Differentiation has long been a priority among pharmaceutical advertisers working in such heated blockbuster categories as sleep aids, statins, and allergy medications. But now, with new evidence showing that me-too advertising is creating more category demand than individual brand loyalty, marketers are trying even harder to break the mold.

"Increasingly, these drugs are in competition with each other," said Owen Shapiro, vice president at Leo J. Shapiro Associates, a market research firm. "There's an adage in consumer goods: 'It's almost more important to be different than better.'"

Takeda is one company that seems to have taken this adage to heart, creating a stir with its new commercials for insomnia drug Rozerem (ramelteon). Instead of blooming flowers and refreshed men and women contentedly stretching after a good night's rest, the ads feature Abraham Lincoln, a beaver, and an astronaut taking over some hapless fellow's kitchen--with the tagline, "Your dreams miss you."

Shapiro's latest study found that more than half of patients (54 percent) will initiate discussions with their doctors about specific drugs--yet surprisingly, they were more likely to ask about generic equivalents than the brand itself (48 percent versus 16 percent). Moreover, patients who ask for generic equivalents are more likely to request drugs "fairly often" than those who ask for branded drugs (70 percent versus 49 percent).

The numbers suggest that consumers are paying attention to pharmaceutical promotion, but they're also more sophisticated about issues like drug prices and bioequivalence.

The study is not the first to question the return on investment of direct-to-consumer advertising. In 2002, Dick Wittink, a professor of marketing and management at Yale University, found that DTC ads--because of their scattershot approach--provided the highest ROI for large brands that were recently launched. For smaller brands and those that were later in their lifecycle, medical journal advertising was the suggested approach.

More recently, 48 percent of drug marketers noted that difficulty measuring ROI from DTC campaigns was a significant concern in 2006--one of their top three, in fact, according to a study from the Medical Broadcasting Company.

Yet companies continue to spend heavily on DTC advertising: Between 2000 and 2005, spending grew 80 percent to reach $4.6 billion, according to Verispan.

Consumers are getting information about specific drugs (brand and generic) from their own independent research, particularly on the Internet. Yet pharma companies are just beginning to target this medium.

"The reality is: It's hit," said Mark Bard, president of Manhattan Research, of the trend toward online consumer health research. "This is the way people get information today."

Manhattan Research's latest consumer study found that 53 percent of adults use the Internet to find healthcare information. They're twice as likely to turn to the Web as to television, and twice as likely to be satisfied with what they find. "It's control," Bard said.

To draw consumers to brand Web sites, pharma companies need to think about tools such as search engine optimization, to make sure their sites are readily found by search engines like Yahoo and Google. In addition, once they find a site, consumers want to be able to communicate directly with the company (to request additional information, for instance)--something that 80 percent of pharma sites don't offer, according to Bard.

"Pharma for the most part, in terms of [consumer experience], is arguably behind most other industries," he said.

Articles

Studies show pharma has succeeded at raising disease awareness. Brand loyalty, though, has suffered.

Good News, Bad News

After the termination of clinical trials for torceptrapib, Pfizer's hold out for softening the blow of losing patent protection on mega-blockbuster Lipitor, the company is fighting to hold onto its reputation as the industry's most enviable marketing powerhouse.

In typical Pfizer fashion, the company has amplified marketing and promotional efforts around the world's best-selling drug--despite cost cutting in sales and operations that began late last year and will almost certainly accelerate in light of the torceptrapib news.

For the second consecutive quarter, Pfizer was one of the most aggressive contractors for preferred formulary status with managed care organizations (MCOs) and pharmacy benefit managers (PBMs)--and Lipitor (atorvastatin) was the brand that came up in negotiations again and again, according to consulting firm Cognet-X, which conducts weekly surveys of MCO and PBM executives.

Respondents revealed that Lipitor and Exubera (Pfizer's much-hyped inhaled insulin product) were the most heavily promoted brands in the third quarter.

The addition of generic simvastatin to the statin category this year left not only Pfizer but also AstraZeneca fighting tooth and nail to retain market share. But unlike Crestor (rosuvastatin) and Vytorin (Merck/Schering-Plough's ezetimibe, simvastatin combo), Lipitor experienced a downturn in the number of formularies that listed the drug on a preferred tier.

Pfizer executives "don't want to lose market share to the generics now," said Sharon Bender, executive director of strategic initiatives at Cognet-X. "That's their flagship product; they have the most riding on it. Its importance to Pfizer cannot be overstated."

