Merck's research ahead of the campaign showed that it was dealing with a situation in which only five percent of women and
girls surveyed could make the link between HPV and cervical cancer. After the campaign, awareness "rocketed to approaching
an excess of 50 percent," says Lybrand. "That was the key metric in terms of whether 'Make the Connection' was resonating."
Then came "One Less," the first ads to mention Gardasil by name. Once again, girls ran, jumped, and danced their way through
the spot while pledging to be "one less" cancer statistic—with their supportive mothers standing beside them. "The idea was
really to deliver on the strong and powerful message of empowerment," Lybrand says.
Physicians on Board
Analysts have predicted that the vaccine could be a blockbuster, and the early results are encouraging. In his December presentation,
Loescher pointed to some early markers. On the policy front, there has been "broad" professional and governmental endorsement.
In terms of payers, 80 percent of publicly eligible and 94 percent of insured individuals now have vaccine access. Among physicians,
about 50 percent of pediatricians are stocking the vaccine, to look at just one specialty. And among consumers, awareness
has increased 10-fold, and sales of the vaccine were $70 million in the third quarter of last year, the last period for which
numbers were publicly available at press time.
The launch of the vaccine also gave the company its first opportunity to unveil its new model for reaching out to physicians.
Having already pledged to cap the head count of its sales force, Merck redeployed reps to cover the growing vaccine division.
Professional outreach included online channels like video-detailing as well as encouraging physician-to-physician communication.
Education efforts had to be tailored to at least three different specialties. Pediatricians knew how to give vaccines but
many were less versed in the nuances of HPV. Gynecologists were familiar with the disease but their practices weren't set
up to offer vaccinations. Family practitioners skewed somewhere in the middle.
Merck provided unrestricted educational grants to professional societies to help physicians address issues ranging from vaccine
inventory, to legally required patient forms, to reimbursement. Vendors specializing in continuing medical education also
identified experts who could communicate with other physicians about the vaccine. "We developed resources to help offices
understand the logistical side," Haupt says. "We tried to give them as much information about the disease as we could."
To Be Continued ...
Merck execs like to talk about a turnaround for the beleaguered company. "We have the momentum and the credibility," Clark
told analysts back in December. "The good news is that we have not declared victory."
In other words, the story of the brand of the year is to be continued. The next phase will focus on whether the vaccine can
benefit women ages 26 to 45, as well as its efficacy in boys and men, 10 percent of whom will have at least one episode of
genital warts in their lifetime. Merck's researchers are also looking at long-term efficacy data as well as the vaccine's
ability to offer "cross-protection" against other cancer-causing strains of HPV. Finally, they are studying its concomitant
use with other adolescent vaccines.
"We're interested in determining the impact of the vaccine in the real world," Barr says. "With cervical cancer, it'll take
a couple of decades. What we hope to see in a shorter amount of time is a decline in the number of abnormal pap smears...the
number of surgical procedures."
The speed and urgency that's driving Merck isn't only about unmet need. The company needs to move fast to capitalize on a
first-to-market position, before GlaxoSmithKline's Cervarix throws its hat in the ring. (FDA is expected to review Cervarix's
application sometime this year.)
But it is clear from talking to the people who work within the Gardasil franchise that this isn't just another product launch.
It's a cause.
"The goal of the company was to create substantial, paradigm-shifting vaccines," Barr says, when asked why the company chose
to pursue HPV prevention more than ten years ago. "The burden of the disease in the United States was huge. This work was
really the result on the part of the company to focus on something novel."