And that makes sense for the industry. We don't need to waste money encouraging patients to argue with their doctors about
brands. In "Marketing 101," we all learned that targeting a concentrated group of gatekeepers (like physicians) is a far more
efficient buy than promotion to the universe they serve. Consider how much money must be spent to get a patient to a doctor
to ask about brand "X" only to have that physician say the brand is either inappropriate or not the first choice. Instead,
consumers need to know they have a treatable problem and must be motivated to seek that treatment. Then the individual product
teams can use professional promotion to battle for brand share of the newly diagnosed patients in the doctor's office.
Over the years, the industry has worked through existing or specially convened advocacy panels or government-industry collaborative
groups to raise awareness of disease states such as hypertension, high cholesterol, and clinical depression. Certainly, sending
controlled messages through DTC ads was important to category expansion by helping patients rapidly identify themselves as
candidates for treatment. But these disease categories' success would have been lessened without the strong PR messages from
doctors, advocacy groups, and the government.
Steps along the path
For example, the National Heart Lung and Blood Institute (NHLBI) led several public education efforts that raised hypertension
and cholesterol awareness—and dramatically reduced the rate and effect of heart disease. To facilitate this effort, NHLBI
partnered closely with the industry and even maintained an open panel of interested persons from pharma companies. In addition
to NHLBI's own public health advertising, the organization would allow pharma companies that sponsored programs to print the
NHLBI symbol on their privately created company literature, as long as it passed muster of the NHLBI review process, which
also helped to increase the credibility of the messages.
Another example is the National Public Education Campaign for Clinical Depression, which was rolled out by a coalition of
more than 150 advocacy groups (many of which were supported by pharma companies) to increase awareness of the chemical nature
of the illness, its rapid treatability, and the need for aggressive screening.
Education and destigmatizing disease greatly expanded the market for drugs. Then, salesforces battled for market share—appropriately—in
The reason advocacy-based public education builds longer-term support than brand-name DTC promotion is founded on a fundamental
PR principle: a message's credibility is greater when delivered by impartial third parties than by entities seeking to profit
Unlike DTC, advocacy-based promotion brings with it a cadre of allies who've bonded with their industry colleagues in pursuit
of a common cause. This factor grows in importance as the pharma industry becomes more of a political target. Advocacy groups
who know a company and its values can be counted on to speak out for it and relevant issues in times of need, and the media
will view them as more objective sources than industry spokespeople.
A case study of this advocacy benefit is the way nonprofits helped correct misinformation that nearly caused patients to stop
taking a vital medication en masse. The problem started when the New England Journal of Medicine published an "outlier" drug study alongside an editorial that clearly stated that the study had serious flaws and should be
viewed in the context of other more favorable studies. But that balance initially received precious little media coverage
up against the efforts of a publicity-seeking nonprofit that called on patients to spontaneously discontinue their medications—without
seeing a physician who could put the new (and flawed) data into perspective. Almost immediately, disease advocacy groups stepped
in, publishing "See your doctor first" messages and—citing themselves as authorities—put the data into a medically responsible
perspective for consumers.
When interviewed about this controversy, company spokespeople just pointed to the advocates' comments and said they agreed
with the balanced message those organizations delivered. No DTC campaign can produce this kind of credible support or enhance
the image of industry in this powerful way.