HEALTHCARE AGENCY RANKINGS 2002: The hands that feed - HealthcarePR - and in particular pharmaceuticals- was the driver that kept agencyheads above water in 2001

Healthcare was by far the number-one PR growth sector in 2001, reporting a growth rate of 7%, according to the Council of PR Firms. And 19% of all reported agency revenues for the year came from healthcare.

Healthcare was by far the number-one PR growth sector in 2001, reporting a growth rate of 7%, according to the Council of PR Firms. And 19% of all reported agency revenues for the year came from healthcare.

That number rises even higher among the top ten agencies, where 24% of all revenues were generated from healthcare practices. In a tough year, healthcare was the hand that fed PR.

And it doesn't take a research scientist to see why. The global pharmaceutical market is now estimated to be worth a whopping $400 billion, and many in the industry are facing the daunting prospect that, by 2005, a record number of popular brand name drugs - Flonase, Paxil, and Zoloft, to name a few - will lose patent protection. Then there is the ever-lingering issue of whether Capitol Hill will pass a Medicare bill that covers prescription drug costs. Throw into the mix a generation of baby boomers that is continuing to age at the same time as workforce shortages in hospitals are becoming an increasing problem. You are left with a situation that is a potential crisis for some, but a plethora of opportunity for others. For PR pros, the latter applies.

Fleishman-Hillard's healthcare practice was number one for 2001, reporting $60 million in revenue and a significant 71% growth rate. The firm, however, came up flat in overall revenue. Having experienced negative growth rates in its technology, government/nonprofit, and professional and financial services sectors, Fleishman would not have ended up with its overall number-two ranking had it not been for its success in healthcare.

Similarly, RMD Public Relations, an agency located just outside Columbus, OH, experienced growth in its healthcare practice, while its other two concentrations - technology and retail - did not fare nearly as well.

"When times are bad, people get sick, and their emotions are heightened, says Sue Reninger, managing partner of brand strategy for the firm. "When that happens, they crave information."

After September 11, as some people's physical condition deteriorated alongside the economy, the need for healthcare PR increased. RMD, a full- service agency that offers PR and advertising services, noticed its clients craving education rather than creativity. "PR helps communicate what people need, opposed to what they'd like to have, says Reninger. "When people feel bad, PR is a smarter tactic."

A fistful of pharma

In the case of pharmaceuticals, PR is not only a smart tactic, but an imperative one. Thanks to such one-sided attempts to explain the industry to the general public, such as Peter Jennings' ABC special Bitter Medicines: Pill Profit and the Public Health, it is not very difficult to convince any brand name drug company that investing in PR is absolutely necessary.

The ABC special, which ran last month, is a poignant summation of why healthcare PR pros working with pharmaceutical companies have been far from pressed for business over the past year. In brief, Jennings and other critics of the industry claim that major drug companies are unjustified in charging as much as they do for their products. Additionally, the companies have been accused of engaging in unethical practices that intentionally delay generic versions of their drugs from becoming available.

Stephanie Marchesi, SVP and co-director of US healthcare for MS&L, points to a trend of pharma companies increasingly recognizing the importance of PR. "We have noticed that our services are more highly valued than they've ever been before. Clients are willing to invest more in educating consumers. What used to be a 15-minute brainstorm session has been elevated to spending several days really talking about your message with a client."

Valued as they may be, PR pros are still faced with the challenge of building positive corporate reputations that suggest an appropriate balance between humanity and profitability.

Several "me too or standard drugs have recently hit the market - Eli Lilly's Prozac Weekly and Schering-Plough's Clarinex, for example. There is some debate over whether they offer a significant improvement over what already exists. Critics say these drugs are nothing more than slightly modified versions of the originals that are produced for the sole purpose of maintaining profit flow.

