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.

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.

Megan Svenson

Bonus Benefit 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 from it.

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.