Devising an effective medication-compliance campaign often starts with one question: Why aren't patients taking their medications?
"There are some approaches that have been known to work," Boehm says. "If the challenge is medication cost, coupons may work.
If it's disease denial, education may be in order. If it's forgetfulness, reminders may help. Marketers have to determine
what the right mix is for the right set of consumers."
What effect on compliance, if any, will innovative mechanisms of drug delivery have for chronic diseases like diabetes? Pfizer's
Exubera (human insulin [rDNA origin]), for example, an inhalable insulin for type 1 and type 2 diabetes, just received FDA
approval and is expected to hit the market soon. Will patients be more receptive to inhaled insulin than to injections or
pills? Yes, according to at least one investigator on the Exubera team.
"Many people who could benefit from insulin are fearful of injections, so they delay treatment five years or 10 years, placing
them at risk for serious complications," says William Cefalu, MD, an investigator from Pennington Biomedical Research Center
who worked on Exubera. Cefalu feels the draw of fewer—or no—injections will bring more diabetics into treatment sooner. Will
the same principle apply to fast-acting medicines that melt under the tongue, such as allergy medicines, or inhaled through
the nose, like migraine treatments? Marketers will be watching very carefully.
Unforgettable: Lexapro and Effexor
It's Not What You Say...
The media that deliver pharmaceutical marketing messages also affect their impact.
"Even though awareness is high in several specific therapeutic categories, the messages are not serving the purpose of the
information," says Sue Ramspacher, senior vice president of GFK Market Measures. "When asked where they get the most helpful
information, people rate their doctors high. Advertisements are really down at the bottom."
This perception, thus far, has not been measurably affected by PhRMA's sweeping guidelines. "Despite messages being delivered
in a more somber, education-type format, DTC ads are still not being viewed as a big information source," Ramspacher says.
"It's a fact [that] magazine and newspaper DTC can be more helpful than TV and radio."
Electronic media—primarily Internet communications—continue to gain credibility in DTC messaging. Spending for the top-10
products in this channel took a dip in 2005, although AstraZeneca's heartburn medication, Nexium (esomeprazole magnesium),
and Novartis' toenail antifungal, Lamasil (terbinafine HCl), remain among the top-three spenders. Pfizer's Viagra (sildenafil
citrate) jumped into third place, up from seventh last year. Notable new entries to the top-10 Internet spenders in 2005 included
Sanofi-Aventis' insomnia-med, Ambien (zolpidem tartrate), and Eli Lilly's Cymbalta (duloxetene), for depression.
Are these Internet spends early signs of the new PhRMA guidelines at work? "I can't say I've seen a whole rash of solutions
come out on the Internet," Boehm says. But she thinks Lilly, with its combination TV and Web site campaign for Cymbalta (
http://www.depressionhurts.com/), may be on to something.