Pharma companies counter that Prozac Weekly is a significant improvement over the original Prozac because it needs to be taken less frequently, which makes it much more convenient for users. They say brand name medications need to be as expensive as they are to fund the R&D that makes the drugs possible. The industry estimates that it costs $800 million to bring one drug to market. Not to mention the many drugs that are researched extensively but are not approved by the FDA and, therefore, never make it to market.

Attempting to get end users to understand what goes into developing new medications has become less about individual companies and more about positively positioning the entire pharmaceutical industry.

From a corporate point of view, the outlook is grim. "It has been an extremely difficult 12-18 months, and I don't see it getting any better, complains Carolyn Glynn, VP of public affairs for Roche, maker of obesity drug Xenical. Aware that she is part of an unfashionable industry right now, Glynn knows that as a communications specialist, it is her duty to try and change that perception. "Our role is to convey why so much money is necessary. However, it is very difficult to explain to the general public what their lives are worth. We as an industry have had a hard time defending ourselves for that reason."

Those on the agency side have a slightly less wounded tone. "Our role is to counsel clients on doing a better job of promoting themselves, and not just defending, says Nancy Turett, president and global director of Edelman's healthcare practice. "This is a long-term project though.

It is a challenge to build a reputation based on the value a drug company brings to its customers because the benefits of most medications will not be measurable for years."

David Catlett, partner/director of global healthcare for Ketchum, agrees that demonstrating to the public the value of the work pharma companies do is not something that can be done overnight. "You can't build a reputation on what you are going to do, he says, quoting Henry Ford.

In the meantime, Catlett and other communications specialists working with brand name drug companies have dedicated themselves to counseling clients on being as transparent as possible. "People in healthcare need to do everything they can to be straightforward and candid with the different publics, says Catlett.

Ketchum's healthcare practice directs a large portion of its efforts towards educating people on conditions. "There is a huge unmet need in terms of public education, explains Catlett. "There is much too wide a gap between how many people have certain diseases and how many are actually receiving treatment. Informing the public about the conditions that precede medication is a preliminary step in getting them to appreciate the value of the R&D behind pharma companies. Inaccessible therapies, lack of diagnosis, disease education and patient compliance are among the issues Ketchum's healthcare practice addresses.

And for the philosophy that an educated consumer is best, Turett feels that targeting the appropriate audience is key to positioning the pharma industry as something other than greedy and self-serving. "The industry can't keep talking to itself and to think tanks. It needs to engage in dialogue with regular people. The end user is going to be a lay person, not a healthcare professional."

An enormous increase in the dollars spent on direct-to-consumer (DTC) advertising for prescription drugs has resulted in many patients walking into doctors' offices and asking for a medication, without even knowing exactly what it does. A commercial for Merck's Vioxx drug, for example, does not give any information on what symptoms the drug treats or what its side effects are. It simply states that it is a "pain relief medication. This drug that costs eight times more than Advil and Aleve is advertised as curing the same ailment as the cheaper products.

This is where PR comes in, according to Marilyn Castaldi, senior partner and healthcare practice chair for Fleishman-Hillard. "These drug companies are not doing enough by simply marketing products. PR plays a valuable role in being an adjunct to DTC advertising. The ads are an introduction, and then people should have the option of reading further and finding out more through PR."

Jeff Winton, VP of global PR for Pharmacia, agrees that providing patients with as much information as possible needs to be a key focus of communications professionals. "We basically just need to be out there telling our story.

Every industry has its turn in the hot seat, and this just happens to be our time. The only way to combat it is to make sure that our voices are heard."

Hot topic on the Hill

The pharmaceutical industry may be able to attribute its position in the hot seat to the fact that it is an election year. "With Congress faced with having to do something about instating a prescription drug benefit, pharma has been in the limelight, says Ame Wadler, managing director/chairman of US healthcare for Burson-Marsteller.

Many industry veterans have seen drug companies come under fire like this before. According to Glynn, the current state of the industry is cyclical, and when it goes away will "depend on whether government passes a prescription drug benefit."

