TOP 50 HEALTHCARE PR: Healthy growth for the Top 50

The role of the health PR consultant is changing as clients call for strategic advice to help them work with the changing face of the NHS. Kate Nicholas and Peter Robinson report

The role of the health PR consultant is changing as clients call for

strategic advice to help them work with the changing face of the NHS.

Kate Nicholas and Peter Robinson report

The POM-to-P switches that bridged the gap between the ethical and OTC

market last year have finally peaked, but a raft of major mergers and

acquisitions including that of Glaxo/Wellcome, Pharmacia and Upjohn,

Rhâ„¢ne- Poulenc Rorer/Fisons, Sandoz/Ciba Geigy (Novartis) and

Cynamid/Wyeth-Ayerst have created ripples in the PR market, as agencies

find themselves taking on a more strategic role at corporate and product

development level.

Medical Action Communications continues to dominate the market with a

pounds 4.5 million healthcare fee income, with B-M closing the gap in

the 1996 healthcare league table with a 64 per cent rise in healthcare

fee income to pounds 3,853,666.

Fusion moves up two places with in a substantial increase in fee income

from pounds 835,582 to pounds 1,256,068 and the Grayling Group has edged

its way into the top ten having increased its healthcare fee income from

14 per cent of its total income to 23 per cent - breaking through the

pounds 1million barrier. Complete Pharma also enters the top 10 with a

58 per cent increase in fee income. At number 26, Ruder-Finn had

something of a renaissance since Lee Tomkins took over as managing

director in January 1995. The agency reported a 74 per cent rise in its

overall income, 90 per cent of which is accounted for by its healthcare


While the major POM-to-P switches have now peaked, products will

continue to cross the counter and agencies report a continuing need for

pharmacy education programmes.

PR companies are also increasingly being called in to provide strategic

consultancy on NHS developments and identify new audiences among the NHS

Trusts and health commissions, as pharmaceutical producers try to get to

grips with new purchasing structures and the devolution of the decision

making process to a regional level.

At the same time NHS bodies are gradually turning on to the potential of

PR. Agencies such as Elliott & Cater, Kenyon Associates and Clear

Communications have developed a niche in NHS PR, although the hiring of

outside agencies tends to be somewhat cloak and dagger, with many NHS

bodies concerned about public perceptions of their spending.

As the industry comes to terms with government pressure to reduce

healthcare costs, there is a considerable interest in US-style managed

care initiatives, and disease management, with the patient emerging as a

powerful target audience for healthcare PR.

These new levels of patient empowerment have led to some high-profile

consumer-related campaigns on ethical products. H&K’s campaign on behalf

of Ritonavir one of the major new HIV compounds in development, has a

strong consumer element.

Pharmaceutical manufacturers are now also tackling the final frontiers

such as Alzheimer’s, schizophrenia and depression, and relying on public

relations to assist their entry to new therapy areas. Medical Action

Communications, for example, advised SmithKline Beecham Worldwide

Strategic Product Development Neuroscience’s team on its entry into the

area of Parkinson’s disease and Pfizer International on approaches to

schizophrenia and Alzheimer’s disease.

As both audiences and therapies become more complex the public relations

brief has come to encompass corporate and public affairs - with obvious

benefits for generalists such as Hill & Knowlton - while specialists

report that their ethical and OTC work has broadened to encompass an

increasing amount of media relations and medical education work.

Munro & Forster, the agency which dominated the Pom-to-P switches last

year, recently worked with Centeon, a joint venture company between

Rhone-Poulenc Rorer subsidiary Armour Pharmaceutical and Hoechst AG

subsidiary Behringwerke, on the transfer of Armour’s equity to Centeon,

advising on positioning and communication with current subscribers.

Internationalist agencies such as Complete Pharma have also benefited

from a growth in pan-European work - the European acquisitions of the

last year plus the standardisation of healthcare systems due to cost

considerations, having led pharmaceutical companies to view Europe as a

single region, with increasing implementation of pan-European campaigns.

As the demands placed upon agencies by healthcare clients change, many

generalist agencies are taking a more flexible approach to the division

of disciplines. Grayling, for example has broken down the barriers

between disciplines with greater cross-fertilisation between consumer

and pharmaceutical PR and is now looking at acquiring a smaller

specialist agency to enable growth while avoiding client conflict.

