Pharmaceutical marketing: just what the doctor ordered?

Marketing to physicians and directly to consumers has become a common practice for drug marketers with advertisements for prescription drugs appearing through many channels of the mass media. Indeed, so effective is this form of advertising that investment in pharmaceutical marketing has skyrocketed in recent years. In 2000, pharmaceutical companies spent US$2.5 billion on mass media pharmaceutical advertisements, but by 2003 this number had increased to over US$3 billion and last year an estimated US$7.5 billion was spent on direct-to-consumer (DTC) advertising.

Despite concerns regarding the practice, DTC was permitted by the FDA in 1997. Since then, drug companies have been allowed to advertise prescription drugs through a variety of media including newspaper, magazine and TV. Currently it is only legal in the US and New Zealand.

Many argue as to the necessity of advertising prescription drugs and medicine in the same way as other consumer products, whilst others believe that the communicating of information is essential to help patients make an informed healthcare choice. Whatever the final diagnosis, drug marketers must ensure that promotion is delivered in a responsible and astute manner.

Building loyalty

Advertising prescription drugs to consumers is a tricky business, most obviously as they are not products consumers choose to buy, but rather purchase out of necessity. For drug marketers, it isn’t a case of convincing consumers that they are ill; instead, it’s about persuading patients that their product is the most effective available on the market.

However, building brand loyalty is a difficult task in any industry. The pharmaceutical industry has firmly established principles for its marketing, but these rules are slowly having to be adapted as patients become more information-savvy and demand more choice and freedom when making important decisions about their healthcare. Differentiation is the key, particularly in a market where specific medicines produced by a number of different companies, such as Asprin, contain virtually identical ingredients.

For most consumers, the number one concern when choosing a pharmaceutical product is how a particular product can benefit them and improve their well-being. Communicating these benefits in the most effective and simplest terms is a priority for most pharmaceutical companies. “The important evolution for the marketing of drugs is that people as consumers are less focused on what is in it and rather on how it improves their life,” argues Jim Priors at The Partners, a branding and design agency whose clients include Pfizer. “Ways in which the communication can be made are pretty critical to building the relationship between the consumer and the brand.”

For many pharmaceuticals, branding has remained fairly rigid for many years, following set formulae with features that are distinctive and recognizable. In her article “Semiotic Codes in the Pharmaceutical Industry,” Diane Fox-Hill, a Semiotics Expert at international product design and innovation consultancy PDD, describes how pharmaceutical companies rely on a tried and tested ‘rhetoric of science’ that reassures consumers that the product is dependable and beneficial. These products achieve credibility with consumers as they communicate ‘authority, trust and science’.

Some of the idiosyncratic features of pharmaceutical packaging that Fox-Hill identifies include lots of white space, large blocks of conservative color (usually blue or red), use of straight lines, and use of specific symbols such as heartbeats or triangles. The author identifies how other industry sectors have ‘borrowed’ these techniques to make their products look more convincing. Good examples can often be found on food packages that mimic some of the codes used by pharma packaging to ‘give the impression of a scientific approach’. This also works the other way, with drug companies ‘borrowing’ marketing techniques from other sectors in an attempt to appear more ‘friendly’ and distinctive and less clinical.

Many pharmaceutical marketing projects suffer from a lack of direction when re-vamping their products, and need to perfect the balance between maintaining a scientific look whilst also appealing to consumers on a more relatable level, argues Fox-Hill. “I’ve seen instances of drug companies re-branding themselves, but without actually thinking about where that re-branding is taking them,” says Fox-Hill. “They’ve come up with a much softer and interesting image and it looks great, but it doesn’t necessarily look as plausible as it could do. There’s a question of tone and adjustment. It’s not that they have got it wrong, just that they haven’t sufficiently thought though all the messages. At the moment, they want to have a foot in both camps. That’s fine, but there has to be a balance between being medical and being friendly.”

According to Fox-Hill, pharmaceutical companies lack a sense of urgency to improve their marketing techniques. As a result, there is a likelihood they might suffer in the long-term. “A lot of drug companies are used to making a lot of money and that can breed a lot of complacency when it comes to their marketing,” she argues. “Many rely on the fact that their product is better and therefore it will sell better. However, what the consumer sees as better isn’t necessarily what the pharma company sees as better.”

Spreading the word

The internet has become one of the most effective knowledge channels in recent years. As a result, patients are able to surf the internet for information about healthcare, thus becoming less reliant on doctors and other medical experts for advice. Additionally, consumers now rely very much on peer networks for advice and recommendations on reliable and dependable products to buy. In response, drug marketers are trying different approaches, most predominately to speak to consumers on their level rather than too authoritatively, which has been the case in the past.

“For drug marketers, the trick is to acknowledge that people have access to more information and have a demand and appetite for much more. They need to create a partnership dialogue between the brand and the consumer, rather than what has historically been an adult-child relationship,” advises Prior.

“Before, the brands and the doctors would tell the consumers what was right for them. That has now changed. The opportunity now is to create dialogue, connection and to have some new areas beyond the delivery of drugs as product,” adds Prior.

