The Art of Advertorial

They look like articles, but they work like ads -- and they're crucial in conditioning the market.
May 01, 2004

In today's cluttered marketplace, it's not only important to tell your audience about your product, but to get them to anticipate it. There are few better ways to do that than a well-timed, well-placed advertorial.

Certainly, a market that's knowledgeable and anticipates a new therapy is more important than ever. With increasing pressures for companies to maximize product lifecycles, advertorials are one way for companies to increase uptake for their therapies—particularly biologics, which represent vastly new and more complex approaches to disease.

"There is every indication that companies are trending more and more toward educational rather than promotional materials," says Robert Osborn, senior vice-president, magazines, at Dowden Health Media and a past president of the Association of Medical Publications. "The Office of the Inspector General makes it appealing to pharma companies to focus on education."

This article outlines what advertorials are, highlights how companies should use them, and explains how to evaluate the tactic to determine if it is right for the company's brand.

By Definition An advertorial is simply an ad that is designed to deliver the experience of reading an article. In the pharma industry, companies use advertorials to convey sound bites of science that educate a target audience of physicians about specific aspects of a disease and its management in new and different ways.

Beyond the design, advertorials differ from typical ads in that they are based in education and are scientifically rigorous, often citing clinical studies and information, rather than hard-selling a product. Companies often use advertorials as part of their prelaunch marketing mix, and therefore don't include the product name. But that's not to say that the advertorials aren't branded—quite the contrary. Well-crafted advertorials create the drug's prelaunch messaging, which evolves into its launch messaging, and as such are part of the foundation of the brand. Therefore, companies should take time to consider the visual elements and messages of the advertorial, which in the long term, will help to drive home messages that will eventually be tied into a comprehensive brand promotion.

CLICK ON IMAGE TO ENLARGE Increase in Advertorial Usage
Prime the Market Within the prelaunch category, companies can use advertorials to achieve several goals. A review of 40 advertorials (that ran from January 1995 to June 2003) obtained from 253 journals under 60 medical titles—including general, popular, and specialty journals—revealed four primary messages that pharma companies aimed to convey when using the medium. Specifically, companies used advertorials to:

  • show relevance of a new therapeutic agent's mechanism of action by explaining its relationship to the disease process
  • build awareness of a disease state in anticipation of a new therapeutic class
  • create an urgency to treat diseases earlier and more aggressively
  • address the need for new treatment options that improve quality of life for underserved patient populations.

Explain the mechanism. Advertorials that fell into this category aimed to establish a new understanding of the etiology or progression of a disease and set forth the premise that new drugs under clinical study would specifically target the proposed pathology. Of the advertorials analyzed, companies used this approach most often, particularly for immunologicals, to explain the new science to physicians. (See "Across Categories.")

Case in point: the advertorial that Biogen developed two years before launching Amevive (alefacept), which would become the first FDA-approved biologic to treat psoriasis. Because physicians had traditionally managed the disease using standard oral agents, Biogen needed to educate physicians about a new treatment paradigm that would allow them to address the underlying immunologic causes of psoriasis—T-cell activation. So the company took out a three-page unbranded advertorial, "Looking Beneath the Surface," in the Journal of the American Academy of Dermatology, which underscored the need to treat psoriasis at the cellular level, at the cause of the problem, to provide long-lasting remission. That way, when Amevive was approved, physicians understood the benefits of long-term management of the disease.

In the therapeutic area of oncology, Genentech ran advertorials highlighting the role of vascular endothelial growth factor (VEGF) . In doing so, the company established an educational platform for the reader in understanding how Avastatin (bevacizumab), which works by inhibiting VEGF, helps fight the disease in patients. Those advertorials were similar to Biogen's in that they had a primary focus on pathogenesis and introduced new therapeutic modalities that use a novel mechanism of action to target and treat the underlying cause of the condition.

Companies can also include language in these types of advertorials that represents their commitment to delivering a scientific explanation about disease progression and discovering novel therapeutic options to treat that condition. Alternatively, companies can use corporate branding to express that same idea.