Even in its defensive position, Pfizer is still playing hardball--battling not only for preferred status but also to eliminate restrictions like step therapy and prior authorization that can keep patients off the drug. The company also has been offering rebates for other Pfizer products when Lipitor was given preferred formulary status.

But Bender noted that the company is likely to face greater hurdles next quarter. With the loss of torceptrapib, Pfizer's desperation is well noted. "I wonder if there will be a perception in managed care that it's a buyer's market," she said.

But contracting is just one area where Pfizer is focused. The company in April launched a new advertising campaign for Lipitor, the theme of which highlighted its benefits and cost-effectiveness. The company has also conducted additional post-marketing studies on Lipitor, in order to differentiate it from its competitors.

Yet with Pfizer's plan to cut 20 percent of its sales force--a figure that could likely increase--the company's in-house and agency marketers are questioning whether there could be reverberations on their side of the business as well. After the first round of sales force cuts last year, Pfizer cut its promotional budget 15 percent, perhaps foreshadowing things to come in 2007.

But John Kain, vice president of marketing at ImpactRx, noted that Pfizer is not about to pull promotional support from its biggest earners or most promising new brands. The company might actually increase its journal adverting or consumer outreach to make up for lost detailing opportunities. "They're not just going to go quietly into the night," Kain said. "They're just too smart to do anything really blunt."

The company itself has pledged to maintain "strong" sales support for Lipitor, Celebrex, Geodon (ziprasidone), Lyrica (pregabalin), Exubera, Chantix (varenicline), and Sutent (sunitinib).

On the advertising side, Pfizer remains dedicated to its mature brands. This year, it launched new direct-to-consumer campaigns for Viagra (sildenafil), Celebrex (celecoxib), and Zyrtec (cetirizine).

With time ticking on Lipitor's patent, Pfizer is pulling out the stops to make the best of what valuable time it has left.

Clock Watchers

Could Acomplia be the next diabetes drug?

Sanofi-Aventis appears to be saying "yes"--at least in Europe, where it has been approved since June as a weight-loss agent. The company also seems to be building an arsenal of data to promote the drug's anti-diabetic benefits if and when the drug gets approved in the United States.

Sanofi-Aventis' recently completed Serenade trial--the second to look at Acomplia's (rimonabant) effect on blood-sugar levels--showed that the drug not only helped patients with weight loss, but also lowered blood sugar. Type 2 diabetics taking the cannabinoid type 1 receptor blocker had better blood sugar and weight control, higher HDL levels, and lower triglycerides than patients taking a placebo.

Spokeswoman Julissa Viana would not comment on whether the company would seek to market Acomplia as a treatment for diabetes or pre-diabetes. But company officials have been positioning Sanofi-Aventis as a growing player in the $20 billion global diabetes market. In a presentation at last month's Credit-Suisse conference in London, two executives from marketing and medical affairs outlined studies on how Acomplia reduces heart risks.

There are big bucks at stake. While some European countries are reimbursing Acomplia, other major markets--Germany, most notably--are not. If Sanofi-Aventis wants to get the drug on Europe's publicly funded formularies, it needs to position the drug as more than a lifestyle treatment. A diabetes indication would likely do the trick.

Viana noted that reimbursement considerations were not the reason the company undertook the study. "The purpose of the program was to add to our knowledge," she said. "There's value in pursuing additional trials."

The blood-sugar data has also been used to win over physicians, and diabetes specialists and cardiologists have been core audiences for professional promotion efforts. Marketing messages have focused on how obese patients with heart risks will have a greater benefit from Acomplia than those who take the drug only for cosmetic reasons.

Marketers are also trying to reinforce those messages to European patients. Through the company's "It's What You Gain" program, patients have access to a Web site and phone number, motivational tools, and educational information about Acomplia.

Sanofi-Aventis, which works with a number of Publicis agencies across many of its brands, including Acomplia, in February received an approvable letter from FDA for Acomplia's weight-loss indication; additional information was submitted in late October. The user fee goal is April 26, 2007, according to the company.

Recent drug trials, and marketing efforts in Europe, for Acomplia indicate that Sanofi-Aventis may be seeking a life-threatening indication for its much-hyped weight-loss drug.

Pharmaceutical Executive-12-13-2006

Good News, Bad News

Clock Watchers

Lifestyle Decision