FOCUS: HEALTH PR - Unlocking the global market. While adapting their PR to local cultural climates, pharmaceutical companies are also focused on global markets. Ben Bold reports

Consolidation is the order of the day for pharmaceutical companies.

Consolidation is the order of the day for pharmaceutical


The past few years have seen mergers and acquisitions galore and the

result is that pharmaceutical companies are looking at marketing and

selling their products on a global scale.

While they are growing, the world is getting smaller. The inexorable

rise of the internet means that medical communities are shrinking and

the need for consistency of communication is getting greater.

In addition, the increasing globalisation of communications has enabled

the consumer to gain greater access to information, opinion and comment

across all longitudes and latitudes.

These factors have created a greater need for a uniform identity and

this is why the requirement for pharmaceutical companies to talk to all

their audiences with a consistency of message has become of paramount


Pharmaceutical products were once considered rather esoteric. The

consumer is now, however, more savvy and it is therefore important for

drug companies to offer products that possess an ’identity’.

Medical ’brands’ are the future. The obvious, and high-profile, example

of Viagra illustrates this point. The consumer interest generated by

’word of mouth’ was unprecedented - the media, and consequently the

consumer, in the UK was talking about Viagra before it had even been

launched here.

Carefully thought-out communications play a vital role in getting

companies’ messages across accurately and to a far more diverse audience

than in the past.

However, there are many difficulties involved. Different countries are

subject to different laws, regulations and cultures and the importance

of adapting the communications process to meet these criteria is


As Gary Hobbs, managing director of Medical Action Communications, says:

’Global brands are de rigueur for FMCG brands but pharmaceutical

companies, until recently, have not put the brand at the centre of their

communications strategy - they have concentrated on the product.’ MAC’s

clients include Pfizer, Glaxo Wellcome, and Johnson and Johnson.

Traditionally pharmaceutical companies have launched drugs in different

countries or regions under different names and by using different


The brand was not put at the centre of a communications strategy: the

pharmaceutical company instead concentrated on the type of product and

adapted this differently to suit different local markets. These products

were generally targeted at the medical community; the consumer was not

considered somebody to whom they were relevant.

There have been efforts to establish global pharmaceutical brands for

some time, but it was rare for a company to do so, and the approach was

usually oblivious to the differences between local markets. A company in

the US, for instance, might have used the same tools to communicate a

brand in other countries that it had used in its home market.

There was, and to a certain extent still is, a blissful ignorance of

different cultural climates. Press releases were often just translated

and sent out to other markets, with no attempt at adapting them to a

foreign market.

Before global consolidation took its grip on the pharmaceutical

industry, multinational drugs companies tended to be structured in a

such a way that they were nation-focused, comprising separately located

divisions that concentrated on particular areas. Pharmaceutical

companies would have separate budgets for different countries and

regions, and communications strategies behind a drug would be completely

different for different markets.

Because different tactics and different names were used for drugs there

was no sharing of knowledge and experience between local PR companies

across international barriers. One nation would launch a pharmaceutical

product under a completely different name from another and by using

completely different means.

One theory of why pharmaceuticals started to become brands which

required global marketing pivots on the spread of HIV in the 1980s. The

formation of the AIDS community was a catalyst for patients becoming

more involved in health issues.

The Western world suddenly became aware of this rapidly-spreading fatal

disease and therefore any developments in the treatment or prevention of

it garnered interest from those outside of the medical community.

Patient power has become an increasingly significant phenomenon and

consumers are now a lot more health-literate as a result (PRWeek,10

March). As they are playing an increasingly involved role in their own

healthcare, it is essential for pharmaceutical companies to respond to

this and market themselves to the consumer as well as to the health


The pharmaceutical industry is increasingly finding that it must think

of itself as a global or multinational organisation and not think in

terms of being UK- or US-based. Companies that have recently

consolidated or been taken over have set up more international marketing

teams at headquarter level. There are growing numbers of foreign CEOs

and senior managers based in central offices to help develop the

globalisation of business.

The bottom line is that pharmaceutical companies are selling many of

their products multinationally or globally, and to do this as cost

effectively as possible they need to create a central communications and

PR drive.

As David Gallagher, managing director of healthcare for Ketchum Europe,

explains: ’There is no such thing as a German or US pharmaceutical

company - they are all multinationals.’ Ketchum’s healthcare clients

include Janssen and Warner Lambert.

As a result there is now an increasing move towards multinational

brands, and PR companies are spearheading the pharmaceutical companies’

drive in this direction.

