Rules and Reps Mix it Up

Of course, other industries don't labor under the same regulatory strictures that pharma must endure. And regulatory additions like the Physician Payment Sunshine Act and DDMAC's heightened sensitivity to non-kosher ads have now made promotion even more of a balancing act. Giants like Pfizer and GlaxoSmithKline have received warnings from FDA over various campaigns, both DTC and professional, and the agency is showing no signs of resting on its regulatory laurels.

Professional marketing via sales reps took a dive last year; with the sales force often the first to feel the heavy hand of cost-cutting, companies felt the need to divert funds to culling new customers via DTC. Of the respondents to a Cegedim Dendrite study on DTC who anticipate an increase in spending in 2010, nearly half said that increase would result from a shift to targeted DTC. Add to that the increasing need for vagueness in DTC ads, and you've got a recipe for double the DTC spend on certain brands—which is what TGaS found. "You have to spend more money to achieve the same level of educational effect and overall presence," Wray says.

Part of the solution to the effectiveness problem also comes in the form of online ads. "With an ad on a site, at least users can click to get more information," says Thorbahn. "On TV or in print, you're left with these reminders or unbranded ads, where the likelihood of getting someone to call the one-800 number or visit the Web site is much lower"—though Web promotion during a TV ad (something as simple as a "For more safety information, please visit our Web site at http://www.product.com/" tag) has shown a definite increase in traffic. While it may seem difficult to measure the impact that tag has on traffic, Wray says there are two ways to do so: Create a unique URL that consumers wouldn't enter without prompting from an outside source (i.e. Cymbalta's http://www.depressionhurts.com/), or just look for a correlation between increased offline ads and traffic.

Paid search ads (the ones you see next to your search results on Google, for example) aren't as easily monitored as display ads that appear at the top of your homepage of choice, so the importance of ad verification is also on the rise. Razorfish that notes as a portion of the budget, ad verification went mostly overlooked in 2009. Ad placement is as crucial online as in traditional media; a Viagra ad appearing next to a result for a Web site with high tween traffic leads to just as low an ROI as a Viagra ad in Teen Beat magazine. Thus, 20 percent of the Razorfish respondents indicated a desire to at least dip their toes in the verification pond, using third party vendors to shoulder the burden.

Another challenge stemming from sales cuts—from personnel to overall spending—is finding more efficient avenues for professional marketing. The answer here, too, lies in the online space. Healthcare professional portals (HCPs), besides being cheaper than thousands of physician calls and sample drops, are an easy way to engage with HCPs without incurring the wrath of FDA and the public at large. TGaS found that companies have actually incorporated these portals into their natural cost of business; they no longer have to show ROI for these expenses. The same goes for the essential product site, which not only provides another dimension to a campaign, but also helps with regulatory compliance via those site-direction tags in traditional ads. Rather than going through all the prescriber's information (PI) on-air, companies can offer a subset and tell the viewer where to find the complete PI.

But not all pharma companies have been sitting back on their heels the last five years or so. Merck was far ahead of the curve in its series of Gardasil campaigns, launched when the drug hit the market in 2006. The company seamlessly integrated static and non-static Web, unbranded, and traditional DTC ads into cohesive, intelligently evolving campaigns aimed straight at young women, drastically boosting visibility (and even earning it Pharm Exec's first Brand of the Year designation in 2007).