Across the globe, only regulators in the U.S. and New Zealand permit pharma organizations to use direct-to-consumer advertising to sell prescription medications.
It wasn’t always this way.
DTC advertising for prescription drugs in the U.S. was only legalized in 1997 after successful lobbying by big pharma, explains healthcare consultant Reenita Das. And during the past two decades, the practice has earned its fair share of critics.
Common charges include misleading patients or eroding the patient-doctor relationship. Das cites an FDA survey in which 65 percent of physicians said DTC advertising sent confusing messages to the patients, and 8 percent said they felt pressure to prescribe a branded drug after patients cited a DTC drug advert mentioning a product.
Still, there are proponents of DTC advertising. Many in pharma and the broader healthcare community see DTC advertising as an effective means to encourage discussions between patient and doctor and to educate the public.
The precarious balance between information and marketing is precisely where medical affairs teams can apply their expertise to improve DTC advertising.
Of course, the U.S. public and physicians are right to place demands on pharma’s advertising. Vital safety and efficacy information is essential. A fact box, for example, would go a long way in improving public-pharma relationships. Dr. Steven Woloshin, co-director of the Center for Medicine and Media at the Dartmouth Institute for Health Policy and Clinical Practice, says a fact box listing in plain language would be valuable.
Woloshin and colleagues conducted a study of 231 participants, in which one group received advertisements with the brief summary and the other a drug facts box. The facts box helped 70 percent of patients correctly identify the safer and more effective drug compared with only 8 percent in the summary cohort.
A benefit of DTC advertising is that it facilitates dialogue surrounding illnesses and conditions. Merrill Matthews, resident scholar with the Institute for Policy Innovation, gives the example of the “iconic television commercial starring a cute white blob” explaining how serotonin levels affect mental health. The ad for anxiety and depression medication Zoloft helped to broach a previously taboo subject in the early 2000s.
Viagra is another example of how marketing encouraged men to seek help for a very private affliction.
It’s important, however, that DTC advertising encourages patients to speak with their physicians about a treatment. They should not make treatment decisions alone, but rather use the adverts as a starting point to find out more with their doctors, says Caryl Anne Crowne at DTC Perspectives.
Pharma might be better off focusing on digital channels in terms of creating effective marketing budgets. Marketing consultant David Impey says the assumption that every dollar spent on TV advertising brings back $2.10 is outdated.
In contrast, online advertising is closer to an ROI of 5:1 because target markets can be better defined. It’s also because television DTC ads tend to lack innovation resulting in “formulaic, safe, non-disruptive and boring from start to finish,” he explains.
Digital advertising would provide pharma with greater room to innovate and to be creative.
To succeed at connecting with patients via social media, pharma needs to be specific about its strategy. For a start, organizations should define their specific marketing goals using the SMART paradigm of Specific, Measurable, Achievable, Relevant and Timely, says Web Savvy Marketing founder Rebecca Gill. An example of a specific goal is to post five videos on social media platforms in the next 30 days.
Gill also says content must be meaningful so that it resonates with the audience. Understanding the patient journey is vital — a pertinent role of the MA team. Once the patient journey is documented, marketing teams can better engage patients.
Vital to any successful social campaign is understanding that pharma is no longer the sole gatekeeper of the information. Online communities, reviews and detailed analyses of drugs and pharma companies make the information far more democratic. The Digital Marketing Institute recommends creating value-driven branded content that informs prospective patients. This content would include identifying common pain points of patients, predicting and answering patients’ frequently asked questions — and ensuring all communication is transparent and engaging.
The DMI lists Johnson and Johnson’s ‘Care Inspires Care’ campaign as an effective example of value-driven content that was informative, emotive, eye-grabbing and disseminated through social platforms and blogs. The campaign encouraged users on Facebook to engage in random acts of care. The success of this campaign was its ability to connect with people on an emotional level.
There are certain principles that pharma should adhere to when promoting drugs on social media, such as the standards set out by the National Advertising Division and Federal Trade Commission, write lawyers Lawrence I. Weinstein and Alexander Kaplan at Proskauer Rose.
Care should be taken when advertisers share or retweet customers’ social media posts. Doing so could be tantamount to the advertiser making product claims. Pharma is also responsible for third party messaging such as when consumers share posts detailing their actions or decisions being based on an advertiser's campaign.
When it comes to accessing influencers to promote a drug, pharma companies must ensure influencers disclose any incentive offered to them.
The FDA makes the distinction between information and advertising, Weinstein and Kaplan explain. Any messaging that explicitly or implicitly promotes a specific drug is considered advertising. MA teams should lead information dissemination campaigns on social media that focus on disease awareness rather than how a specific drug could treat it.
One of the best defenses against criticisms and government interference is for the pharma industry to be better at self-regulation and self-policing, write Michael S. Wilkes, Robert A. Bell, and Richard L. Kravitz at Health Affairs. This requires transparency and ongoing communication with customers.
MA teams can lead the transparent messaging by providing price comparisons, details of benefits and risks. All messages should be written using plain language, rejecting technical graphs and pseudo-scientific jargon, and emphasize potential side effects, focusing less on the drug and more on the medical condition.
Whether advertising takes place online or on television, MA teams need to use their scientific knowledge and patient journey understanding to improve pharma messaging.
Yet the chasm between commercial and clinical within pharma companies is well documented. And it makes for an interesting analysis in relation to DTC advertising. It’s up to MA teams to bridge the gap, according to management consultant Bob Muratore.
In order to do this, MA teams need to focus on real-world evidence and also connect with patient advocacy groups to learn about patients’ experiences of their conditions.
MA teams are increasingly focused on forming better relationships with their colleagues in commercial departments. One way to achieve this is to encourage a culture of coordination and sharing insights, say Sarah Jarvis and John Bienko at management consultancy ZS. Three areas to focus on include:
Self-regulation from pharma is important as is understanding the requirements of the law and ethical questioning from the public. DTC advertising can be effective but it must ensure that patients are well informed of the potential complications and side-effects of treatments. Additionally, DTC advertising should encourage patients to seek further information from their doctors.
DTC advertising is an important aspect of the pharma marketing strategy, with social media offering a new connection between pharma and patient. When MA teams help embed the messaging with scientific knowledge, meaningful engagement can begin.
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