TOP 50 HEALTHCARE PR: Health complex - An increasing consumer awareness of health matters has created a diverse audience for healthcare PR, says Robert Gray

The healthcare PR sector in the UK had an active year during 1998. As the PR Week league table shows, there was plenty of movement in fee income among the leading healthcare consultancies.

The healthcare PR sector in the UK had an active year during 1998.

As the PR Week league table shows, there was plenty of movement in fee

income among the leading healthcare consultancies.

In percentage terms, double digit changes were the norm. For the most

part, fortunately, these reflected positive growth. But there were also

a handful of double digit decreases, some of them quite substantial,

including Manning Selvage and Lee, which saw healthcare income drop by

40 per cent, and the Red Consultancy, whose healthcare fees dropped by

43 per cent.

The performance of the leading agencies in the sector was particularly

good. Well over half of the top 20 consultancies posted fee income rises

of above 15 per cent. ’The UK is currently in a healthcare boom and the

appetite for health issues and products among journalists is as strong

as I’ve ever seen it,’ says CCD Healthcare PR managing director Justin


There are a number of challenges currently facing PROs in the healthcare

sector, as this is a time of great change in the structure of the NHS

and the way in which pharmaceuticals are being promoted.

The past year has been one of continuing merger activity among

pharmaceutical companies, as exemplified by Astra’s recent merger with

Zeneca and Sanofi’s merger with Synthelabo.

According to GCI Healthcare managing director Catherine Warne, PR in the

healthcare sector has to change as society at large becomes more

drug-conscious. ’It’s no longer good enough to say you’ve got a

fantastic drug.

There has to be a clinical justification, patient justification and cost

justification as to why this drug should be used,’ she says. ’ The job

now is to demonstrate how this helps the medical community achieve

targets as set out by the Government.’

But while the Government is setting targets centrally, there is also a

great deal of local-level responsibility. For example, the arrival of

Primary Care Groups (PCGs) is having a major impact on


PCGs, which consist of doctors, pharmacists and lay members, make

prescribing decisions at a local level. Jonathan Street, managing

director of NHS specialist consultancy Jonathan Street PR, says demand

from PCGs for media training has been high, in anticipation of a high

level of local media scrutiny.

At the same time, pharmaceutical companies need to communicate the

benefits of their products to the PCGs.

Lowe Fusion managing director Julia Cook says: ’People around the

country who are going to be influencers within PCGs are going to be

really important to get to.’

In this changing climate, pharmaceutical companies are having to be more

dynamic and fleet-of-foot in their marketing than ever before. As a

result, they are coming to expect greater adaptability from their PR


’In the old days you could stick a four-man team in place and know in

advance what fee you would get for the year,’ says Caroline Ashe,

director of healthcare at Countrywide Porter Novelli. ’Now programmes

are reviewed at least every six months, and often every three months.

Clients have different needs throughout the year, be it media relations,

internal communications, corporate reputation work, issues, education or

a new launch. As a result, consultancies must be flexible, supple and

fast to react. Those that aren’t will lose out.’

The jury is still out on the likely impact of the recently established

National Institute for Clinical Excellence (NICE), which will evaluate

pharmaceuticals in terms of healthcare economics and ’disease outcome

assessments’ - medical-speak for how the administration of a drug will

affect the development of a disease.

It is clear, however, that the greater debate about the cost and

clinical effectiveness of medicines is changing the nature of drugs

communications programmes. Edelman head of global healthcare Nick May

explains: ’Ever since NICE came onto the scene, a public affairs element

to healthcare communications has become more important than ever.’

Of equal importance, says Munro and Forster Communications managing

director Brian Gunson, is the continuing growth of ’patient

empowerment’. ’Although EU regulations prevent pharmaceutical companies

marketing branded ethical treatments direct to consumers, there is a

growing recognition among governments across Europe that patients now

want a greater say in their own treatment,’ he says.

In ever greater numbers, patients are using the worldwide web as a

source of information on their medical conditions. As the internet is a

global medium it often reveals treatment disparities around the world.

If a drug for a certain disease is available in one country but not in

the patient’s homeland they will understandably want to know why. This

situation has precipitated an upsurge in international assignments for

UK consultancies.

The importance of the web in all of this has also encouraged many of the

top players to build up their new media skills. Shire Hall even

purchased a minority stake in internet specialist Netwise.