And Grayling is by no means the only larger agency seeking new

specialist acquisitions. The last year has seen an increasing number of

smaller consultancies brought into the fold of larger full service

agencies. Vox Prism Targis was finally absorbed into its parent

Countrywide during 1995, Concept Public Relations was bought up by

Charles Barker in May, while Manning Selvage and Lee acquired Joan Scott

PR earlier on in the year.

Even with the influx of new agencies such as Sante and The Workhouse

onto the market, it remains to be seen whether specialist agencies have

the breadth of resources and disciplines to continue to stand alone.

Key to Company movement: NM - Non-mover; CL - Climber; FL - Faller; NE -

New entry

NM 1 Medical Action Communications pounds 4,470,000

Consistency is what counts when you’re fighting off the young Turks of

the business and Medical Action has managed double digit growth in every

one of its eight years so far.

‘I’m more interested in consistent growth than meteoric rises.’ says

managing director, Stephen Bullock. ‘It means our business can be well-

planned and resourced.’

Fee income rose 11 per cent to pounds 4.47 million. A hallmark of the

year for the ethical specialist was introducing clients to new

therapeutic areas at an international level. SmithKline Beecham moved

into the area of Parkinson’s disease and Glaxo Wellcome moved into

diabetes. Pfizer International involved working on schizophrenia and

Novo Nordisk expanded from the epilepsy field into women’s healthcare

and human growth hormones.

NM 3 Shire Hall Communications pounds 2,338,594

Fee income was up 16 per cent at this dedicated healthcare agency.

Highlights included international pre-launch work for Janssen-Cilag on a

new pharmaceutical company to be launched in September.

Other wins included an internal communications project for Glaxo-

Wellcome, corporate and product work for bio-tech company, Hybridon.

Novo-Nordisk brought in international work on diabetes, and there was a

disease management programme for Sandoz.

On the loss side, Merck Sharp and Dohme’s Zocor cardio-vascular work

finished, along with Allen and Hanburys’ Flixotide drug for asthma

sufferers.‘We maintained our share of OTC business but the big POM to P

switches have peaked,’ says Shire Hall chief executive Margot James.

Last June the agency also set up an integrated health services division

with a range of specialists helping manage the general industry move

towards disease management.

CL 5 Hill and Knowlton pounds 1,330,340

UK-based consumer related campaigns on ethical brands have been the

focus of a major drive for healthcare managing director, Noel Hall.

Healthcare contributed pounds 1.33 million last year - 11 per cent of

H&K’s pounds 12m group income.

‘The UK is a focus for us and l am looking to bring a broad range of PR

skills to ethical accounts,’ says Hall. ‘As the industry accepts the

need to communicate with patients more, an agency which combines

healthcare with a strong consumer capability has a lot to offer.’

Wins during 1995 included oncology products for Zeneca, a skin patch

treatment for chronic cancer pain for Janssen-Cilag and Ritonavir, a new

HIV compound for Abbott Laboratories. There was also work for Cephalon

on two new neurological compounds and on opthomology products for Ciba-

Vision. The agency also won Britain’s third largest private healthcare

insurer, PPP.

Jill Pooley joined the division as head of health policy in January 1996

after working in the NHS for 20 years, the first non-PR specialist to

come on board and Hall sees this inside-track on the NHS as crucial to

the agency’s growth.

Health policy related work has been another important area of growth,

and in February this year H&K teamed up with health policy body, the

Health Services Management Unit to advise drugs companies on how to deal

with the market-driven NHS.

CL 6 Fusion Communications pounds 1,256,068

Winning Glaxo’s pounds 120,000, Imigran migraine treatment from

Edelman’s medical division following a five-way pitch was the highlight

last year for healthcare specialist Fusion Communications.

Glaxo contributed to a 57 per cent increase in fee income to pounds 1.26

million. Work on Glaxo centred on opinion leader development.

‘Relatively little of our work on the ethical side is media relations,’

says managing director Neil Kendle. ‘What we are doing is opinion leader

development, conferences and so on. We are also very involved with

primary care opinion leaders, particularly GPs, nurses and pharmacists.’

