FOCUS: HEALTH PR - Exploring the other medical avenues/Alternative medicines and treatments are becoming more accepted by the medical establishment. Sue Beenstock questions whether PR has found itself a new role to play

Twenty years ago, alternative medicine was just that. A different method of health treatment for enthusiasts who chose to eschew traditional medicine in favour of more ’natural’ therapies. Now many of us have consulted at least an osteopath and the trend towards the use of homoeopathy and aromatherapy is gaining pace.

Twenty years ago, alternative medicine was just that. A different

method of health treatment for enthusiasts who chose to eschew

traditional medicine in favour of more ’natural’ therapies. Now many of

us have consulted at least an osteopath and the trend towards the use of

homoeopathy and aromatherapy is gaining pace.



Here’s Health, the Emap title for complementary health enthusiasts, even

considers the national dailies its main rivals. The message is clear:

alternative health is now mainstream.



Here’s Health’s newly appointed editor, Sheena Miller, sums up her

typical reader. ’She wants to take charge of her and her family’s

health.



She distrusts antibiotics and is proactive,’ says Miller. Unfortunately

this is Everywoman of the 1990s, the one who shops at Boots and reads

anything from the Independent to the Daily Mail. This may be why Here’s

Health has enjoyed only a minimal year on year rise in circulation, from

42,417 to 42,558.



The interest in complementary medicine has enjoyed phenomenal growth -

the market was worth an estimated pounds 72 million in 1996, up 36 per

cent since 1991, according to a Mintel survey published at the end of

February.



Mintel market analyst Moira Paterson, says there has also been an

improvement in packaging and on-pack information.



’Many people told us they would buy or try products if they had more

information and manufacturers seem to be addressing that with clearer

positioning, leaflets and colour coding,’ she comments.



Herbal medicines how have 53 percent of the market, homoeopathic

remedies account for 28 per cent and aromatherapy oils (excluding

toiletries) have enjoyed the biggest growth, up 133 per cent from a low

base in 1992, to 19 per cent of the complementary market, according to

the Mintel survey.



With such widespread, but unregulated usage, it’s not surprising that

the Consumers’ Association has spotted an opportunity. Last month saw

the publication of its first book on the subject, The Which Guide to

Complementary Medicine. According to author Barbara Rowlands, research

by Sheffield University shows that 75 per cent of GPs want some

complementary therapies available on the NHS and four in ten already

provide access to acupuncture, chiropractic or osteopathy.



With the complementary market value set to rise by 45 per cent by the

year 2001 to pounds 104 million, it will still be a fringe area in the

pharmaceutical industry. But the increasingly mainstream appeal of all

things complementary suggests this could be a lucrative market for PR

practitioners of all kinds.



But Justin Clark, formerly of Hill and Knowlton and Shandwick, and now

director of Clark Coombes Drake (CCD), alternative healthcare

specialists, disagrees.



’Alternative may be fashionable, but this is a low-scale, low-budget

industry,’ he says. ’PR is generally done in-house by non-PR people,

interested in the medical, rather than business side, of

operations.’



CCD has handled the British Chiropractic Association’s PR for five years

and in the last four has stage-managed National Back Pain Week, a

promotion which puts callers straight through to their local

chiropractor via a national freephone number. Last year, 23,000 people

rang and 50 per cent bought treatment, all for a PR budget of pounds

5,000.



Unlike almost every other complementary therapy, chiropractic and

osteopathy are regulated, and accepted by most orthodox practitioners.

This means that along with conventional approaches to health writers and

personalised releases to local newspapers, Clark sees a new opening.



’Bed rest and aspirin are the traditional GP cure for back pain but it

usually means lots of home visits and recurring problems. If we can put

the GP in touch with their local, named chiropractor, the problem will

be far more effectively handled and reduce costs to the fundholder,’ he

says.



Hospital trusts are also being informed about their local chiropractice

while practitioners themselves are being given guidelines about how to

approach GPs. Some NHS Trusts, such as Lewisham Hospital in South East

London, even employ a homoeopath to whom local GPs can refer patients on

the NHS.



But wholehearted establishment acceptance is still a long way off. Nicky

Smith, account director at Maureen Cropper Communications which handles

Bach’s flower remedies, believes that fighting complementary medicine’s

’cranky’ image is still priority - a view echoed by Valerie Grundon, who

has worked in the field for almost 20 years. She handles Seven Seas

range of supplements, Hofels herbal tonics and New Era nutritional

treatments.



All require a level of knowledge and understanding to administer.



’To an extent, we have learnt to target the ethnic pharmacists simply

because people from Asia and India have a lot more understanding of

complementary remedies and feel at ease recommending them,’ she

says.