’The drive towards greater communications with consumers is certainly

gathering pace,’ says Shire Hall Group chief executive Margot James.

’There’s a definite change in orientation, with clients devoting bigger

budgets to targeting consumers.’

James believes pharmaceutical companies will start to advertise more -

telling consumers about types of treatment rather than promoting

specific products, to stay within the regulations - and that this

advertising will have to be tightly integrated with PR. Interactive

media will also have an important role to play in the new marketing mix

as patients turn to the internet for information.

The emergence of functional foods - which can broadly be described as

food products containing nutrients which help reduce the risk of various

diseases - is another factor driving the consumerisation of healthcare


Grayling managing director healthcare Peter Holden says: ’Food

manufacturers are realising that if they have a health benefit for a

food, they need the expertise of healthcare consultants to communicate

that benefit to the medical community and beyond.’

Ruder Finn client services director Mike Dixon adds: ’We are now seeing

the existence of a healthcare continuum, with ethical medicines becoming

over-the-counter, the growth of functional foods, and cosmoceuticals

(active skincare products which overlap cosmetics and pharmaceuticals)

all needing specialised marketing support.’

Increasingly, drug manufacturers are also calling PR advisers in at an

earlier stage in the product cycle, often at the pre-marketing stage, to

partner the client’s brand marketing team. Cohn and Wolfe executive

director healthcare Angie Searle says: ’Pharmaceutical companies which

involve you in that way get a lot more value out of the agency.’

Within the NHS, meanwhile, crisis and reputation management are being

taken ever more seriously. With Government league tables including the

number of hospital deaths for the first time, NHS trusts are under

greater pressure to justify performance. ’It’s another turn of the screw

towards greater transparency,’ says NHS specialist Street.

These Government tables will undoubtedly become even more sophisticated

in the coming years and will be pounced on by both local and national

media. The great fear among trust administrators is that one day they

might be involved in a major scandal.

’Hospitals are much more ready to handle crises than a few years ago,’

argues Street. ’All hospital management teams are looking very carefully

at risk management issues.’

In order to cope with the changing healthcare scene, specialist training

for healthcare PR practitioners has been taken up a notch. Ketchum

managing director Paul Blackburn explains: ’Staff training and career

development opportunities for healthcare consultancy staff are becoming

more of an issue. Those consultancies able to give their staff more

skills and opportunity will thrive.’

During the past year, the foundations have been laid for significant

changes in the healthcare industry. PR practitioners have a challenging

period ahead, looking at ways to communicate with new audiences, and

dealing with new issues.

If they can meet the rapidly changing communication needs of the sector,

the healthcare market will still be in great shape this time next



Rank      Company                                   UK healthcare income

                                                               (pounds )

