HEALTHCARE: Campaign Challenge

Mark Johnson looks at how PR can work alongside disease awareness initiatives

Under the current strict regulatory climate that forbids advertising, marketing or promoting prescription drugs, disease awareness campaigns (DACs) have increased in popularity.

Yet, even as late as last year, the balance between promoting disease awareness, but not the therapy, proved difficult to get right. Even this method of promotion can have damaging consequences, should a drug company be found guilty of promoting a particular therapy when the guidelines say it should only be raising awareness of the condition or disease.

Last year, for example, one component of an erectile dysfunction campaign, sponsored by Pfizer, that featured in The Observer magazine, was found to have been in breach of the Association of the British Pharmaceutical Industry (ABPI) code of practice. While Pfizer was not found to have been promoting a prescription-only medicine, there was a technical breach of the code because the company's logo was deemed to have been too close to the strapline.

This breach of code sent one of many warnings to healthcare PR practitioners that any interpretation of guidelines must be checked and double-checked.

Putting a disease awareness campaign together is a complex process. But at the close of last year, the Medicines and Healthcare products Regulatory Agency (MHRA) worked in collaboration with the ABPI to produce guidelines.

These have made life easier for healthcare PROs working on DACs, although the challenges have not been completely erased. There are those in the industry who believe the MHRA guidelines leave too much room for interpretation and would prefer greater clarity on some points.

One particular issue that remains controversial is the position of companies seeking to run an awareness campaign in an area where they have the only therapy on the market or have a market leading position. The guidelines state: 'DACs for diseases or conditions where there is only one, one leading or few medicinal treatments potentially draw attention to one medicinal product, albeit indirectly, regardless of whether it is referred to or not. DACs in these circumstances require particular care.'

The problem, say healthcare PR consultants, lies in defining when a therapy has a 'leading' position in the market.

'While the guidelines do quite a good job by setting out what a good disease awareness campaign should look like, the danger areas, which they do outline, arise when you are a market leader,' explains Kinetic Communications Consultancy managing director Karen Moyse. 'This raises the question: "What is a dominant market share?"'

She also points out that an additional challenge facing any disease awareness campaign is not so much the regulatory environment but 'disease fatigue'.

'People become immune to the constant drawl of doom and gloom,' says Moyse. 'Scare tactics can be counterproductive.

'You also have to constantly refresh the message. It's as much about cutting through to people when they're incredibly busy as it is about competition with other pharmaceutical companies,' she adds.

The Prostate Cancer Charity's 'Spunky Monkey' campaign is an example of how the communications team has used humour to keep its message fresh.

Aimed at younger men, as well as women, the campaign set out to educate about the biological function of the prostate in order to 'sensitise' them to prostate cancer messages when they reach an age of increased risk.

The charity placed postcards in bars and clubs across the UK, asking people to rank various animals in order of ascending ejaculate volume on a website to win a Club 18-30 holiday. The competition received 328 entries, and 83 per cent of the postcards, which also contained educational information about the prostate gland, were picked up in the 750 bars and clubs in which they were distributed.

After such a success, can we expect more campaigns to follow suit and use humour to get their message across? Red Door Communications managing director Catherine Warne warns that apart from the question whether or not humour is appropriate, it can have other drawbacks.

'Of course the funny campaigns create laughs,' she says, 'but the target audience may end up taking no action. This is partly because a lot of campaigns fall into the trap of having too many key messages. For disease awareness campaigns especially, you have to decide on a single message with which to reach the target audience.'

To ensure a DAC stands out from a classic marketing communications programme, include a range of other relevant parties in the process, advises Avenue HKM chief executive Joanne Marchant. 'Any disease awareness campaign has to be part of an integrated programme, and you must have the healthcare professionals and patient groups on board as well,' she says.

Furthermore, given that DACs promote awareness of a disease rather than a specific therapy, there is always the risk the campaign's sponsor will increase sales for a competitor to the cost of their own bottom line.

Yet, efforts to make the PR industry more measurable by improving evaluation have not been lost on healthcare PR specialists.

The Healthcare Communications Association (HCA) launched its own evaluation toolkit in June, aimed at equipping healthcare PR practitioners with ways to demonstrate ROI (PRWeek, 13 June). It explains points such as how to agree realistic measures of evaluation, when to take measures, and how much it should realistically cost.

'You have to identify the key audience and know what behavioural change you wish to bring about,' says Warne, who sits on the HCA Evaluation sub-committee. 'DACs that work well are those that are well targeted rather than using a scattergun approach,' she adds.

Disease awareness campaigns remain one of the best ways for pharmaceutical companies to get their message across to target audiences, given the regulatory environment. But in such a crowded market place, the challenge remains to produce high levels of creativity that will have a long-term impact.


Hepatitis B is 100 times more infectious than HIV and is second only to smoking tobacco as the biggest cause of cancer worldwide, according to reference papers. However, it is a preventable disease.

Aventis Pasteur embarked upon a disease awareness campaign last year aimed at raising the number of vaccinations against the disease among at-risk groups, specifically gay men. One in five gay men in London have been infected with hepatitis B, which is sexually transmitted, according to a clinical paper.

Analysis by market research company Plus Four showed that there was a general awareness of the disease among gay and bisexual men, but there was little real understanding. Therefore, many men were not taking action by getting vaccinated against this life-threatening infection.

The aims of the six-month campaign were to increase vaccinations against hepatitis B among gay men in London by 10 per cent and to demonstrate that education could achieve such a rise in vaccinations. Red Door Communications supported Aventis Pasteur in the project.

The B Safe campaign targeted the gay media and bars in London's Soho district and set out to explain that hepatitis B is a deadly disease that spreads easily. The best action to take is vaccination.

A series of eye-catching materials bearing the B Safe branding was developed using appropriate imagery and language that would ensure men would pick up the key facts about the disease while out in bars and clubs. The materials included a margarine tub (a pun on 'spreads easily') containing a flyer, matches, condoms and lubrication. Beer mats, posters in washrooms in bars and clubs, as well as detailed health information leaflets were also distributed.

In order to provide vaccinations, the campaign forged partnerships with Sorted, a sexual health service from the Chelsea and Westminster Healthcare NHS Trust with health centres in Soho and Victoria that provide free, confidential hepatitis A and B vaccinations for gay men.

London's premier gay and lesbian music and dance event, Purple in the Park, was chosen as the most appropriate launch venue. A clinic was set up on-site so that Sorted could provide vaccinations. This created a news hook and an opportunity to communicate directly with the target audience.

With the intention of administering 30 vaccinations, based upon the most vaccinations given during a three-hour period at the Sorted clinic, the campaign launch got underway.

On the day, 78 people received a hepatitis B vaccination, far exceeding expectations. The gay and regional media was targeted to encourage at-risk men to seek vaccination, with media packs sold in prior to the launch at Purple. News hooks such as new opening days for the clinic were created on an ongoing basis.

The overall vaccination take-up increased by 13 per cent during the campaign, with a 22 per cent increase among 18 to 24-year-olds. Forty-eight per cent of respondents were spontaneously aware of promotional activities involving hepatitis B during the six-month campaign, which was the only integrated awareness campaign running at the time. The Sorted Clinic had to open an extra night a week to cope with the demand for the service following the launch of B Safe.

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