Packaging and presentation remains a major issue. New Era’s A-S

combination salts have been repackaged in cartons, but the single salts,

which are more complicated to take, have stayed in pots, in their

traditional health food outlets. ’This is because we’re appealing to an

informed customer, not the supermarket shopper,’ says Grundon.



Peter Sofroniou, editor of the trade paper Natural Product News, says

this targeting seems to be working. ’In the last few years we’ve seen

just about every herbal remedy being put in blister packs, competing

head on with the little white pills. I’m not convinced that’s what

people want.



If it’s an alternative to a drug, shouldn’t it look like one?’



Not if ’alternative’ is another name for an unprofessional

concoction.



Over the last five years, Boots has increased its emphasis on

complementary sales and brought out own-brand herbal products to give

them a wholesome, reliable image. Last October, vitamins and

alternatives PR was brought back in-house, under PR manager (and

pharmacist) Tim Legge, allowing a more holistic approach to product

positioning.



’For the first time, it meant we could take products from OTC and

complementary sectors and show how they could be used together. So, for

example, in a first aid/travel kit promotion this summer, we could

include conventional things, plus tea tree cream or rosemary essential

oil to help reduce jet lag,’ he says.



Alternative products are positioned alongside vitamins to extend

customer choice, says Legge, but away from orthodox medicines where they

may confuse people.



Alternative products are not licensed and can’t make medical claims.



According to Julie McClean, co-director of Kanuka which handles

Tisserand aromatherapy oils, this can make life tricky. Kanuka cannot

describe a product as a ’stress relieving oil’, though it can say it

helps relieve stress.



Nevertheless, there is increasing emphasis on providing journalists with

scientific backup for such claims: Kanuka’s Aroma 97 conference in July

will bring orthodox medics and aromatherapists together, pooling

research from around the world.



And Scotia, the evening primrose oil licence holder, has invested

heavily in establishing its benefits through clinical trials. Its

nutritional subsidiary, Efamol, is taking a similar route to give the

brand a more serious profile against competition from own-brands.



’We’re unusual in always citing clinical trials in press releases,’ says

Jean Garon, whose company handles Scotia’s PR as well as vaccines for

SmithKline Beecham. ’Our job on both is science-based and educative,’

she says.



But despite this increasingly scientific approach, market worth and the

small size of most complementary health manufacturers means the

pharmaceutical giants can ignore it. Caroline Ashe, director of

healthcare at Countrywide Porter Novelli, says Wellcome, which developed

AZT, felt ’honour bound’ to mention complementary therapies in all of

its Aids/HIV literature.



But attempts to find out what Glaxo, SmithKline Beecham et al are doing

to counter claims by enthusiasts made for complementary medicines met

with silence. ’Complementary medicine is a pimple on the elephant’s bum,

it’s simply of no relevance,’ said a press officer from one drugs

multinational.



BIOFORCE: HERBAL COURSES AND COLUMN INCHES



Smallwood PR, based in Leicester, has handled Bioforce’s range of herbal

tinctures for almost four years. Bioforce is a Swiss company which

launched in the UK ten years ago, since when Britain has emerged as its

best new market. Bioforce produces 300 products, but Echinaforce far

outsells anything else, accounting for 25 per cent of sales and it is

one of the top five sellers in health food shops.



’We were ticking along quite nicely until four years ago. By then we

realised we needed a specialist who could devote more time to our PRas

we were being swamped with press enquiries,’ says Bioforce managing

director Janyn Tan. As a small company with a turnover of pounds 2

million a year, advertising was deemed too costly, ’and it’s not what

we’re about’. Instead, Bioforce allotted a budget of around pounds

20,000 a year for PR, plus a further pounds 10,000 to pounds 20,000 to

spend on literature.



The appointment of Judith Smallwood coincided with the repackaging of

the herbal tincture range - the labelled glass bottle was boxed, with an

attractive photograph of the relevant herb on the front (this was

slightly updated six weeks ago). It allowed for stronger Bioforce

branding and more information.



Initially, Smallwood’s emphasis was on general education about herbal

products, targeting both retailers and consumers. ’Column inches was the

main thing,’ she says. ’It was classic stuff, making contact with

individual journalists and beginning with generic PR for the herb. So it

was about echinacea, explaining the benefits of the raw ingredient and

not worrying too much about the branding.’ The fact that it was an

interesting and photogenic subject, from a manufacturer which claims to

be a pioneer in the field, helped, says Smallwood.



Information from clinical trials was presented in jargon-free language,

backing up Bioforce’s claims for the plant. These double blind trial

results were particularly effective in the specialist press. Trade

magazines, such as Chemist and Druggist, run sections on the natural

health market and demand technical information.