Fusion has its eye on a PR Week award for a recent video it produced on

a doctor who suffers from migraine. Realising how difficult it can be

for people to empathise with sufferers, Fusion got the doctor to refrain

from taking medication when he got an attack and to film himself over a

weekend. The result makes harrowing, but effective viewing.

Fusion also started work with Zeneca on the launch of an asthma product.

About 75 per cent of business was in ethical pharmaceuticals and the

agency is engaged in a new business drive to increase OTC work.

CL 12 Manning Salvage and Lee pounds 825,185

Director of healthcare Europe, Howard Godman, joined Manning, Selvage

and Lee in September 1995 from rival Vox Prism Targis and saw healthcare

fee income rise from pounds 469,596 to pounds 825,185 for 1995.

Highlights included pre-launch work for Eli Lilly’s new osteoporosis

treatment and UK specific-work for Reckitt & Colman on OTC and

prescription products. In October, Professor Walter Spitzer, at the

centre of the row over the Government’s warning about contraceptive

pills, used the agency to put his views to the UK media. As a result the

agency picked up two more pieces of international issues management


On the loss side the one year programme on Nurofen for the Boots

Healthcare International, the OTC operation of The Boots Company, came

to an end.

‘A big difference is the growing awareness of health economics and of

the financial aspects of where drugs fit into government and insurance

plans,’ says Godman.

CL 13 Countrywide Communications pounds 810,470

Within the healthcare section of its client list, Countrywide spent last

year shaking out unprofitable and conflicting business following the

absorption of healthcare agency, Vox Prism.

‘With the merger we saw some clients leave for a variety of reasons and

sometimes there were areas with a conflict of interest,’ says managing

director Paul Miller. ‘Net income was less after the merger but in terms

of profit we earned more since a certain amount of business we inherited

through the merger was not profitable.’

New clients included Pharmacia and Upjohn and a medical press campaign

for the Meat and Livestock Commission - communicating the low fat and

high iron content of meat - which the agency recommended be shelved when

the BSE issue flared up. Miller says: ‘We have a strong base in ethical

and are broadening into OTC. There is a need to adapt.’

NE 14 Charles Barker pounds 708,795

Charles Barker took a quick side-step into healthcare in May last year

with the acquisition of specialist, Concept PR.

Concept, a mature 20-year old, with six staff and fee income of around

pounds 400,000 brought with it such OTC accounts as Roche, Seven Seas,

Jordan, Chefaro Proprietaries and retail and beauty clients. Founder and

managing director of Concept, Beverley Benson also joined Charles Barker

too, working under Steve Gebbett in consumer marketing.

The new Charles Barker Healthcare made a pounds 708,795 contribution in

its first year, amounting to 13 per cent of group fee income. ‘We have

won a lot of cross company business with a healthcare link,’ says

Benson. ‘A major example of that was BUPA and the Community Pharmacy

Action Group (CPAG). Both of these involved corporate and public affairs

input as well as healthcare.’

There is no ethical business so far, though there is increasing POM to P

work creating consumer awareness, most recently taking dandruff shampoo,

Nizoral from POM-to-P.

Benson is happy with the first year in new surroundings. ‘Its been a

happy marriage. We have got accounts we would not have had without

Charles Barker and they’ve got accounts they would not have had without


CL 20 Medical Imprint pounds 536,110

Healthcare specialist Medical Imprint, saw a drop in healthcare income

from pounds 607,315 to pounds 536,110 in 1995.

The drop was due to the loss of SmithKline Beecham Biologicals. However,

it picked up the Association of British Pharmaceutical Industries which

has involved an education campaign launching patient packs, initially

for doctors and pharmacists. These will be phased in over three years

for complete courses of treatment. At the end of the year the agency won

the Department of Health’s pounds 150,000 contract for the Health

Alliance Awards. There was also work for Knoll Pharma, Roche and Bio

Products Laboratory. On the charity side there was work for Victim

Support with a booklet for GPs and A&E departments.

Marketing director Ciaran Duck says: ‘A couple of years ago you had to

sell the medium but now clients do not need to be sold the benefits of

professional relations and are becoming more open to new ideas and


There was continuing work for Du Pont Pharmaceuticals on its Improving

Management in Parkinson’s initiative.

