Advertising workshop

pharmafile | September 7, 2005 | Feature | Medical Communications |   

The investment risk in developing a profitable brand is huge and with every new brand launch comes escalating expectations. At the same time a dearth of new blockbusters and an influx of generics have served to magnify the importance to pharmaceutical companies of making each new brand launch a success.

These days, changes to the pharmaceutical environment, such as the shift away from GPs having complete control over their prescribing decisions, have had a knock-on effect on the make-up of launch campaigns. The days of a typical brand launch involving nothing more taxing than a novel advertising concept supported by a GP-targeted mailing campaign could now be history.

Instead, launching a brand has become a much more complex process, throwing up more and more hurdles over which new treatments must jump if they and their product managers are to be successful.

Mike Lane, managing director at Lane Earl and Cox Advertising, has been involved in the launch of some of the industry's biggest blockbuster drugs: Pfizer's Lipitor, Merck's Vioxx and AstraZeneca's Symbicort, and believes pharma companies are facing an increasingly challenging route to brand launch.

"The countries comprising the UK are allowing or disallowing new products using different criteria. The outcome might eventually be that a company would only promote its new product in Scotland because NICE has decided not to recommend it in England," said Lane.

NICE guidance is often needed for the most innovative and expensive brands while the Scottish Medicines Consortium (SMC) and the All Wales Medicines Strategy Group (AWMSG) want to review all brands launched and give their local approval for use.

A negative review from NICE can have severe repercussions for pharma companies, making it extremely difficult for them to encourage the use of their new drugs, even when they have clear clinical and therapeutic advantages.

"Cynics might argue that there is a clear correlation between premium priced products and a negative review from NICE," says David Higgins, managing director at Saatchi & Saatchi Healthcare. "None the less, the more expensive a product is in comparison to its competitor's, the more advantages it has to show to stand a chance of succeeding."

Symbicort and Losec

So what makes a successful brand launch? One instructive example would be Lane Earl and Cox's advertising campaign for AstraZeneca's asthma treatment Symbicort, which was heralded as the most successful ad campaign for generating awareness in 2001.

The campaign was designed specifically for the local UK market, having been tested against global executions. The key to its success, according to Mike Lane, was that it eschewed traditional thinking that the advertisement has to be a synthesis of the selling message.

"We reasoned this message was a complicated one, and should therefore be primarily communicated via the field force. This freed up possibilities for the imagery for the advertisement, and allowed us to create an aura of something big happening in the field of asthma," adds Lane.

This approach enabled AstraZeneca to build expectations for the brand among the medical community that the company's field force could then respond to by giving doctors  the complete story about the new product.

A different path was followed by LEC's work on the launch of Schering-Plough's hay fever treatment NeoClarityn. In this case the creation of the new brand's identity was driven by the success of Clarityn, the product it was following on from.

"We wanted to present the drug as the natural successor to its parent Clarityn. The simple imagery of a goldfish with a strapped-on shark's fin captured this brilliantly," Lane says.

He admits that other executions had tested better, but by going with their intuition the agency and product manager were rewarded with NeoClarityn becoming market leader just 13 months after launch.

Though these campaigns were successful, there are many creative, award-winning campaigns that failed to stimulate sales.

Pitfalls and challenges of launching a new brand

Although there may be no hard and fast rules for launching a new brand, there are several suggestions for how not to do so. "Don't test a new campaign to death," says Lane. "Some of the most iconic consumer campaigns were launched without being tested – if they had been, they would have bombed, so sometimes a marketer needs to play a hunch."

The stage of a product's development at which pharma companies involve their advertising agency of choice is another area of contention. "Phase III or even earlier is ideal for the ad agency, as opposed to being bought in to finish off the salesforce materials just before launch," says Higgins. "Being involved earlier in the process means the agency can contribute to the strategic thinking and add value to the marketing effort."

He defines the ideal relationship for new brand launches as one of trust and mutual respect between pharma and agency. Armed in this way, the agency can be placed in a position to offer strategic advice and act as a sounding board for its client as well as producing its best work.

Changing the ground rules

Lane and Higgins both accept that tighter regulation on drug promotion is inevitable in the wake of the Vioxx affair and sustained criticism of the pharmaceutical industry's marketing practices. But opinions differ as to whether this will be a good thing or not.

Lane believes that plans by the MHRA to vet new promotional materials will serve to reassure stakeholders that campaigns are approvable and legal, rather than seeing pharma companies being caught out after a campaign has been launched.

Higgins, meanwhile, thinks the anticipated tightening of promotional activities in the ABPI's revised Code of Practice will significantly impact on how pharma communicates with its target audiences and the channels used. Either way it seems to presage another change in the way new brand launches will be conducted.

MARKETING TO PATIENTS

The landscape for marketing to consumers is undergoing a fundamental change as companies reassess the sort of communications they should be producing.

The industry is under increasing pressure to prove it acts in a responsible and ethical manner, which impacts on how it provides information to the public.

