DTC's Next Chapter

Marketers spent the last 10 years learning how to advertise to consumers -- the next 10 will be about integrating those efforts.
Jun 01, 2004

Orchestra conductors may, at first, seem like an unlikely comparison for pharma marketers. After all, a conductor's job is to ensure that each instrument harmonizes with others within the section; that all the sections complement one another; and that the timing, tone, and pitch of each disparate part are flawlessly executed. But when one appreciates the challenges facing executives today in integrating all components into the marketing mix, the analogy seems appropriate.

Understandably, direct-to-consumer (DTC) advertising is only one movement in the composition. But faced with industry's increasing reliance on DTC to drive preference for the growing number of parity products, consumer marketers' biggest challenge—and opportunity—comes in leveraging the benefit of the whole marketing mix. In doing so, not only can they prompt patients to talk to their physicians, but they can actually influence that dialog, and, ultimately, affect how well patients adhere to and comply with the prescribed regimen.

To better understand those challenges, Pharmaceutical Executive convened a roundtable of esteemed DTC marketers responsible for some of the biggest and most effective consumer campaigns. The discussion revealed the struggle that integration poses to consumer marketers in advancing their craft. But it also highlighted how much these executives have learned since 1997—they are now focused on return on investment (ROI), they are moving slowly and smartly into new tactics and formats, and, by looking to their peers in consumer packaged goods, they have a much better understanding of their target audience. Here's a summary of that discussion.

Quotables: On Brand Positioning
Follow the Leader In today's information age, consumers, not companies, are leading the integration effort. Patients are connecting the dots between ads they see on television, the magazine story with their favorite celebrity talking about a health issue, and the e-mail newsletter containing tips on heart health. In fact, patients have logically grouped those messages around a brand or disease, and marketers are struggling to keep up.

"What always happened, and still happens, is that professional agencies claim the territory of the physician's office and everything else is considered DTC," says Jim Sandino, former president of Lowe Consumer Healthcare, now president of the J. Sandino Group. "Yet the campaign for Accutane, which blurred those lines by putting simple branded devices inside dermatologists' offices, was a very effective tactic to extend DTC into physicians' consciousness and actually right into their office."

Inside Information. Andrew Schirmer (right) and Anne Devereux (left) share their insights on what makes DTC advertising tick.
"At the end of the day, you need to put the patient together with the doctor to have that important dialog," says Frank Hone, executive vice-president, global business group, Healthworld Communications. "We have to help guide it. One way we've done that, in the direct response DTC campaign we developed for Avonex, was to include a question card for patients to bring to doctors, which guided the conversation to get the positive outcome we desire."

Roundtable attendees agreed that the lack of a central marketing architect hampers program integration. "It's incumbent on clients to take that leadership position, to bring everyone together and make sure that everyone has an aligned strategy in bringing the brand to market," says Amy Niemann, vice-president of marketing for Barr Laboratories. "Not only the consumer and professional ad agencies, but all of the folks who are working on the business, whether it's interactive, public relations, or medical education."

Quotables: On Integration
Several participants noted that if clients don't drive or reward integration efforts, they simply don't happen. "We did a major product launch for a client last year, and there was all this talk about interagency integration," says Bill Drummy, chairman and CEO of Heartbeat Digital. "We had all the meetings and we did all the right things. Everyone agreed. But with the lead agency dictating the creative, none of it happened. There are very few clients that have the actual insight and the force of will to say to the agencies that they have to come up with a comprehensive campaign and stick to it."

It may be unrealistic to think that clients have a handle on how to best integrate agencies. More and more, partnerships seem the ideal answer, with companies and agencies trying new ways to bring around a brand-centric, versus a budget-centric, approach.

BBDO, for example, recently appointed Anne Devereux to the new role of chief integration officer. "Many of us from a holding company and large-agency perspective are creating integrated service networks inside the agencies, so the onus doesn't only fall on the client," says Devereux. "It's worth all the meetings and all the energy to break down those silos because you will see the results in the marketplace."

Patient Care. Denise Strauss (left) stresses the importance of reaching patients with credible spokespeople. Frank Hone (below) discusses how to effectively create dialog between patients and physicians.
Small agencies have created their own networks as well, whether formal or on a project basis. Sandino says the latter approach was effective in creating and launching an integrated DTC campaign for Kremers Urban's omeprazole in less than three weeks.

Next Stop: Persistence and Compliance Integration efforts may also be the key to increasing and advancing persistence and compliance programs.

"You don't see any more than 10–15 percent of total media dollars spent on compliance and persistence," comments Michael Guarini, managing director of Ogilvy & Mather's healthcare practice. "For those programs, the industry is just adopting a lot of the standard consumer marketing tactics, like free trial offers or coupons."

Quotables: Revamping the Brief Summary
Certainly, environmental forces will dictate that marketers increase their efforts in this area. "There will be intense pressure on price over the next couple of years," says Anthony Manson, senior vice-president, managing director, Sudler & Hennessey. "All companies are going to have to deal with that. All of a sudden, getting that repeat script may be a more viable way to grow the business than the acquisition part. So we may see changes in the pattern of spending in the next couple of years."

Denise Strauss, director of marketing for Bayer Men's Health and Levitra, says new efforts will be more interactive. "The opportunity with compliance and persistence isn't as much with national broadcast media, but it's online and through customer relationship marketing. That's where we'll see an increase in investment with more product managers using those tools to grow loyalty and compliance."

Marketers should also focus on getting inside conversations between patients and doctors, where the greatest opportunity to change behavior lies. "Industry is extremely limited to incentivize physicians to give out patient support material," says Sandino. "On the other hand, the only patients who voluntarily enroll in compliance programs often need it least. So companies are only getting a small improvement in drop-off rate. It's analogous to everybody going after the two top quintiles of doctors. You need to get to the physicians in the next two quintiles down who are trying to grow their practice. Similarly, we need to get to the not-so-good patients in order to make a compliance program truly effective."

The Ins and Outs of Regulation. Anne Myers (left) and Louis Morris (right) talk about the various challenges and opportunities in working with FDA to create new formats for DTC communications.
"This is where integration is going to be crucial," says Devereux. "Just look at the diagnosis process for a patient with high cholesterol. The doctor says, 'I'm going to put you on this exercise regiment, and if you can't get your numbers down, I'll give you this drug.' So despite all of the patient's best effort, he fails, gets Lipitor, and feels like a loser. What's his motivation to stay on the drug? Until we get into the doctor–patient dynamic, we're going to have a very hard time hitting the adherence issue on our own. That's why integration is the path of the future."

New efforts show that to be true. Novartis' most recent "Take Action for Healthy Blood Pressure" campaign highlights integration with messages aimed at the public through an educational initiative and medical education for physicians, and thus creates conversation between patients and doctors using the same language. Also unique is the campaign's money-back guarantee, which drives patients to physicians' offices to get tested and increases compliance.

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