CL 22 Cohn and Wolfe pounds 518,109

Cohn and Wolfe notched up a 17 per cent increase in fee income to pounds

518,109 and staff numbers have doubled since June. New wins included a

programme to promote the antibiotic Ciproxin and an educational drive

for the laxative brand Xyrofin.

But the most significant event of 1995 was the launch of Inform - a

clinical trial patient recruitment service developed with the help of Du

Pont Pharmaceuticals and SmithKline Beecham. Pharmaceutical firms were

initially cautious but business is now booming with the recent signing

of two more blue chip drug companies, bringing in a further estimated

pounds 200,000 in fees. Cohn and Wolfe’s healthcare director Martin

Ellis estimates Inform will account for 50 per cent of agency income by

the end of this year. ‘Our position in the marketplace is now secured,’

he said, ‘leaving us to capitalise in the remainder of 1996.’

Cl 28 GJW pounds 322,978

General lobbying and public policy specialist GJW is building up its

healthcare client base, with health related work now accounting for a

larger slice of group fee income. Last year healthcare contributed 8 per

cent of fee income at pounds 322,978 - about 30 per cent up on the

previous year.

Healthcare is expected to contribute much more in 1996 with the addition

at the beginning of this year of Professor David Taylor, formerly

associate director of Health Studies at the Audit Commission who, as

director of health affairs at GJW, provides health economic input.

Finance director, Nigel Clarke explains: ‘He will be looking to bring

health economics much more into public policy discussion as part of a

direct move towards evidence based medicine.’ Clarke says that the

agency will also be expanding economic studies of structural concerns in

the NHS and developments in Eastern Europe.

Last year involved new work for BUPA, looking at the future of pharmacy

for Boots and there was new work for Bristol Myers Squibb and Janssen-

Cilag. ‘A lot of what we are doing is non-party political,’ says Clarke,

‘but we are coming up to an election and clearly there are some

unresolved issues in relation to healthcare structure such as the future

of GP fund holders and long term care.’

NE 29 Clear Communications pounds 303,874

‘The NHS is doing a lot of in-house PR now, but is still needing

agencies as back-up’ says Scarlett MccGwire, senior partner of NHS

specialist, Clear Communications. Healthcare contributed pounds 303,874

last year, representing 79 per cent of fee income.

An important win was the London and south east zone of the National

Blood Transfusion Service which involved media training and general PR.

The agency put out positive stories about the Blood Service and also

launched an (umbilical) Cord Bank for use in leukaemia procedures to

replace bone marrow transplants. Training for the NHS Women’s Unit was

expanded with the introduction of courses for ethnic minorities at

managerial level. Work also started for the fund-raising organisation,

the Surrey Ambulance Foundation.

The agency went into overdrive last year for the NHS breast screening

programme. MccGwire says, ‘A surgeon from the Marsden said that the

programme was a waste of money. We went to work putting people up for

interview and within a week he had said that his words had been

misinterpreted. The nice thing was that during that time more women than

ever accepted their screening appointments.’

CL 33 Elliott & Cater pounds 221,626

Sussex-based Elliott & Cater started as a NHS specialist but is becoming

more general in outlook.

Healthcare income was 80 per cent of total fee income which totalled

pounds 277,033 - an increase of 60 per cent on 1994. ‘The NHS is a far

more sophisticated client now and knows what it wants,’ says managing

director Claire Cater. ‘There is less money and more people living

longer so it is important to consult and get to grips with what people

really want from the health service. ’

A high profile win was St Bartholomew’s School of Nursing and Midwifery

which involved a launch just prior to Christmas of its new identity

following its separation from the hospital. There was also stoma-care

work for Coloplast Limited and press relations for King’s Healthcare


Crisis communications is proving a growth area. ‘We do a lot of crisis

management and have had many calls from Trusts to be on call for crisis

situations,’ says Cater.

CL 34 GCI Group London pounds 199,788

GCI Group London consolidated its presence in the healthcare sector last

year with the recruitment of associate director Catherine Raba from

Edelman in September 1995.

Raba’s new healthcare division got off to a good start building on

existing client the Multiple Sclerosis Society and reaching a 1995 fee

income of pounds 199,788 - six per cent of total income. The agency won

Pepcid AC, a treatment for heartburn, which is its one OTC account, and

Searle with a project for its prescription only treatment, Zydol. Work

for the Multiple Sclerosis Society involved a new treatment for MS. It

won Sanofi Winthrop which involved media relations for HRT. The agency

also works with the Motor Neurone Disease Association.