There are many difficulties in developing and constructing a globally

integrated communications drive. The global healthcare, communications

or branding agency must liaise with the pharmaceutical company and

conceive an identity and vocabulary that is adaptable, but that retains

the central brand values. As the entire process is about communication,

it is important to involve local agencies at as early a stage as


For most global PR programmes the primary target is the chain of local

or affiliate agencies. If all parties are to be actively involved in the

global promotion of a drug, then it is vital that their central

strategies are aligned. Gallagher says: ’A typical approach for a global

entity is to develop template materials. ’Here’s a logo, here’s how

we’ll discuss the product and here’s what it does.’’

It is then often up to the agencies in the local markets how they will

communicate, without compromising the integrity of the core brand.

Hobbs adds: ’A year or so before the launch of a pharmaceutical product,

responsibility is handed to the affiliates. Local agencies make

independent decisions. This is the point at which there’s a danger that

the communications chain can be broken and that messages can become


So communication to local agencies must be extremely well managed from

an early stage, and throughout the entire process. Ann Moravick, senior

vice president and global head of healthcare at Manning Selvage and Lee,

says: ’The idea is to develop a strategic approach that is as general as

possible that can be adapted to suit a local market. You can do one

thing in one market that you can’t do in another.’

There is the danger, however, that a pharmaceutical company or global PR

agency can dominate the communications process in local markets and end

up telling independent agencies what to do. ’You don’t want to take away

the motivation from local affiliates. You can’t be too prescriptive,’

Moravick says.

Another issue which is crucial is to integrate all marketing


Hobbs says, ’If communications are not consistent then doctors will

perceive confusion. If a doctor attends successive international

meetings and receives different messages from events and press releases

then it will create confusion and therefore a lack of confidence in the


There are many tools and materials with which the global agency can

provide the local agency. For example, international meetings can be

organised by the global agency and affiliates can then invite their key

opinion leaders and media to these. Central on-line networks or

intranets can be set up, enabling those involved in every country and at

every level to keep abreast of developments.

’Locally there is more latitude to use the materials provided for them

centrally,’ Gallagher says. ’We would produce material for use around

the world and they would have the opportunity to adapt them.’

The key point is to set off the whole brand development, advertising, PR

and education process in the right way. Many PR and medical

communications agencies say that it is sometimes the case that a drugs

company finds it hard to appreciate that a local market might require a

local approach.

Some US based pharmaceutical companies, for instance, are shocked that

different regulations exist in Europe.

Angie Searle, executive director of Cohn and Wolfe healthcare, which has

just picked up work for Novartis, says, ’Some US companies think that

they can take the US principle and apply it across Europe. We have to

educate clients about the value of core local programmes.’

The US has the largest consuming market presence for pharmaceutical

companies, and regulations allow pharmaceutical companies to advertise

direct-to-consumer. Because consumers are essentially paying for their

own healthcare through medical insurance, the culture is also such that

the consumer is generally more health conscious.

’US companies have exercised more latitude and are more aggressive in

targeting pharmaceutical products,’ Gallagher says.

The internet has opened up a new medium for disseminating information,

but while it is an excellent means of communicating, it is vital that a

pharmaceutical company carefully manages the messages of its


This is hard to do in the present climate, as guidelines in Europe do

not allow a pharmaceutical company to actively promote or discuss their

brands direct-to-consumer (DTC). However, anyone can access a company’s

US web site and gain information on a product.

’Pharmaceutical companies are anticipating a move towards DTC in

Europe,’ says Atkins. Cohn and Wolfe pushes right up against the

boundaries of these regulations. The agency conducted a survey on behalf

of Prozac that looked into how women worldwide suffer from pre-menstrual

tension. It got patient groups to endorse the findings, and distributed

leaflets to patients through surgeries with the Prozac brand colouring,

but with no actual wording - which would be construed as DTC.

Because of the different regulations in Europe and the US, it is

essential that the global PR agency and in-house department maintain a

strong relationship with their international offices, affiliates or

network members.

’Some pharmaceutical companies take a tight-rein approach. Some might

want a similar worldwide approach, and others might say adapt your

strategy according to the local market so that the core identity is

still there.

The degree to which they push that is widely variable,’ says Atkins.

Despite the relative independence that is allowed of local agencies,

central to a global drive is the consistency of theme, which must

percolate down to all levels of the communications process. What the

global agency can do is feed templates down the chain to local


For example, for their global ’Quit and Win’ campaign for Nicorette,

Shandwick used an image taken from the Swedish part of the campaign. It

was a photograph of a bonfire of cigarettes. The image clearly conveyed

a symbol that could be sold across the globe.

