company High Touch Communications, has his eye firmly on the pharmaceutical market as a potential source of customers for his customer relationship management software. ‘There hasn’t been a lot of activity in terms of Web presence [for pharmaceutical companies] but that’s all changing because the costs have come down so much for personalization and site management tools.’

But reaching consumers on the Web also presents new difficulties, says Diane Kalina, founder and president of Oakville, Ont.-based Minerva Communications and now the VP, director of continuing health education and business development for Cundari Health in Toronto, which recently purchased the company. She says that while just about all doctors are Web literate, the same can’t be said for a large portion of drug consumers.

Kalina has worked with companies including GlaxoSmithKline, Leo Pharma, Merck Frosst, Novartis Pharmaceuticals and Stiefel Canada and has noted the rise in pharmaceutical information on the Web. Outside of DTC regulations, Kalina comments that doctors present ‘a uniform level of sophistication and familiarity with computers.’

‘All physicians have at least a minimum amount of software and education. It’s harder to get to the little old lady in the country. If you ran a program on how to make sure she takes her medication properly, I really doubt if she’d find it or know what to do if she did find it.’

Then again, it depends on the therapeutic category. ‘Multiple sclerosis doesn’t hit elderly people as much as it hits in your prime,’ Kalina says. ‘Doctors can give out Web site info to those patients and they do recommend various Web sites. If [today's consumers] get diagnosed with something else when they’re 85, they won’t have lost those Web skills.’

Doctors on the web

‘Online physician market has reached saturation’

Drug makers eyeing the online consumer market already know the terrain; doctors are tough customers, demanding targeted, relevant, useful information.

A May survey by New York-based health-care marketing information and services firm Manhattan Research concluded that ‘the overall online physician market has reached saturation.’ In other words, all doctors are online.

The study, which sought to define trends in online information usage among American doctors, also identified a large and growing group of what they refer to as ‘essential integrators.’ The term refers to doctors who are keeping up with the latest information on PDAs, taking electronic continuing medical education courses, researching clinical trials, increasing connectivity levels with the insurance community (the payers) and occasionally communicating with patients through e-mail.

The number of ‘essential integrators’ doubled in the last year, and already 19% of American doctors are using online communications to talk to patients. Canadians in the field expect those statistics are in line with stats for Canadian doctors.

Pharmaceutical marketers have long used the Web to target doctors, usually through the sites of specialty journals that specialists are already reading. But as doctors grow more comfortable with integrated technologies, marketing campaigns are adapting to suit their needs and their schedules. It seems to be working. This year, 22% more doctors noted that the Web was a time-saver than in past studies.

Online continuing medical education is ‘a huge trend.’ So is online clinical recruitment. Health communications company Euro RSCG Life has used the Web to conduct focus groups where doctors from across the country can offer comments and advice on advertising campaigns. Opt-in mailing lists are another growing trend.

Euro RSCG Life has also used the Web to create customizable sites loaded with product information. A new Web site for Lundbeck’s anti-depressant drug, Celexa, went further when the company decided to offer online tools that would not only provide doctors with information, but would make it easier for them to communicate with a multicultural group of patients. The site was accessible in French or English, but doctors could also print the data in seven languages.

DTC regulations (finally) under review

A legislative review process of direct-to-consumer (DTC) advertising of prescription drugs is finally underway, one year after Health Canada announced plans to revisit the regulations first enacted in 1953.

Currently, Canadian pharmaceutical marketers have only two options for marketing directly to consumers. The first is branded messaging that excludes mention of product attributes or conditions the drug treats. Alternately, companies can focus exclusively on raising awareness of a medical condition without mentioning the drug by name. Health Canada is concerned that some advertisers are flouting the spirit of the regulations by running both kinds of advertising.

The review of current advertising regulations is part of a larger study of the Canada Health Protection Act. Public consultations seeking the views of Canadians will begin in the fall.

The announcement comes as pressure mounts from lobby groups who view the rules as outdated. Earlier this summer, Canadian Newspaper Association president Anne Kothawala called for an end to the ban on DTC advertising at a Senate committee hearing studying the state of the Canadian news media. In addition to increasing advertising revenue for media outlets, Kothawala believes that a made-in-Canada solution could reduce consumer confusion caused by spillover from American DTC advertising.

Kothawala views the latest announcement as ‘a real opportunity’ and plans to make a presentation to the review committee.

‘The government has finally recognized that Canadians want to take control of their own health. They recognize that the physicians don’t have the time to talk [patients] through every possible option. Consumers want to do the research and find out what’s available to them.’

Kothawala also notes that groups opposed to the DTC advertising are ‘starting to recognize the status quo is untenable.’

Ottawa-based Canadian Medical Association spokesperson Caroline Levine states flatly that the CMA continues to stand behind a position paper published last September that reads, ‘DTCA is not information but marketing, and sends the message that a prescription drug is a ‘consumer good’ rather than a health-care benefit.’

However, an updated position paper released in March outlines a number of principles on which the CMA would like future consumer information to be based. These include focusing on education rather than sales, using evidence-based messages, and establishing a mechanism for independent third-party accreditation for all consumer information. The paper suggests that brand-based messaging should include the generic name of the drug as well as information on who needs the drug, who doesn’t need it, the drug’s relative cost and side effects.

A timeline for the process has not been announced.