"Organisations are being held up as being either unethical or inappropriate in the way in which they are marketing to consumers, none of which I frankly feel is true," says Ian Busby, client services director at Paling Walters. "So they are taking an even more ethical stance in the way in which they choose to promote."

This doesn't mean consumer marketing is being abandoned. On the contrary, analysts Frost & Sullivan expect spending by the European pharmaceutical industry on communicating with consumers to grow from its current $85 million to reach $345.5 million by 2008.

US-style direct to consumer advertising, has never been allowed in Europe,  restrictions allowing only informative exercises  known as disease awareness campaigns in the UK.

In recent years there have been a number of notable disease awareness campaigns. The UK's first-ever disease awareness campaign was Stepwise, produced by Norris Lincoln Adcom for Novartis. The long-running campaign, which focused on raising consumer understanding of fungal nail infections, used a variety of different media.

Stepwise was followed by a number of other campaigns, including celebrity-fronted ones for erectile dysfunction.

Viagra's manufacturer Pfizer enlisted football legend Pele for its cause. Meanwhile, Levitra manufacturers Bayer and GlaxoSmithKline worked with UK advertising agency Langland for its own awareness raising – the SortED in 10 campaign featuring racing driver Sir Stirling Moss.

Frost & Sullivan consumer marketing is evolving a more comprehensive approach focusing on improving patient outcomes and adding value. This changes its focus to something more accurately termed direct-to-patient (DTP) communications.

DTP involves providing patients with educational materials after their doctor has made a prescribing decision. It aims to inform patients about their condition, with the agreement and approval of their doctor and so leaves the prescribing decision entirely to the doctor.

A DTP initiative could be as simple as an information leaflet for doctors to give to patients about their prescribed treatment, but companies are also producing more ambitious support programmes.

A good example is Roche's Motivation, Advice, Proactive Support (MAP) programme for its obesity treatment Xenical. MAP offers Xenical patients access to dietary advice and information and help with setting treatment goals. Patients are told about it by their GP or pharmacist and given a freephone telephone number for a call centre where they can speak to either a dietician or nurse trained in nutrition. Monthly newsletters, food diaries, fat and calorie counters and pedometers are also offered at various stages of the programme.

MAP adheres to concordance principles by encouraging patients to set their own goals and build on small successes in partnership with their healthcare professional.

Patients on Abbott Laboratories' rival obesity treatment Reductil can access a similar programme while GlaxoSmithKline offers patients taking Nicquitin CQ its Committed Quitters programme to help them stop smoking.

This approach aims to promote a virtuous circle: helping patients to use medicines properly, leading to doctors recording better outcomes and boosting the health economic arguments for pharma to promote.

One potential problem with DTP is that it could be misunderstood and viewed by the medical profession as mere marketing spin.

"If DTP is used as a straight marketing tool and doctors are not kept in the loop about what you are doing and why, then scepticism creeps in about whether you are marketing products to patients, which shouldn't be the  programme's intention," says Busby.

In the post-Vioxx world pharma companies are already changing their marketing tactics and DTP activity is one way to do this.

GOING GLOBAL

Pharma companies are under increasing pressure to maximise sales in as short a time as possible, with most first-to-market drugs enjoying just months rather than years before a competitor is launched.

This pressure is one of the many which has fostered the developement of global promotional campaigns. If successfully executed, such a campaign can offer pharma companies a number of advantages in terms of costs and the unity of brand identity.

But John Perkins, client services director at Rapp Collins Consumer Health says the core benefit from working on a global scale comes from the degree of control it affords companies.

"Successful global advertising in the pharma arena is an exercise in control of key messages that generate cost savings where possible. If the campaign is globally controlled, the global team can be sure all markets will run with an execution that best communicates the key campaign message as accurately as possible," he says.

Cost savings come from only having to develop a single campaign template, which is then rolled out across the necessary territories. Despite the prevalence of the model, it has some critics.

Philip Chin, managing director at Langland, says he remains unconvinced the approach works in all cases, and cites a lack of supporting data.

"For brands that have already been launched in different markets and have established brand identities it may not even be commercially sensible to try to realign them under a single global campaign," he adds.

The main stumbling block for a global campaign is how it will be perceived in the various global markets – cultural differences and mis-translations can easily derail the strongest campaign and should never be underestimated.

"Just translating a concept from one language to another may destroy its meaning or, worse, result in a negative impact," says Michel Dubery, a partner at Rapp Collins. He cites the example of 'control', a concept that is frequently used to promote pharmaceutical products in English as a marker of effectiveness. However, the equivalent word in French or German carries with it negative connotations of being checked up on.

The size of global projects presents another practical consideration for pharma companies.

"The large number of stakeholders involved means you need to factor in much more time to gain approval for the work compared to a campaign required at a national level," says Chin.

He warns that global branding should not be another reason for stifling genuinely creative thinking, which can help differentiate your brand.

"When it comes to making decisions on what creative work to pursue, be mindful of not simply ending up with the concept that all members of the team felt they could live with.