98   97                                                 98            97

1    1    Medical Action Communications          7,520,000     6,530,000

2    2    The Shire Hall Group                   4,222,000     4,167,000

3    4    Hill and Knowlton (UK)                 3,028,350     2,250,360

4    3    Meditech Media1                        2,958,000     2,698,000

5    6    Shandwick UK                           2,586,300     2,030,720

6    8    Ketchum                                2,401,982     1,705,150

7    5    CPR Worldwide                          2,079,272     2,033,611

8    7    Holmes and Marchant                    2,004,990     1,795,200

9    10   The Grayling Group                     1,779,910     1,513,073

10   13   Munro and Forster Communications       1,609,155     1,135,674

11   11   Cohn and Wolfe                         1,565,764     1,256,275

12   9    Lowe Fusion Healthcare                 1,478,293     1,576,707

13   20   Countrywide Porter Novelli             1,433,009       851,952

14   15   The Workhouse                          1,220,845     1,032,046

15   18   Ruder Finn                             1,158,798       876,332

16   22   GCI Group                              1,039,038       715,274

17   12   Edelman Public Relations Worldwide       982,722     1,140,368

18   21   Euro RSCG International

          Communications                           927,616       798,390

19   19   Harvard Public Relations                 787,140       862,800

20   24   Sante Communications                     766,761       623,221

21   16   Charles Barker BSMG2                     673,897     1,026,128

22   17   Manning Selvage and Lee                  535,500       897,120

23   25   Jonathan Street Public Relations         460,748       412,852

24   27   EMC EuroPR                               403,657       317,764

25   31   BMA Communications                       355,016       253,204

26   -    Henderson Group One                      316,749             -

27   -    Jo Spink PR                              316,665             -

28   30   Nexus Choat                              297,920       273,700

29   37   Myriad Public Relations                  270,352       154,773

30   28   Harrison Cowley                          242,472       304,085

31   -    Talking People1                          219,822             -

32   32   Packer Forbes                            217,597       231,487

33   -    Beattie Media                            206,000             -

34   -    CCD                                      205,000             -

35   41   Fleishman-Hillard UK                     176,973       133,987

36   40   Barkers Public Relations                 167,680       139,801

37   29   The Red Consultancy                      163,556       289,406

38   42   Square Mile Communications               151,056       132,156

39   38   Staniforth                               124,070       143,280

40   36   Golley Slater PR                         105,102       172,128

41   -    Republic Communications                   81,068             -

42   35   Keene Communications                      80,565       219,840

43   -    Profile Public Relations                  71,761             -

44   -    Wyatt International                       70,255             -

45   -    Amanda Barry Communications               66,006             -

46   -    Lawson Clarke                             63,366             -

47   -    Kinross and Render                        55,653             -

48   -    Audax Communications                      49,260             -

49   -    Keene Public Affairs Consultants          45,391             -

50   -    Barrett Dixon Bell                        44,800             -

Rank      Company                                 % growth      Total PR

                                                  (pounds)        income

98   97                                                               98

1    1    Medical Action Communications                 15     7,520,000

2    2    The Shire Hall Group                           1     4,222,000

3    4    Hill and Knowlton (UK)                        35    23,295,000

4    3    Meditech Media1                               10     2,958,000

5    6    Shandwick UK                                  27    25,863,000

6    8    Ketchum                                       41     9,607,929

7    5    CPR Worldwide                                  2     2,079,272

8    7    Holmes and Marchant                           12     3,783,000

9    10   The Grayling Group                            18     8,090,500

10   13   Munro and Forster Communications              42     2,298,793

11   11   Cohn and Wolfe                                25     5,399,185

12   9    Lowe Fusion Healthcare                        -6     1,478,293

13   20   Countrywide Porter Novelli                    68    17,912,610

14   15   The Workhouse                                 18     1,220,845

15   18   Ruder Finn                                    32     1,655,426

16   22   GCI Group                                     45     7,421,700

17   12   Edelman Public Relations Worldwide           -14     8,933,832

18   21   Euro RSCG International

          Communications                                16     8,834,437

19   19   Harvard Public Relations                      -9     4,373,000

20   24   Sante Communications                          23       766,761

21   16   Charles Barker BSMG2                         -34     9,627,095

22   17   Manning Selvage and Lee                      -40     3,570,000

23   25   Jonathan Street Public Relations              12       658,212

24   27   EMC EuroPR                                    27     1,009,143

25   31   BMA Communications                            40     1,613,708

26   -    Henderson Group One                            -       316,749

27   -    Jo Spink PR                                    -       363,983

28   30   Nexus Choat                                    9     3,724,000

29   37   Myriad Public Relations                       75       844,850

30   28   Harrison Cowley                              -20     4,849,441

31   -    Talking People1                                -       666,128

32   32   Packer Forbes                                 -6       310,853

33   -    Beattie Media                                  -     4,120,000

34   -    CCD                                            -       205,000

35   41   Fleishman-Hillard UK                          32     2,212,160

36   40   Barkers Public Relations                      20     2,223,875

37   29   The Red Consultancy                          -43     3,271,117

38   42   Square Mile Communications                    14     2,157,945

39   38   Staniforth                                   -13     2,481,390