Pros and cons

There is no doubt that DTC has had an enormous effect on the pharmaceutical industry, although there are many pros and cons associated with this kind of advertising. In support of DTC, the approach certainly provides information about products, empowers consumers and provides them with the necessary knowledge to make more informed decisions regarding their health. Consumers are made aware of the existence of certain products that they may not have known existed beforehand.

“The increase in DTC marketing has resulted in creating more educated patients – which, in turn, has encouraged a steadily growing number of them to take control of their treatment,” enthuses Betty Rhiew-Breslin, Director of Marketing for the Women’s Healthcare/Dermatology Business Unit at Biovail, a Canadian-based pharmaceutical company. “More patients are doing research on the treatment options before they see their doctor. In addition, more patients are requesting a specific branded drug product that they have seen advertised for their treatment.”

This view is also supported by Gary Howes, Head of Health Sciences and Commercial IP at commercial law practice Stringer Saul LLP, who agrees with the approach. “It does raise people’s awareness about the availability of certain treatments,” he suggests. “Patients might not have been aware that certain products existed in the first place. For example, you may be on an existing long-term treatment, and a more effective treatment is developed – but it is unlikely your clinician will proactively contact you about it, it will possibly only come to light when you go back to the doctor.”

Many medical professionals have also show their support for DTC, claiming that patients ask more thoughtful questions during their visits and are more aware of possible treatments. On the other hand, there is no certainty that advertising pharmaceuticals has a positive effect. One concern is that seeing an advert might convince people that they have an ailment or condition, thus persuading people to take something they might not need. “Pros put forward are that DTC drug advertising can lead to a more informed, health-conscious, public. The other side to that is that a person sees an advert and it mentions a few symptoms – and they think they have the disease even when they don’t,” warns Howes.

This view is also shared by Prior, who identifies the seriousness of supplying patients with drugs they don’t need. “The argument against is that we can’t afford to create demand for products that aren’t actually best for the consumers. It’s bad for consumers and it is bad for doctors and prescribers. It damages the patient-doctor relationship if people are coming in potentially asking for things that they shouldn’t. This creates significant risk. Pharma companies and communication companies have a responsibility – they need to take an assertive moral stance on what and how they market to ensure that the best interest of the public is also taken on board.”

Doctor’s judgment can also be seriously undermined if they are pressured into supplying prescriptions that they deem unsuitable for the patient. Doctors may be entitled to consider the value of their position if their judgment is overruled by patients in favor of marketing by specific drug companies. “The worst possibility is when patients insist on a particular treatment they have seen advertised, which isn’t necessarily what the physician thinks is best for them,” says Howes. This can break down the trust between the physician and the patient.

Broken trust

One of the biggest challenges drug companies face is overcoming the sensitive issue of trust, which has deteriorated between consumers and drug companies. Drug companies are viewed with apprehension and suspicion by consumers who consider them to have an emphasis on profits above all else. Repairing this damage is likely to be a long-term and difficult process.

“Consumer anxiety needs to be combated,” says Fox-Hill. “All the pharma companies have a huge problem with trust. The only time trust isn’t a problem is when a product is so price-sensitive that consumers have no choice but to choose it. Where there are other issues, then consumers are asking questions. They do need to provide us with more information and to write in plain language that consumers can understand. Drug companies aren’t helping to engage with the consumer and to create trust. Better communication is essential as trust is already damaged. If they want to up their bond and improve consumer loyalty then they need to reach the consumer on their level rather than talking down to them.”

Looking ahead

As the internet continues to provide masses of information, consumers’ appetite for more knowledge regarding their health and well-being is likely to grow. The internet is a perfect tool to search for answers without any constraints. It also provides pharmaceutical companies with an opportunity to reach millions of potential customers “The growing emphasis on the web and online marketing initiatives is definitely going to continue to increase,” explains Rhiew-Breslin. “Doctors are increasingly pressed for time in terms of trying to maximize the number of patients they see during office hours. This can create a challenging environment for a pharmaceutical sales representative who is trying to see a doctor and convey key messages relating to the therapeutic benefits of their medicines. A great way to complement the sales force efforts is with online initiatives, such as e-detailing, whereby you reach the physician when he or she is more amenable to learning more about your brand and/or products.”

Building a better relationship between consumers, healthcare professionals and drug companies is also likely to become much more apparent. Drug companies are slowly beginning to realize that an ethical image is crucial to attracting and retaining customers. “We will see much more dialogue between consumers, healthcare professionals and drug companies,” foresees Prior. “The whole ethos of people in the world and how they interact is changing – they will expect brands to act in a responsible and meaningful manner, and will enter into relationships with businesses and brands that meet the expectations people have of them. Dialogue and listening will be important.”

As competition continues to increase, so will the need for pharmaceutical companies to improve and adapt their marketing to attract customers. Building back trust must be the first crucial step. What’s needed is for drug companies to inject a dose of balanced and impartial information into their marketing, whilst striving to preserve the all-important physician-patient relationship through putting the public’s needs before their own. Achieving this may halt any impending advertising overdose.