At the beginning of this month, a Wall Street Journal report noted, "The US is the only major industrialized nation without some version of government price controls for drugs. In the past few years, as drug prices have been slashed in Europe, drug makers have raised US prices by between 2% and 3% annually, and sometimes even more."

The rising cost of prescription drugs is a topic that has caught the attention and peaked the interest of many Americans. An aging generation of baby boomers has resulted in a large population of people who require prescription medications, as well as a new generation of offspring who are commonly the voices of reason and information for their parents. "The children of baby boomers deserve equal attention, says Castaldi. "They're the ones talking to parents about the newest medical advances, so we have been reaching out to them just as much as the parents."

Should Congress pass a bill that requires Medicare to cover the costs of prescription drugs, it might quiet the storm that has been swarming around pharma companies for a while. However, those companies could also be left with fewer R&D resources, which could prevent them from creating medications at the rate that is possible without federal restrictions.

"There is no panacea, says Catlett. "If we get into completely socialized medicine, innovation is going to go down the drain."

And innovation is just as valued by PR people as it is by the pharma companies they work for. There has been little to no interest from agencies in the possibility of scooping up business from generic drug companies, which are primed for potential success as an approximated $30 billion worth of drugs in the US are expected to lose patent protection in the next few years. Turett explains, "There will not be a lot of work done at Edelman on promoting generics. Those drugs have their place, but we would rather prepare the market for advanced therapies and innovations."

Turett does not stand alone in her position.

No generic drug companies would comment for this article, but Ilyssa Levins, chairman of GCI's healthcare practice, says, "Generic companies have stated that they will be spending money primarily on regulatory and sales. While they could probably use PR, it does not appear that it is a spending priority for them right now."

Plenty of room for hospitals

It might not pay as much. It might not make the front page of the Journal's Marketplace section every day. And it might not have an accomplished broadcast journalist slandering its every move on prime time TV. But there are still a great deal of opportunities in what Stacy Lewis, SVP at MGA Communications in Denver, calls "old fashioned healthcare PR, or hospital PR. The importance of hospitals, like pharmaceuticals, is on the rise in large part because of baby boomers. Issues such as facility expansion and closures, competition, work force shortages, and CEO turnover have developed into situations where media relations is critical.

Hospital beds in thriving areas are filling up quickly with aging baby boomers, just as the industry struggles to recruit nurses, lab technicians, and pharmacists. Lewis attributes the shortage of nurses to a demographic shift. "Teaching and nursing used to be the standard professions for women.

As their options increased, the numbers of nurses dropped. This, combined with the lack of attention and money paid to those who have opted for nursing, has created what some are calling a crisis situation.

Equally challenging is addressing the problem of closing hospitals. Many facilities that were in areas of heavy population at one time are having trouble filling beds because the area is no longer thriving geographically.

"Whenever you close a hospital, it can result in ill will in the community because the facility is usually such a presence, explains Charlotte Evans, associate VP and leader of Carter Ryley Thomas' (CRT) health sciences practice. "Our number-one priority is to help the public understand why the hospital needed to close. We do a great deal of outreach to the community and to employees of the closing facility."

Reninger, whose firm has also helped hospitals with recruiting and community outreach, explains how much of the work RMD did over the past year has been bittersweet. "Hospitals need PR less when times are good. I don't think we have ever seen a more important year to be out there and visible to the community. It is a time of people trying to understand the unknown, and for us letting them know that they can turn to their area hospitals to get answers."

Increased crises in hospitals have resulted in a highly-competitive market. A series of M&As has taken place, and are predicted to be an increasing trend this year. "If a merger means a hospital closes down, that needs to be addressed with the community, says Evans.

"Furthermore, people don't always see hospitals as businesses, says Reninger. "It is our job to communicate that, and balance it with emotion and compassion."

Looking to the future

Hospitals are not the only healthcare organizations involved in M&A.