40   36   Golley Slater PR                             -39     2,102,048

41   -    Republic Communications                        -       540,451

42   35   Keene Communications                         -63     1,611,300

43   -    Profile Public Relations                       -     1,435,220

44   -    Wyatt International                            -       702,547

45   -    Amanda Barry Communications                    -       314,316

46   -    Lawson Clarke                                  -       352,034

47   -    Kinross and Render                             -     1,113,068

48   -    Audax Communications                           -       492,601

49   -    Keene Public Affairs Consultants               -       453,911

50   -    Barrett Dixon Bell                             -       448,000

Rank      Company                                    Staff     % overall


98   97

1    1    Medical Action Communications                 92           100

2    2    The Shire Hall Group                          69           100

3    4    Hill and Knowlton (UK)                       320            13

4    3    Meditech Media1                              100           100

5    6    Shandwick UK                                 374            10

6    8    Ketchum                                      136            25

7    5    CPR Worldwide                                 32           100

8    7    Holmes and Marchant                           44            53

9    10   The Grayling Group                           107            22

10   13   Munro and Forster Communications              53            70

11   11   Cohn and Wolfe                                71            29

12   9    Lowe Fusion Healthcare                        24           100

13   20   Countrywide Porter Novelli                   266             8

14   15   The Workhouse                                 10           100

15   18   Ruder Finn                                    25            70

16   22   GCI Group                                    128            14

17   12   Edelman Public Relations Worldwide            96            11

18   21   Euro RSCG International

          Communications                               152            11

19   19   Harvard Public Relations                      56            18

20   24   Sante Communications                          15           100

21   16   Charles Barker BSMG2                         115             7

22   17   Manning Selvage and Lee                       53            15

23   25   Jonathan Street Public Relations              11            70

24   27   EMC EuroPR                                    18            40

25   31   BMA Communications                            16            22

26   -    Henderson Group One                           10           100

27   -    Jo Spink PR                                   10            87

28   30   Nexus Choat                                   69             8

29   37   Myriad Public Relations                       22            32

30   28   Harrison Cowley                              104             5

31   -    Talking People1                               19            33

32   32   Packer Forbes                                 11            70

33   -    Beattie Media                                 71             5

34   -    CCD                                            4           100

35   41   Fleishman-Hillard UK                          29             8

36   40   Barkers Public Relations                      44             8

37   29   The Red Consultancy                           65             5

38   42   Square Mile Communications                    28             7

39   38   Staniforth                                    45             5

40   36   Golley Slater PR                              41             5

41   -    Republic Communications                       11            15

42   35   Keene Communications                          26             5

43   -    Profile Public Relations                      24             5

44   -    Wyatt International                           14            10

45   -    Amanda Barry Communications                    9            21

46   -    Lawson Clarke                                 15            18

47   -    Kinross and Render                            25             5

48   -    Audax Communications                          13            10

49   -    Keene Public Affairs Consultants               8            10

50   -    Barrett Dixon Bell                            15            10

All figures relate to the year ended 31 December 1998 Fee income= PR

fees plus mark-up.

Only agencies where healthcare accounts for five per cent or more of UK

fee income are included.

1. Does not include fee income from offices outside the UK, which were

included in 1998. 2 Includes healthcare fees from LSA.


Restructuring at Medical Action Communications (MAC) has continued

following its acquisition two years ago by North Carolina-based contract

pharmaceutical organisation Quintiles Transnational Corporation. MAC

chief executive Stephen Bullock has taken on the further role of CEO at

Quintiles Medical Communications, an umbrella under which to grow global

healthcare PR and related services.

Last year QMC acquired QED Communications, a New York State healthcare

consultancy. ’We can really provide clients with a global service now,’

says Bullock. ’My remit is to continue growing the group through


MAC’s UK team has been strengthened. Gary Hobbs joined as MD and chief

operating officer at the start of this year from Franklin Scientific

Projects and Smita Desai joined in 1998 from Shire Hall as strategy

development director with a brief to explore new media opportunities and

hone traditional media relations activity.

New business for MAC has included work for Pfizer on its central nervous

system portfolio, developing Janssen Cilag’s gastrointestinal portfolio

and promoting the use of Bristol-Myers Squibb’s compound Pravastatin in

the treatment of heart attacks.

A 15 per cent rise in fee income kept MAC well out in front of the


’We’re pleased to be consistently performing in the marketplace,’ says

Bullock. ’We’ve been able to grow by investing in our people and our


2. THE SHIRE HALL GROUP - pounds 4,222,000

A one per cent growth in fee income compares unfavourably with many of

its competitors but it was still more than sufficient to keep

independent consultancy Shire Hall in second spot.

This was a year of change for Shire Hall, with Lois Hall stepping up to

become managing director of Shire Hall International, the international

campaigns arm of the group, following the departure of Smita Desai to

join Medical Action Communications. Sarah Harwood assumed the MD role in

the UK.