‘Healthcare PR is no longer about drug promotion but disease management

and therapeutic categories,’ says Raba. ‘It demands quality education

programmes and results, and evaluation is very important since it is now

all very much results driven. This year we are looking to develop our

OTC business as well as the ethical side.’

FL 44 Kenyon Associates pounds 133,730

Healthcare formed 43 per cent of fee income which totalled pounds

311,000 at Liverpool-based Kenyon Associates.

‘The market was pretty much static,’ says managing director, Roger

Kenyon. ‘The pace of expansion is now slowing down as far as we are


Kenyon has developed a niche in work for hospitals and was one of the

first agencies to work for the new Trusts. Work included Ashworth

Hospital, a special hospital for offenders with work on publications,

videos, corporate identity and media training. A major gain was West

Lancs Hospital won in December with work on publications and media


‘People in hospitals at all levels are becoming keen on media training,

particularly middle management,’ Kenyon says. ’That market did not exist

a few years ago but a lot more people at all levels are confronting the

media now.’

CL 47 McCann Erickson PR pounds 81,560

McCann Erickson’s UK network which has been active, in one form or

another, for some eight years has until now concentrated its healthcare

expertise in its three year old Bristol office. However, managing

director Ron Dyson expects to see healthcare become a larger part of

group fee income over the coming year with other McCann Erickson


Last year healthcare income at the Bristol-based agency reached pounds

81,560 which was 10 per cent of fee income and marginally up on the

previous year.

At present a majority of the agency’s work is within the packaging

sector of the pharmaceutical industry. Work last year included medical

packaging for Rexam Healthcare and activities in the cardio-vascular

field for Bayer Pharmaceutical.

The three-year-old healthcare division is at a relatively early stage of

its development. ‘Healthcare is an area we are very keen to develop in

the years ahead,’ says Dyson. ‘McCann Erickson UK is one of the largest

pharmaceutical advertising agencies, if not the largest, so it makes

sense from a public relations point of view to match that capability.

There is a significant opportunity for us there. Over the course of the

next two years you should hear a lot more from us.’


Top Healthcare Consultancies 1-30 (part one)


Rank Company UK healthcare % overall Total UK

income income PR income

1 Medical Action 4,470,000 100 4,470,000


2 Burson-Marsteller 3,853,666 35 11,010,475

3 Shire Hall 2,338,594 100 2,338,594


4 Shandwick 1,345,800 6 22,430,000

5 Hill & Knowlton (UK) 1,330,340 11 12,094,000

6 Fusion Communications 1,256,068 100 1,256,068

7 The Grayling Group 1,148,366 23 4,928,609

8 Munro and Forster 1,117,821 70 1,596,887


9 Holmes and Marchant 1 1,089,460 38 2,867,000

10 Complete Pharma PR 964,124 100 964,124

11 Daniel J Edelman 961,191 23 4,179,093

12 Manning Selvage 825,185 39 2,115,860

and Lee

13 Countrywide 810,470 6 13,507,826


14 Charles Barker2 708,795 13 5,452,267

15 Advisa Medica 668,363 95 703,540

16 Euro RSCG International 608,800 10 6,087,997

17 Harvard Public 597,600 20 2,988,000


18 Fleishman-Hillard UK 561,617 25 2,246,466

19 Maureen Cropper PR 554,400 63 880,000

20 Medical Imprint * 536,110 98 547,051

21 Ludgate 522,513 10 5,225,132

22 Cohn and Wolfe 518,109 20 2,590,547

23 The Rowland Company 488,641 14 3,490,294

24 Lynne Franks* 480,927 19 2,531,193

25 Greenlines PR 381,278 100 381,278

26 Ruder-Finn 348,764 90 387,516

27 Cameron Choat 332,640 16 2,079,000

and Partners

28 GJW 322,978 8 4,037,222

29 Clear Communications 303,874 79 384,650

30 Public Relations 266,391 16 1,664,946


All figures relate to the year ended 31 December, 1995. Fee income = PR

fees plus mark-up. All figures are certified by an auditor except those

marked *. 1. Figures relate to Holmes and Marchant Counsellor

healthcare division.2. Acquired Concept PR in 1995.



