Healthy Skepticism Library item: 1734

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

O'Connell V.
Drug Marketers' Ads Penetrate Text of Online Medical Studies
Wall Street Journal 2002 Mar 28
http://online.wsj.com/article/SB1017264444467884800.html?mod=googlewsj

Full text:

Breaking a longstanding taboo in medical publishing against mixing ads and medical research, drug makers are experimenting with several controversial tactics online for promoting prescription drugs to physicians.

“Open up to the possibilities,” beckons an Internet ad for Pulmicort Turbuhaler, a prescription steroid medicine for asthma. The ad shows a large pair of lungs, and a father and child heading along a golden path under clear, blue skies. What’s surprising about the ad is where it appears: in the middle of a clinical paper, written by physicians, about research for treating asthma.

The ad-studded research paper is posted on eMedicine.com Inc. (emedicine.com), which provides peer-reviewed reference material on disease to physicians. The site, owned roughly 20% by Seneca Investments LLC, a joint venture partly formed by ad agency Omnicom Group Inc., is courting drug companies such as AstraZeneca PLC by providing desirable ad placements for drugs such as AstraZeneca’s Pulmicort and Nexium, a heartburn medication.

Keeping commercial plugs far away from scientific research has been a commandment of medical marketing to physicians. The rule’s proponents argue it is crucial to preserving the integrity of research. “Placement of advertising adjacent to editorial content on the same topic is prohibited,” the American Medical Association states flatly in one edict. The AMA publishes medical research in 11 print journals including the prestigious Journal of the American Medical Association, known as JAMA, and more than seven Web sites.

People in the field say eMedicine.com may be the only physician-targeted medium now permitting drug advertisers to penetrate the scientific content of published research so deeply with their messages. “It’s accurate to say we recognize this may be viewed as controversial,” says Jon Adler, eMedicine’s president and chief medical officer. “But there’s no intent to mislead people. Anything that is advertised or sponsor-centered is identified as such, and there’s a thorough peer-review process of the content.”

In the current ad drought, others are permitting a new degree of closeness between editorial content and ads targeted to the medical profession. Industry critics and even ordinary physicians are starting to complain that the practice has gone too far. “Drug ads shouldn’t appear next door to professional research,” says Michael Fleming, a physician in Shreveport, La. “I am sure there are studies done that show that’s an effective advertising tactic. Personally, I don’t care for it. It strikes me that they are talking down to me as a physician.”

Jim Coyne, a divisional spokesman for AstraZeneca, one of the most aggressive online advertisers, says, “In the space of a banner [ad], we don’t have the real estate to provide all the details. … We are just trying to point people to where they can get additional balanced information.”

Medical journals in the print world have been grappling with how to keep drug ads at bay for a long time. The New England Journal of Medicine, for instance, runs ads only at the front and back of the publications, far from the editorial content. JAMA in the late 1990s even sought to break its reliance on drug ads and briefly ran ads for Range Rovers, Wellcraft boats, Steinway & Sons pianos and even McDonald’s Corp. The journal ultimately returned to running primarily drug ads, though not near any formal scientific material.

But online, even these journals say they are being forced to exert more control over advertisers than ever before. The New England Journal allows drug ads on tables of contents for related “collections” of research. Six months ago, it created a committee of four people to scrutinize every online ad it received for the Web site. The committee tries to make sure ad claims aren’t too aggressive and even checks out the claims of sites that the ads link to. It forbids such sites to “trap” doctors by making it difficult for them to return to the journal’s own content. “The online ads are very public, and they are out there for everybody to see,” says Arthur Wilschek, head of ad sales at the New England Journal of Medicine. “We just want to make sure they are all in good taste. We are very protective of our brand.”

There’s nothing illegal about mixing ads with research. The Food and Drug Administration regulates drug claims made in advertising and prohibits companies from implying that products can treat diseases for which they haven’t been approved. But there’s no specific agency prohibition against placing ads in the middle of scientific editorial content.

Still, it’s a practice that many in the medical profession find offensive. “When physicians see related ads within scientific articles, the hair on the back of their necks rises,” says Joetta Melton, publisher of the American Family Physician and other professional journals and Web sites from the American Academy of Family Physicians (www.aafp.org), based in Leawood, Kan.

Yet in the ultracompetitive world of drug marketing, advertisers are eager to bond with doctors, and the Internet presents many new opportunities. Sanjay Pingle, executive vice president at Medsite Inc., a closely held New York medical marketing company, says drug companies such as GlaxoSmithKline PLC, Merck & Co. and Pharmacia Corp. have begun creating “virtual detailing” programs, in which physicians can learn about drugs online. Drug makers also are catering to busy physicians with “interactive grand rounds,” continuing education programs on medicine on the Internet and on hand-held personal digital assistants.

Forced to compete, even some of the most staid names in medical research say they are rethinking their approaches to advertising. For instance, the Academy of Family Physicians hired someone to solicit educational grants from drug companies and intends to develop paid ads that it calls “micro-sites,” a kind of online advertorial embedded in a Web site on a related topic. In one project now under way for Johnson & Johnson’s McNeil Consumer Healthcare unit, the family doctors group will create information on over-the-counter medications and place it on its Web sites for physicians.

American Family Physician’s Ms. Melton argues that the venture, expected to launch next month, isn’t advertising at all, but rather a form of sponsorship modeled after the soft-sell approach used by National Public Radio and public television. The group plans to give McNeil a credit line, such as “This project is funded by an educational grant from Johnson & Johnson,” she says.

Late last year, eMedicine began courting drug companies with new ad options, such as its “integrated micro site,” a format drug companies can use to bury a sales pitch inside online chapters on related diseases. Laz Caba?as, head of ad sales at eMedicine, says the number of readers clicking on this new ad format to see more information is 40 to 170 times as high as the typical rate for so-called banner advertisements at the top of a page.

Ad agencies are, of course, thrilled to have new options to present to pharmaceutical clients, which in the past might have been blocked from linking their brands so closely with editorial research. “When a doc reads a printed medical journal advertisement, we don’t know what is on his or her mind,” says Brad Aronson, president of I-Frontier, a Philadelphia advertising agency for GlaxoSmithKline, Schering-Plough Corp., and Novartis AG. “The online sites present an amazing opportunity to reach docs when they are thinking about the disease at hand.”