Gloria Gibbons took over as MD of Shire Hall’s medical education

business 4D Communications, which is working on programmes for drugs

such as Asmanex and Lotronex that are tied in with PR assignments run by

Shire Hall.

New clients include Schering-Plough, with product assignments for asthma

treatment Asmanex and erectile dysfunction drug Vasomax. Also new was a

brief for Schering Healthcare’s oral contraceptive range, a Novartis

epilepsy drug, SmithKline Beecham’s diabetes treatment Avandia, a

pan-European advertising and direct marketing brief for Phillips’

Sensortouch thermometer, and Glaxo Wellcome’s Lotronex, a treatment for

chemotherapy-related nausea which, it has been found, also treats IBS.

On the debit side, out went the business for Pfizer’s migraine drug


Shire Hall also bought a stake in internet specialist Netwise and can

now offer clients web solutions. ’We’re moving much more into the

multimedia market,’ says James.

3. HILL AND KNOWLTON - pounds 3,028,350

A healthy 35 per cent growth in fee income, the best percentage growth

in the top five, saw Hill and Knowlton seize the number three


This upsurge was driven by a combination of organic growth and new


Wins included Glaxo Wellcome influenza drug Relenza, Johnson and Johnson

Gynecare for a product used to treat heavy periods and pre-launch work

across five European countries on an ethical cardiology product for

Procter and Gamble.

The consultancy also picked up work from new clients AstraZeneca,

Janssen Cilag and Pharmacia and Upjohn, but had a significant business

loss in Astra’s market leading peptic ulcer drug Losec, on which the

agency had worked for four years.

There was organic growth from Roche on controversial anti-obesity drug

Xenical and in other areas. There were also new media communications

assignments in the disease areas of HIV and hepatitis C. ’The whole new

media area is getting bigger and bigger for us,’ says Hill and Knowlton

managing director UK healthcare practice Karen Moyse.

The healthcare team was bolstered by the hiring of two associate

directors: Antonia Betts and Juliet Chamberlain, from Shire Hall and

Complete Pharma, respectively.

’What we’re able to do is bring together our consumer marketing

expertise with the ethical marketing people to produce a hybrid offer,’

concludes Moyse.

4. MEDITECH MEDIA - pounds 2,958,000

This year’s fourth-ranked agency is Meditech Media, the 12-year-old firm

with a global outlook which has been busy building a presence in

overseas markets. Last year saw new offices open in Singapore, Sydney

and Rome.

Similar to Medical Action Communications in that it offers clients

integrated healthcare communications solutions rather than just PR,

Meditech Media has been able to provide clients with a one-stop

marketing consultancy shop. Its two biggest clients in PR terms are

Glaxo Wellcome and SmithKline Beecham.

The consultancy is active in pre-marketing and product launches.

Meditech Media PR director Kate Davies says: ’A lot of our clients

recognise the need to recoup profits on drugs as soon as they are

launched. We’re involved in a lot of opinion leader development


The agency has been involved in communications in the area of

antibiotics for respiratory tract infections, as well as areas including

asthma, oncology - the study of tumours - and genital herpes.

Davies adds: ’All our clients are international offices for

pharmaceutical companies and they often ask us to do global campaigns,

working with their local agencies.’ During 1998, Meditech Media worked

on a global Glaxo Wellcome campaign to mark World Asthma Day to coincide

with the World Asthma Meeting in Barcelona. The agency worked with

Glaxo’s Spanish agency, MCA, on PR for the event.

8. HOLMES AND MARCHANT - pounds 2,004,990

In November 1998, Carol Beaumont joined Holmes and Marchant Counsellor,

the healthcare PR specialist agency of the Holmes and Marchant group, as

international business director. She was previously managing director of

Shire Hall subsidiary 4D Communications. Her arrival pointed up the fact

that the agency realises a strong international capability to be one of

the drivers for future growth.

’The more pharmaceutical companies go global, the more their service

companies need to follow suit. You can’t not go global,’ says Holmes and

Marchant Counsellor managing director Gill Markham.

Another strand for growth, says Markham, is medical education - often

working with pharmaceutical companies in the pre-launch phase running

advisory panels as a means of building presence at major conferences.

Hoechst Marion Roussel is a new client in this area.

Cardiometrics, the company behind a neural network monitor used to check

heartbeats, is another business win. There has been growth in the

issues/crisis practice area as well as organic growth in

consumer-focused accounts such as nappy

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