Healthy Skepticism Library item: 14281

Warning: This library includes all items relevant to health product marketing that we are aware of regardless of quality. Often we do not agree with all or part of the contents.

Publication type: news

Dolliver M.
Big Pharma: Tough to Swallow
AdWeek 2008 Sep 8
http://www.adweek.com/aw/content_display/special-reports/other-reports/e3ic8fa818f78acd577e61a0c8a1679329a?imw=Y

Abstract:

People know they need Big Pharma (ads and all), but they still don’t like it

Full text:

Studies have found a complex landscape of consumer attitudes toward pharma companies and their ads.

If complaining about the pharmaceutical industry were good for one’s health, Americans would be remarkably robust. Sure, Big Pharma’s products often cure what ails us, despite our unhealthy habits. But this hasn’t saved the prescription-drug industry from becoming a target of consumer resentment, as opinion surveys consistently demonstrate. Indeed, the fact that we need these products — sometimes as a matter of life and death — seems to make us all the more irate that companies make profits by selling them to us.

Beneath this general atmosphere of hostility, though, lies a more complex landscape of attitudes toward pharmaceutical companies and the ads with which they target consumers. People are eager to be educated about medical conditions and possible treatments of them, and polling shows they view consumer-targeted ads for prescription drugs as a valuable source of such information. If, for example, women are starting to understand something as arcane (but important) as the link between human papillomavirus and cervical cancer, it’s because marketing efforts for a vaccine named Gardasil have introduced them to the topic.

Give consumers a chance to badmouth Big Pharma in general, and they’ll seize the invitation. Indeed, a Gallup poll last month found people taking a dimmer view of the pharmaceutical industry than they do of the advertising/public relations sector, if you can imagine such a thing. It asked people to categorize their “overall view” of various industries on a spectrum from “very positive” to “very negative.” While the “net positive” score (subtracting negative from positive views) was a woeful -10 for the ad/PR industry, it was an even-worse -14 for the pharmaceutical sector (see the bottom chart on page 27). That’s at the low end of a range within which the number has bounced around in Gallup polling during this decade.

Part of the problem, of course, is that pharmaceuticals just aren’t fun in the way soft drinks and cars and electronic gadgets are. Marcee Nelson, president of GSW Worldwide’s Pink Tank division, a Columbus, Ohio-based agency that focuses on women and health, recounts something she heard at a recent focus group: “A woman who had been diagnosed with crippling rheumatoid arthritis said, ‘I’m being forced to be a consumer of something I don’t want.’ People know that pharmaceutical products can cure them, make their conditions manageable, keep their families together longer. They know drugs save lives. But how can we ever expect them to love an industry with which they would rather not interact in the first place?”

Even when consumers feel a sense of attachment to the specific prescription drugs they use, this doesn’t immunize them against negative attitudes toward the industry in general — in part because so much advertising has spotlighted the individual brand rather than the company that makes it. “For the most part, consumers don’t have well-established relationships with pharmaceutical manufacturers, and in many cases don’t even know who makes the medicines they take,” says Lynn Benzing, CEO of Patient Marketing Group, a Princeton, N.J.-based healthcare communications company. With positive messages focusing on brands rather than on companies, “‘Big Pharma’ has come to symbolize high prices, profiteering and safety-issue cover-ups in the minds of many consumers,” Benzing adds.

Polling confirms that drug safety is a big issue for consumers. In a Kaiser Family Foundation/USA Today/Harvard School of Public Health survey conducted this past January, a narrow majority (55 percent) agreed that pharmaceutical companies “do enough to test and monitor the safety of their drugs,” while 41 percent said companies don’t do enough. When a top-selling pain reliever like Vioxx is pulled off the market for increasing patients’ risk of heart attack or stroke, consumers take note. (An online Reader’s Digest article in the aftermath of Vioxx’s 2004 recall said “millions of Americans panicked” when the news came out, no doubt ensuring further panic.)

To make matters worse, consumers don’t necessarily trust the drug companies to be forthcoming about problems. That was evident in an October 2006 poll by Harris Interactive on behalf of the Pharmaceutical Safety Institute. It asked how confident respondents are that companies “will release any information they have about the adverse reactions of any of their drugs as soon as they have such information.” Thirty-one percent were “not at all confident,” and 26 percent were just “somewhat confident.” Few were either “extremely confident” (4 percent) or “very confident” (10 percent), with the other 29 percent “fairly confident.” The numbers were much the same when people were asked whether they think the companies would “eventually” disseminate all the information they have about the safety of their drugs.

For products that are less complex (and less regulated), marketers could deploy some warm-and-fuzzy advertising to assuage safety concerns. It’s trickier for drugs. “Safety is an issue of perception, and advertising is just one piece of the puzzle,” says Loreen Babcock, chairman, CEO of New York-based Unit 7, an Omnicom Group relationship-marketing agency that works extensively in the pharmaceutical sector. “Perceptions of safety can also be influenced by PR, online, relationship marketing.” And, she says, all these efforts need to be based on a “dialogue” that takes consumers’ worries into account-and does so promptly. Says Babcock: “In the information age, it simply is essential to uncover the root concerns of consumers and address them in as timely a manner as possible.”