The pharmaceutical industry has been engaging in a few high-stakes business deals of its own. In 2001, Abbott Laboratories acquired Knoll from Germany's BASF for $6.9 billion, Bristol-Myers Squibb bought Du-Pont Pharma for $7.8 billion, Johnson & Johnson acquired Alza for $10.2 billion, and Shire Pharma merged with BioChem Pharma for $4 billion.

For PR agencies, that means fewer, but larger, clients. "We have noticed that the industry is shrinking, says Michael Durand, director of global healthcare at Porter Novelli. "This is giving us more responsibility and putting higher demands on our healthcare team. There are greater rewards, but there is more work to do."

Looking to cut costs, it is likely that communications dollars will suffer, there will be fewer RFPs, and agencies will have to work harder for business.

However, thanks to a successful year in which most other industries took a hit, the outlook is hopeful that healthcare PR has proven its indispensability.

Even organizations with in-house capabilities would prefer to trim budgets in other areas rather than lose their firm's services. "There will always be a role for agencies because they bring an objectivity that we can't, says Pharmacia's Winton. "They will always be a good reality check for us. They work with other pharma companies and bring new ideas and fresh thinking to the table.

"You will see companies choosing not to build in-house teams before you see agencies being phased out."

SOURCE: PRWeek/Council of PR Firms Agency Rankings 2002 DISCLAIMER: No audit was required for inclusion in the rankings. While every effort has been made to ensure the accuracy of these figures, PRWeek cannot accept liability for, nor make financial guarantees based upon, the information in these charts

1 Fleishman-Hillard $60,050,000 - up 71%

A 71% growth rate in 2001 shot the healthcare practice at Fleishman-Hillard - which had held the number five ranking for the previous two years - straight to the top spot.

A large part of the practice's success can be attributed to new business.

In government, Fleishman began working for the New Jersey Anti-Tobacco program and the Centers for Medicare and Medicade Services. The New England Journal of Medicine was also gained as a client out of the Miami office.

In the way of pharmaceuticals, Pfizer was acquired as a significant new account.

In addition to new business bringing in a large portion of revenue for the practice, it also expanded its range of work with existing pharmaceutical clients.

Abbott Laboratories, AstraZeneca, Bayer, and Johnson & Johnson are among Fleishman's lucrative accounts.

A new practice co-chair in the US, along with new chairs for Europe and Asia Pacific, were recently appointed. "The idea is to magnify growth by subdividing responsibility and sharing ownership for specific geographic regions or business segments, says Marilyn Castaldi, senior partner and healthcare practice chair. Other new senior additions include Doug Levy in San Francisco, Doug Bell in Cleveland, Marc Greene in New York, Ana Rita Velasquez in Miami, and Chris Foster in Washington, DC.

2 Ketchum $49,265,000 - up 17%

Knocked from the top spot by Fleishman-Hillard, the healthcare practice at Ketchum still managed to grow in 2001 at what David Catlett, the firm's partner/director of global healthcare, calls a "very healthy rate of 17%.

An increased focus on biotechnology, medical devices, and diagnostics helped the group go beyond its strong foundation of work with several of the top ten drug companies. "While pharmaceutical accounts continue to be the core of our business, we've expanded our work in areas where we already have a presence, explains Catlett.

New accounts include the American Association of Clinical Endocrinologists (AACE), and the American Society of Cataract and Refractive Surgery (ASCRS) - both out of Ketchum's Washington, DC office. The New York office began work for Bayer Diagnostics.

Two noteworthy departures from the practice were Chris Smith, SVP, and Tom Jones, VP. Both accepted positions on the client side - Smith going to Aventis, Jones to Novartis.

Significant new hires include Nancy Hicks, SVP of the DC healthcare group, Laurie Flatt, VP and group manager in Atlanta, and Alex Brownstein, VP of biomedical sciences in San Francisco.