Build awareness. Because this approach highlights improvements above and beyond those offered with current treatment options, companies commonly use this type of advertorial to increase the awareness of a condition and present the next generation of therapeutic options.

Merck used this tactic in 1995 when it debuted its advertorial in support of soon-to-be launched Fosamax (alendronate) for the treatment of osteoporosis. Indeed, Fosamax represented a major advance in the management of osteoporosis, and Merck used the expanded space advertorials offer to educate physicians about the prevalence, seriousness, and the need for appropriate treatment of the condition.

Advertorials that follow this approach can be considered almost "refresher" courses because they give the basic facts about the disease. Roche's "The Art of Influenza Management" advertorial is a classic example with dedicated sections on awareness, recognition, and treatment of influenza. Physicians are offered an entire snapshot of a disease and treatment options, both current and upcoming, in a two-page spread.

By increasing disease understanding, these advertorials also lay the path for improved treatment. For example, Lilly ran an advertorial to help physicians build awareness of, and better recognize, the signs of depression. With the headline, "We're not re-inventing it. We're just taking a closer look," the advertorial intends to redefine the symptoms of depression to include physical as well as emotional symptoms. In doing so, the company is educating physicians about psychosomatic illnesses and, in effect, expanding the market for treatment.

Create urgency to treat. Companies use this type of advertorial to encourage physicians to treat diseases earlier and more aggressively. In general, they address categories that are underdiagnosed or undertreated by the medical community.

The approach is exemplified by Aventis' "Deep Vein Thrombosis: A Major US Health Crisis" advertorial run in 2002 and 2003 for Lovenox (enoxaparin). The advertorial aimed to instill an immediate sense of hurry by including a patient case study that reported a woman's unexpected death from a pulmonary embolism.

Another example is the series of advertorials Lilly created that aimed to increase the early identification of sepsis. Within this series, Lilly provided the target audience with information that supported the need for early and appropriate treatment, then explained the cascade of events that may be responsible for the condition. These advertorials also provide the audience with an immediately useable tool—a table of identifying criteria—that guides the early identification of sepsis.

Advertorials within this category also tend to use dramatic and alarming statistical data to emphasize the commonality and burden of the condition, thereby establishing a need for immediate action, such as early diagnosis and initiation of appropriate treatment. For example, Wyeth used a list of startling statistics to convince healthcare professionals, who previously didn't consider obesity a disease, to evaluate and manage the condition appropriately.

CLICK ON IMAGE TO ENLARGE Call for Commitment/Startling Stats
Improve quality of life. This category encompasses several different types of unmet therapeutic needs. For example, it can be used to increase the awareness of an underserved disease category—disease states that are grossly underdiagnosed, undertreated, or inadequately treated. Or—more commonly—this advertorial approach is used to create a need to treat conditions that negatively affect lifestyle and impact patients' quality of life.

This category shares many commonalities with advertorials that create an urgent need to treat. For example, Pharmacia's advertorial for overactive bladder (OAB) demonstrated that despite its high incidence rate—higher than that of Alzheimer's disease—patients, and sometimes even healthcare professionals, do not talk about the condition. That silence only serves to keep the disease stigmatized, undiagnosed, and untreated. The advertorial also went to the next level by saying that when the disease is treated, it is done so with undesirable and poorly tolerated therapies. Through the advertorial, Pharmacia let the healthcare community know that patients should not have to "live with it" or accept overacive bladder as a normal part of aging, but rather to think of it as a condition that can be treated with well-tolerated medications that are "coming soon."

Amgen/Wyeth also created an advertorial that acknowledged the fact that ankylosing spondylitis is inadequately treated and in need of new therapies that can address specific symptoms.

Although companies typically use advertorials for pre-launch activities, marketers may decide to run them after launch as well. Novartis, for example, continues to run its Zelnorm (tegasarod) advertorial to educate physicians about the symptoms and severity of the irritable syndrome so that they will increase diagnoses of the disease.

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