Top Healthcare Consultancies 1-30 (part two)


Rank Company                   Staff    Agency type

 1   Medical Action              58     Healthcare specialist


 2   Burson-Marsteller          147     Full service with healthcare


 3   Shire Hall                  35     Healthcare specialist


 4   Shandwick                  391     Full service

 5   Hill & Knowlton (UK)       189     Full service with healthcare


 6   Fusion Communications       21     Healthcare specialist

 7   The Grayling Group          85     Full service with healthcare


 8   Munro and Forster           40     Consumer and healthcare


 9   Holmes and Marchant 1       45     Full service with healthcare


10   Complete Pharma PR          18     Healthcare specialist

11   Daniel J Edelman            60     Full service with healthcare


12   Manning Selvage             35     Full service with healthcare

     and Lee                            division

13   Countrywide                213     Full service with healthcare

     Communications                     division

14   Charles Barker2             75     Full Service

15   Advisa Medica               10     Healthcare specialist

16   Euro RSCG International    132     Full service

17   Harvard Public              48     Healthcare, technology &

     Relations                          consumer

18   Fleishman-Hillard UK        32     Full service with healthcare


19   Maureen Cropper PR          19     Consumer and healthcare

20   Medical Imprint *           18     Healthcare specialist

21   Ludgate                     58     Financial and corporate

22   Cohn and Wolfe              50     Full service with healthcare


23   The Rowland Company         63     Full service with healthcare


24   Lynne Franks*               49     Consumer

25   Greenlines PR               11     Healthcare specialist

26   Ruder-Finn                  13     Healthcare and corporate

27   Cameron Choat               33     Consumer

     and Partners

28   GJW                         65     Public affairs

29   Clear Communications        10     NHS Specialist

30   Public Relations            41     Full service


All figures relate to the year ended 31 December, 1995. Fee  income = PR

fees plus mark-up.  All figures are certified by an auditor except those

marked *.  1. Figures relate to Holmes and Marchant Counsellor

healthcare division.2. Acquired Concept PR in 1995.



Top Healthcare consultancies 31-50 (part one)


Rank Company                UK healthcare   % overall   Total UK

                               income         income    PR income

31   Keene Communications*     263,500          31        850,000

32   Infopress                 240,000          15      1,600,000

33   Elliott & Cater           221,626          80        277,033

34   GCI Group London          199,788           6      3,329,800

35   Staniforth PR             182,100          15      1,214,000

36   Golley Slater PR          166,653           9      1,831,347

37   Ketchum PR                163,155          14      1,165,392

38   College Hill              162,451           5      3,249,027

39   Fishburn Hedges           161,122           5      3,222,443

40   Pielle                    155,835          16        973,967

41   Sinclair Mason            154,260          15      1,028,398

42   Attenborough Associates   153,473          10      1,534,730

43   Harrison Cowley           137,295           5      2,745,891

44   Kenyon Associates         133,730          43        311,000

45   Health Network            125,355          29        426,377

46   Square Mile                86,452           7      1,235,033


47   McCann Erickson            81,560          10        815,600

48   De Facto Consultants       76,609          13        589,297

49   Kinross and Render         65,165          10        651,647

50   Keene Public Affairs       60,471          15        403,138




Top Healthcare consultancies 31-50


Rank Company                    Staff  Agency type

31   Keene Communications*        19   Full service

32   Infopress                    27   Full service

33   Elliott & Cater               5   Healthcare specialist

34   GCI Group London             66   Full service with healthcare


35   Staniforth PR                29   Full service

36   Golley Slater PR             38   Full service

37   Ketchum PR                   23   Full service with healthcare


38   College Hill                 40   Financial and corporate

39   Fishburn Hedges              37   Financial

40   Pielle                       18   Full service

41   Sinclair Mason               15   Full service

42   Attenborough Associates      27   Full service except financial

43   Harrison Cowley              78   Full service

44   Kenyon Associates            13   Full service

45   Health Network               15   Full service

46   Square Mile                  20   Corporate and financial


47   McCann Erickson              19   Full service

48   De Facto Consultants         12   Healthcare and bioscience

49   Kinross and Render           17   Full service with healthcare


50   Keene Public Affairs          6   Public affairs



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