The local agency comes into its own in adapting the communications

process to its country’s regulative and cultural level.

Janet Morgan, head of pharmaceutical and medical at Euro PR, says,

’Globally we monitor the media coverage and feed it back to the local

agencies so that they can become aware of any big issues coming up. From

a local point of view it is important to be far more aware of

opportunities coming up.’

As pharmaceutical companies continue to extend their global reach, and

growing patient interest means that manufacturers are having to consider

consumers in their markets, the industry is learning from the FMCG


The day when a pharmaceutical product is among the world’s superbrands

may not be too far away.

CASE STUDY: Promoting an anti-psychotic treatment for Eli Lilly

Cohn and Wolfe is exploring ways of carrying out an effective global PR

campaign for a pharmaceutical brand in its work for Eli Lilly.

Zyprexa is an ’atypical’ anti-psychotic treatment that was cleared for

marketing in Europe and the US in 1996 for the treatment of

schizophrenia and related psychotic disorders.

Newer generation anti-psychotic drugs (’Atypicals’) represent a major

step forward from the older ’typical’ anti-psychotics, which are often

associated with a narrower efficacy profile and debilitating

side-effects, resulting in poor compliance and increased risk of

relapse. In spite of the advantages of atypicals over typicals,

prescribing in Europe remains consistently low.

Cohn and Wolfe executed a global communications programme to

differentiate Zyprexa from its competitors, which took into account the

differing needs of affiliates and the marketing stages the drug had

reached in different regions.

The objectives were to establish and maintain one global brand and to

ensure consistent communication of core messages at a local level; to

provide affiliates with core materials for local implementation; and to

encourage affiliates to maximise the opportunities presented by the

programme in their own markets and use the materials provided.

The programme comprised an integrated and comprehensive programme of

external and internal activities. A survey of European psychiatrists was

conducted to demonstrate their support for the conversion to newer


This generated pan-European and local market news hooks to form the

basis of a carefully integrated communications programme.

Press briefings were held at key international meetings to provide a

forum for experts to provide new data about atypicals and Zyprexa. This

provided third-party endorsement and dissemination to a wider audience

through the media.

Affiliates were given the necessary materials and guidance to invite

journalists to the meetings and distribute the press materials in their


Cohn and Wolfe regularly distributed press releases on emerging data,

sending data to local affiliates with guidelines on local


This constant drip-feed of information ensured that ’noise’ was

maintained in local media.

Eli Lilly also established the international ’Lilly Schizophrenia

Reintegration Awards’, which were non-branded so that they could be run

in countries where Zyprexa had not yet been launched.

For the internal aspect of the campaign, Cohn and Wolfe devised a

step-by-step global communications manual. This gave affiliates

information on how to organise a press briefing and provided templates

that could be adapted to meet the local needs of individual markets.

A media resource manual was provided, which contained globally approved

press material. This was regularly updated using the network’s on-line

system. The on-line system was set up that enabled communications

between Cohn and Wolfe, Eli Lilly and the various affiliate offices.

Four regional affiliate PR workshops were held to consolidate their

experience and to provide additional support for the development of

local PR strategies.

Media training sessions were also held for employees of the affiliates

and Eli Lilly.

The media coverage gained as a result of journalist attendance at key

meetings and from the ongoing dissemination of clinical data

consistently carried all core messages. Some affiliates also gained

coverage from their involvement in the ’Lilly Schizophrenia

Reintegration Awards’ programme.

Zyprexa has become a major player in the atypical anti-psychotic



- Identify interdependencies between target audiences - hospital,

primary care, funders, carers, patients and general public.

- Identify the needs (rational and irrational) of each audience within

the framework, reflecting the human and professional requirements.

- Develop a unique global positioning for the pharmaceutical compound

that is aligned to the key needs of the prioritised target


- Develop brand essence, messages, identity and vocabulary, and apply to

the commercialisation plan for the final phases of drug development.

- Construct a global communications strategy to deliver attention,

awareness and agreement for the brand message.

- Develop advocacy at a global level, with extension into national

opinion leader level.

- Market development: identify the limiting steps (patient presentation,

diagnosis rates, compliance etc.) to prescription of the new brand and

dedicate communication effort to removing the blockage.

- Market shaping: develop educational and message-driven initiatives to

orient the market towards the new brand.

- Work with national affiliates and their agencies to localise the

international campaign.

- Collect and assimilate market feedback, and evolve communications

strategy to reflect the developing market.

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