"Marketers need more comprehensive communication programs," Ramspacher says. "They have advertising that prompts a patient
to go see their doctor, and most of the time the doctor will give them what they ask for. But they're losing them somewhere
between the doctor and the pharmacy. This may be an opportunity for advertisers to make sure they have a synergistic disease
campaign which reinforces the need to fill the prescription by using other media channels."
Web-based reminders offer pharma marketers a fast and thrifty connection to consumers. "Behavior is a difficult thing to change,"
Boehm says. "The Internet offers a low-cost option for lifestyle support when a condition requires diet and exercise changes
in addition to drug therapy."
One goal has reigned supreme for pharmaceutical marketers since the dawn of DTC eight years ago—the quest for the greatest
return-on-investment. David Gascoigne, practice leader of promotion management at IMS Management Consulting, says ROI is improving.
Sixty-four brands Gascoigne studied in 2004 showed a median DTC ROI increase of $2.20 for each $1.00 invested. Twelve of those
brands boasted ROI in excess of $4.50 for each $1.00 spent, although seven took a loss.
But Gascoigne cautions that managed care practices may chip into these gains. "It's more difficult to drive ROI for certain
brands and markets with increasing managed care influence," Gascoigne says, whose research shows a direct correlation between
higher "out-of-pocket" prescription costs and lower return on DTC ROI. To get consumers to dig into their own pockets for
a drug, he suggests, ads must be that much more convincing.
"DTC is not just for the big players and becomes a key driver of brand performance, particularly in more consumer-driven markets
and specialty markets," he says. "It can be a key part of the marketing mix for brands with little or no third-party coverage."
Some forward thinking managed care organizations, however, may be starting to see the wisdom in footing the bill for newer,
higher-priced drugs if viewed as an investment instead of a perk.
"A lot of employers do look at their healthcare expenditures and perceive that their drug spending is higher than other categories,
but some are beginning to see this may head off higher healthcare costs for members down the road," says Boehm.
But Gascoigne says the success of a DTC campaign isn't measured simply on the rate of ROI and, like analysts Boehm and Ramspacher,
urges savvy pharma marketers to create a better mix of brand-specific and more general public relations efforts for their
brands. "The ROI for PR is almost double the level of [that for] DTC," he says.
Continuing hostility from activists who say too much is spent on promotion and not enough on R&D might affect DTC spending.
The Washington Legal Foundation, for example, called for the Department of Justice to move its FDA-based promotion investigations
from its consumer to criminal division in March. Burns, however, doesn't see these efforts affecting promotional spending.
"Some activists and regulators say if drug companies took half of the money from their promotional efforts and spent it on
clinical research it would make drugs more affordable," he says. "But the fundamental economics are absent, because pharma
companies know their competitors won't do it. So long as we're driven by capitalism, we will see drug companies spending in
proportion to what they've been doing all along."
Other factors that may potentially impact DTC spending are the rising number of brand-name drugs that will become generic
in the next few years and the addition of 29 million people to Medicare's drug benefit rolls in 2006. But these aren't really
seen by any of the analysts as affecting promotional spending, either.