Indeed, drug marketers must themselves embrace the information age as they seek to reduce consumer distrust. “Pharma companies would be wise to look for ways to become involved in social media,” Babcock suggests, “as this could help eliminate consumer perceptions that pharma companies often seem to be hiding.”

She sees some already making strides in using such media. For one, she notes Johnson & Johnson’s use of YouTube. “The content is existing videos in which J&J already had an investment,” she says. “So that’s interesting-creative reuse of an existing and costly resource.” And she mentions Novartis, which has gotten into the Web 2.0 act by running a contest in which people competed to create the best video for the company’s influenza vaccine initiative. “This effort leverages the fact that consumers trust other consumers more than company spokespersons, and it also tips a hat to the ‘wisdom of crowds’ ethos,” she says.

There’s one consumer concern that’s intrinsically resistant to amelioration through marketing: the price of the drugs. In the Kaiser/USA Today/Harvard survey, just 18 percent of respondents said they regard the cost of such drugs as “reasonable,” while 79 percent said it’s “unreasonable.” And, as the chart on page 28 indicates, few trust the industry to price its products “fairly.” The same poll found 70 percent of respondents agreeing that pharmaceutical companies “are too concerned about making profits, and not concerned enough about helping people.”

It would be nice to think that enough tonnage of well-crafted ads could persuade people that the drugs, however expensive, are worth every penny. Making this unlikely, though, is consumers’ sense that the cost of ads is itself a key factor pushing drug prices upwards: 77 percent of respondents to the Kaiser/USA Today/Harvard study endorsed the statement, “The cost of advertisements makes prescription drugs too expensive.”

Despite such opinions, many people still believe direct-to-consumer ads for prescription drugs can be beneficial — especially as the genre evolves. “Although I still occasionally find myself grimacing at an overly perky voiceover or a silly critter,” says Pink Tank’s Nelson, “I do see fewer romanticized executions than in the past and have observed an evolution toward more insight-driven and authentic advertising.” Gardasil’s unbranded “Tell someone” campaign, aimed at getting women to tell other women about the link between a virus and cervical cancer, is one Nelson puts in the latter category.

However grudgingly, people acknowledge that they learn things from DTC ads. In a survey fielded this March by Princeton Survey Research Associates International for Rodale’s Prevention, Men’s Health and Women’s Health magazines (with a technical assist from the federal Food and Drug Administration), 74 percent of respondents agreed that “Ads allow people to be more involved in their healthcare”; 77 percent agreed that “Ads alert people to symptoms that are related to a medical condition.” A smaller majority (56 percent) said they believe “The ads are done responsibly.”

People do wonder whether drug ads give them a balanced picture of the product’s utility. In online polling conducted for Adweek via Vizu on a wide range of consumer Web sites in the past few weeks, just 23 percent of the respondents said prescription-drug ads “do a good job of conveying the products’ benefits and risks.” Apparently lots of people in the advertising field share that view. In Vizu polling on the Adweek.com site, the same question found a tepid 34 percent of participants saying they think the ads to a good job in this respect.

Note, however, that Rodale’s findings (with differently worded questions) were a good deal more positive. Majorities of that survey’s respondents said DTC magazine ads are at least somewhat useful in conveying a drug’s benefits (75 percent said so) and risks (76 percent). Likewise, 69 percent said TV spots are at least somewhat useful in conveying benefits, and 78 percent said the same of their role in conveying risks.

When drug ads focus on educating people about medical conditions and possible treatments, the big thing they have in their favor is that lots of people are hungry for information about these matters. Gary Stibel, CEO of the New England Consulting Group, remarks, “Next to pornography, I don’t think there are many things people search for more on the Internet.” (Pharmaceutical firms figure prominently on the marketing consultancy’s client roster.) However they may feel about the industry, people realize that its ads give them valuable knowledge. “They’re telling us something we didn’t know that could save our lives,” Stibel says, “and some of it is very tastefully done.”

Despite the seriousness of the subject matter, ads can make effective use of celebrities. But the link between the celeb and the product must be genuine. “Sally Fields for Boniva works because Sally is an osteoporosis patient who is being treated with the drug,” says Nelson in citing one such instance. She also mentions the role of Lynn Redgrave in a GlaxoSmithKline corporate campaign, in which the actress appears “not as a celebrity but as a cancer survivor who is presented without fanfare.”

One potential pitfall for marketers is that educating consumers about conditions and treatments doesn’t always yield action. Despite the barrage of TV spots for drugs that treat erectile dysfunction, 38 percent of the men age 45-plus who suffer from it have never talked to their doctor about it, finds a poll conducted in April by Ipsos Public Affairs for Eli Lilly & Co., maker of Cialis. Discomfort with discussing the topic — notwithstanding the jaunty tone of many ads in the category — is the chief impediment.