After 12 months, Smallwood brought the brand, Echinaforce, centre stage,

culminating last spring in the production of a consumer magazine on all

aspects of herbal medicine and the Bioforce range. It appears quarterly

- currently 100,000 copies per issue - and is given away in health food

shops.



At around the same time Smallwood launched the Bioforce Phytotherapy

Course, a series of correspondence lessons on plant medicine. It was

publicised via leaflets at Bioforce outlets aimed at retailers and

consumers. Smallwood has been thrilled by the response: 450 people,

including health food retailers, a pharmacist, several doctors and

journalists are about to complete the 12-module course, and another 200

are part-way through. There will be a fresh intake in May.



’We’re not trying to get heaps of coverage for the products, or suggest

they’re a cure-all. It’s part of an ongoing educative campaign,’ says

Smallwood. With sales doubling each year, it appears to be working.



BIOTECHNOLOGY: CASH QUESTIONS CAST A CLOUD OVER DRUG ADVANCEMENT



Biotechnology is the creation of new drugs from synthetically-produced,

rather than animal-derived, substances, involving areas of genetic

research and chemistry not covered in the A-level syllabus. Current

worldwide sales of biopharmaceuticals are estimated at dollars 9.1

billion.



As a PR for a biotechnology research outfit, your brief will usually be

to match up companies with developing and probably loss-making products

to backers prepared to invest millions.



In America and Japan the industry is about 10 years ahead of us, but the

UK leads the field in Europe.



Companies such as British Biotech, Biocompatible, Cantab

Pharmaceuticals, Cerebrus, Cambridge Combinatorial, Phytopharm, Oxford

Moelcular Development, Shield and Cortecs, are among the significant

players in this rapidly developing sector.



As small organisations in desperate need of cash, they are vulnerable to

takeover bids from the pharmaceutical giants. In 1994 there were around

50 biotech-biotech alliances globally, the most significant being the

acquisition of Synergen by Amgen (the largest American company). And in

1995, Ciba-Geigy bought a 49.4 per cent stake in Chiron Corporation, the

world’s second largest biotechnology company.



In the more mature US market, generalist PR agencies are moving in on

the act, says Julia Phillips managing director of Noonan/Russo’s London

office, which specialises in biotechnology and financial PR and is

closely aligned to Shire Hall Communications. ’Our key issues are

positioning, differentiating companies and building credibility in a

market where no UK company has yet produced a product,’ she says.



But in the UK, it’s a job for the specialists and so far Shire Hall with

Noonan/Russo, Citigate BioCommunications, Ludgate, Genus, Brunswick

Communications and Buchanan Communications, appear to have the sector

sewn up.



Citigate, the financial PR firm, is the only one so far to create a

dedicated business arm. This deliberate biotech branding exemplifies the

increasing importance of the sector and the specialist treatment it

requires.



The Citigate offshoot was established 18 months ago and now has 11

clients, under the care of a three-strong team, headed by Miranda

Kavanagh. ’Forget everything that looks normal in other companies,

because normal in this sector means loss making,’ warns Kavanagh.



This is one of the three trickiest issues she has to put across. And

while financial journalists may have little difficulty coming to terms

with the separate, negative listing on the Stock Exchange reserved for

companies such as these, others can find it a challenging concept.



Then there is the scientific angle. If the companies are to win

investment, the PR people have to convince brokers, who in turn sell the

concept to their clients. These people understand plain, unscientific

English, not the PhD-level jargon presented by the scientists. This is

where PR people with a scientific background come into their own The

final problem is the volatility of the quoted company. As in new

technology, people are putting money on hope, says Kavanagh, so rumour

alone can cause shares to fluctuate wildly.



Mike Wort, director of Genus Communications which has specialised in

life science and biotechnology-based clients for the past three years,

now has around 20 companies on his books. He believes 450 new biotech

organisations will emerge across Europe in the next two years.



’That’s 450 clients with no one there to help them find funding. This is

a tragedy - we are dealing with significant medical issues here.’ Mark

Cater, account director at Edelman PR Worldwide, agrees. He has overseen

the British launch of the first commercially-available biotech drug for

diabetes, made by Eli Lilly. Internationally, around 36 per cent of

biotech firms have just one year of cash reserves left.



’Many analysts agree the crisis is mainly due to the naivete and greed

of investors who are quick to react to the news of one negative clinical

trial. This has meant the industry only announcing the good news, often

prematurely,’ he says.



PR is not reacting quickly enough to the demands of this emerging

market, says Cater. ’The science exists, but few people know about it,

biotech companies are just not informing their target audiences about

the potential this new technology promises.’ If PR isn’t used at the

clinical trial stage, the prescribers providing the market for these new

drugs, will be unaware of them and the companies will fail, says Cater.



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