"Remember, great advertising very often polarises opinion. Companies need to focus on selecting the best work, which may on occasions be the work that makes the team feel a little uneasy."

In terms of the markets in which a campaign will be used, Perkins suggests prioritising them according to their worth. "It is crucial not to get distracted by vocal colleagues in smaller markets that do not represent significant sales," he explains.

But for Chin the process should be as inclusive as possible. "Getting great work out at the end of the day requires the full co-operation of all stakeholders involved in the process," he says. "Companies need to avoid the phrase so often cited regarding global campaigns: 'I can't use this here – they don't understand my market."

Reductil

Abbott Laboratories markets the anti-obesity treatment Reductil, or Meridia as it is known in the US. The company wanted to use a global direct-to-consumer information campaign to increase the awareness of obesity and the prescription treatments available and commissioned Rapp Collins Consumer Health to do this for them.

"We needed to arrive at a campaign that drove consumers to have an informed discussion with their healthcare professional," Dubery explains.

For what became the I Decide campaign, the agency developed a centralised strategy and creative execution templates to aid the planning and development of local activity. This strategic approach was fine-tuned through research in four countries to validate it.

Press and poster activity centred round the creative theme I Decide using the idea that 'weight loss starts from within' and featuring people recalling the moment they decided they wanted to lose weight  Rapp Collins says the campaign proved extremely successful.

The global future

Dramatic increases are predicted in the number of global campaigns pharma companies will undertake, certainly over the next five years. Whether or not these predictions prove true, some advertising fundamentals will continue.

"When all is said and done, the most important thing at the end of the day is ending up with a great idea for the campaign," says Chin. "What companies do not want to end up with is poor creative work simply being replicated all over the world."

BELOW-THE-LINE

Below-the-line campaigns offer pharma companies the opportunity to talk directly to their customers. This can be done through the field force, using traditional sales materials such as sales aids, leave-pieces or patient information leaflets, or remotely through direct mail or electronic media.

By nature these are short-term tactical tools that are used to achieve a specific marketing objective within a defined time period and, as such, form an essential part of the brand's long-term strategy.

With GPs and clinicians under increasing time pressures, it becomes more difficult for the field force to gain direct access to their target audience, hence the need to look at alternative or additional promotional resources.

Julian Hamilton-Smith, account director at Swordfish Advertising, says: "If possible, and budget permitting, the campaign should try to spread itself across all the promotional options available. In a finite time period, the target audience needs to get the message as soon as possible."

Given that healthcare professionals already receive a plethora of mailings every day, direct mail and other forms of remote contact have to overcome similar problems to those experienced by the field force if they are to be successful -including cutting through a the promotional 'noise' that is presently in the marketplace.

Another consideration is the way pharma's target audience is becoming increasingly segmented as other stakeholders, such as nurse and pharmacist prescribers, enter the frame.

For a below-the-line campaign to be effective, it is important to have something compelling to communicate to the target audience  something that will resonate with them and give them a good reason to prescribe more.

"It is preferable to introduce a new campaign in line with a particular event, such as the launch of a new brand, a line extension or new supportive evidence," says Julian Hamilton-Smith. "It also helps to be able to launch the campaign at a special event, like an exhibition or conference, where the potential target audience will be concentrated.

"Alternatively, the timing of a new below-the-line campaign could be specifically designed to disrupt the launch of a new competitor product or conversely be timed to avoid being lost in the noise from other events."

Calcichew-D3 Forte Flexi-man mailing

Shire's Calcichew-D3 Forte is a treatment for osteoporosis that helps strengthen weak bones. Swordfish's campaign  involved sending doctors a small, red tube containing a small, limp wooden figure with a label carrying a Calcichew-D3 Forte logo and a message, which read: 'Maintains healthy bones in the at-risk elderly.' At the end of the label is a request for the doctor to pull the pin out, resulting in the small figure standing straight and upright.

The creative execution was completely relevant to the message we wanted to convey, explains Hamilton-Smith.

"It is wrong to create a below-the-line campaign that is creative for the sake of just being creative, which can be extremely irritating for the target audience and can have a negative effect on the brand."

Ultimately, then, a below-the-line campaign, as with any above-the-line campaign, must stand out from the crowd and be memorable in order to be effective.

Hamilton-Smith suggests pharma companies planning to conduct a below-the-line campaign consider the following points:

• Create a dedicated campaign team, including all relevant stakeholders
• Try to find a clear differentiation between your brand and the competition
• Define the marketing objectives within the promotional strategy and stick to them
• Distil selling messages to as few as possible and integrate them across all marketing tools
• Set a budget, to define the campaign's limits, and make it work as hard as possible for you
• Ensure all elements support the brand's strategic objectives and keep message and brand consistent in all campaign materials
• Establish the campaign's priority amongst the field force portfolio.
• If you are the product champion, be single-minded about what you want to achieve

"But it's not all about planning and timing," Hamilton-Smith concludes. "It's also about creativity. The campaign, no matter how small, must try to stand out in a crowded marketplace."