More broadly, men may be a challenging audience for prescription-drug marketers. When Adweek asked Nelson whether she thinks men react differently to such advertising than women do, her response was: “I think the real question is, do men react?” She adds, “Women are so much more tuned in to health messages in general, whether they are male conditions, female conditions or gender neutral.” Nelson cites Cialis as a brand that has used its ads to leverage female influence on behalf of a drug that men take.

In an era when patients tend to be rushed in and out of the doctor’s office, the “Ask your doctor” motif of advertising at its best helps people use that time efficiently. “I think it’s never a bad thing to be armed with all the information and treatment options when you go into the doctor’s office,” says Amelia Rosner, svp, creative director for Draftfcb in New York. “It makes the conversation go more smoothly, and it makes them more equal partners,” adds Rosner, whose experience in the field includes work on campaigns for the Cymbalta antidepressant and the Plan B contraceptive. “And if you are rushed, the more information you have, the better use you make of what little time you have.”

None of this means that including a doctor in an ad makes the message stronger. In the Rodale study, 75 percent of respondents said seeing a doctor in an ad doesn’t make the drug seem more effective. And 72 percent said it doesn’t make them more likely to believe the drug is safe. Why is this so? Cary Silvers, Rodale’s director of consumer insights, offers a theory: “To any consumer, a doctor is one of the most overused media characters around. There are TV shows about doctors (Grey’s Anatomy), talk shows with doctors (Dr. Phil), OTC advertising with doctors (four out of five recommend), and, yes, DTC ads with doctors.” Oversupply has debased the currency, evidently. “Given all this, we have said to clients it is OK to use a doctor in an ad, just don’t expect a silver bullet of credibility,” he adds. Even the high-profile Lipitor advertising with Dr. Robert Jarvik (of artificial-heart fame) yielded only a “mild reaction” from consumers, Silvers says. (That campaign was discontinued earlier this year amid pressure from Congress, centering on the fact that Jarvik isn’t licensed to practice medicine.)

As direct-to-consumer marketing continues to evolve, we’re likely to see an increasing emphasis on conveying information to the people who want it, as opposed to the public en masse. Cegedim Dendrite, a Bedminster, N.J.-based firm that provides products and services to the pharmaceutical industry, conducts an annual survey of U.S. manufacturers, agencies and vendors in this sector. The latest study (conducted online this past December and January) sees a gradual shift in that direction, at the expense of the scatter-shot TV and radio that has dominated the earlier years of DTC efforts. “Pharmaceutical marketers are much more concerned about building relationships with customers,” says Lynn Day, the company’s director of relationship marketing and analytics. “They’re going to be providing much more targeted and educational approaches.”

One happy consequence of more precise targeting could be a reduction in the number of ads that come across as a catalogue of symptoms. “By necessity, most DTC advertising focuses on symptoms to quickly get the attention of the subset of the mass market that may actually belong to the target audience,” notes Benzing. As marketers gradually shift away from TV and toward media that by their nature target people who are already treating an ailment (including point of care and point of sale), “the need for a disproportionate focus on symptoms will diminish.”

The key word there is “disproportionate.” As Draftfcb’s Rosner notes, “Diseases are defined by their symptoms. We want to make sure that sufferers know we’re talking to them. It’s very important that they can relate to the scenarios that they see on TV, which are symptom based.” And if an emphasis on symptoms sometimes makes the advertising seem one-dimensional, it’s not as though this is unique to the pharmaceutical sector. Asks Rosner: “Does hair-dye advertising also weigh in on inner beauty?”

Consumers won’t soon lose their taste for grousing about Big Pharma. Still, they do understand that its products help them. In the Kaiser/USA Today/Harvard survey, 63 percent said prescription drugs developed over the past 20 years have made their own lives and their family’s lives better, including 44 percent who said “a lot better.” Moreover, as Rosner notes, “The consumers who complain about Big Pharma are not necessarily the people suffering from the diseases for which we are offering treatments. That makes a big difference. When you have the disease, you listen harder.”

More than in most categories, pharmaceutical ads can’t afford to be stupid. But the smart ads can win a fair hearing. What Nelson terms the “enlightened companies” are already doing more to build consumer trust: “They’re generalizing less. Personalizing more. Talking less. Giving more. Demonstrating they are patient-centric through actions, not just words. If more pharmaceutical brands would follow suit by acting less like advertisers and more like advocates, would people start liking the industry? Maybe. At least they might stop liking to hate it.”

LINKS TO SOME OF THE STUDIES REFERENCED IN THIS REPORT:

The Kaiser Family Foundation/USA Today/Harvard School of Public Health study took a wide-ranging look at consumers’ attitudes toward the pharmaceutical industry and its advertising, including a look at such issues as drug safety and drug pricing. Released in March, the report was based on polling conducted in January. STUDY RESULTS

The Harris Interactive/Pharmaceutical Safety Institute survey examined consumer opinions about drug safety and the readiness (or lack thereof) of pharmaceutical companies to disclose information about problems with their drugs. Released in April 2007, the polling analyzed responses collected the previous October. SURVEY RESULTS

The Gallup poll looked at how Americans regard 25 business sectors, including the pharmaceutical industry (as well as the advertising/pr field). Released in August, it drew on responses gathered that month. POLL RESULTS