Moving forward, Catlett cites "regaining the number-one ranking as the practice's most important challenge.

3 Porter Novelli $41,100,000 - up 0.6%

Porter Novelli's healthcare practice has had the same objectives for several years: providing equal service across all offices; maintaining its three healthcare sectors - pharmaceuticals, biotechnology, and social marketing; and establishing itself as an educational institution, where its staff can learn about trends in medicine and communications.

Even with a flat growth rate in 2001, the practice managed to maintain a reputable ranking, coming in at number three. "Given the rocky economy and the September disaster, we'll accept this, says Michael Durand, global healthcare practice director. "However, this year I believe we'll be back on track for significant expansion."

Last year, PN won business from Astra-Zeneca, Applied Biosystems, Wyeth, the American Cancer Society, NovoNordisk, Shire, and Watson Pharmaceuticals.

Winning an account with Climara Pro, a Berlex product, offset lost business from Berlex's oncology division.

Although the practice managed to maintain almost all senior level employees (it only lost one SVP), Durand acknowledges that it is likely to be an issue in the coming years. "The challenge we continue to face is finding enough well-trained and experienced staff to keep up with the avalanche of new medical and marketing information to ensure that clients receive the same 'Porter Novelli' experience, whether in Chicago or Brussels."

4 Edelman $40,427,331 - up 4%

Edelman's healthcare practice reported a growth rate of just under 4% due to maintaining a healthy balance between new and existing clients.

New business came from Abbott, from which Edelman won an account for the launch of its D2E7 drug for rheumatoid arthritis. The practice also acquired new work from Elan, Baxter, Bayer, and Millennium. Existing partnerships with Johnson & Johnson, AstraZeneca and Pharmacia also grew substantially.

Lost business from Aventis diabetes and Roche Xenical was offset by maintaining accounts with other divisions of both companies.

"We have also played a strategic role in addressing health issues that impact the industry and society, says Nancy Turett, the practice's president and global director. Edelman has done work for PhRMA, BIO, Together Rx, and AdvaMED.

New hires for the practice include Lorie Fiber, SVP/director of emerging health on the West Coast; Carolyn Paul, SVP/director of Rx health in London; and Antje Burbach, managing director of health in Germany.

Looking forward, Turett anticipates that the challenges of the healthcare industry - "consolidation of companies, negative image of the pharma industry, and less robust pipelines - will also create opportunities for her practice.

5 Ruder Finn $33,268,000 - up 4%

Moving up a spot from number six in 2000 to number five in 2001, Ruder Finn's healthcare practice attributes its steady growth rate of 3.64% to low staff turnover and profitable new accounts.

The practice ex-perienced a 10% overall turnover rate last year, with less than 3% coming from senior level employees. Additions to the team include Ken Rabin and Nancy Glick, both EVPs in the agency's Washington, DC office, John Preston, managing director in London, and Jean-Michel Dumont, SVP in Shanghai. "Some modest attrition at the senior level was made up in the new hires that are part of our expansion, says Kathy Bloomgarden, president and CEO of the firm.

Biotech branding and regulatory support capabilities were strengthened.

The consumer healthcare, corporate advertising, and reputations groups were also fortified. "We have continued to focus on achieving a globally aligned team of top health experts, says Bloomgarden.

Having lost no major accounts in the past year, Ruder Finn acquired new business from Novartis branding, Pharmacia corporate, and Johnson & Johnson corporate. Bloomgarden names these three healthcare giants as the practice's biggest drivers.

26 GYMR Public Relations $2,829,857 - up 121%

GYMR attributes its year of banner growth (121%) to the fact that the agency is located in Washington, DC. "We are able to do this well because we're in Washington - the intersect of a formal and informal network of media, policymakers, and stakeholder groups, explains Patrick McCabe, one of GYMR's four partners. "By demonstrating how our client's products and issues are relevant to a national conversation about healthcare, we are able to position them above the din of multiple voices competing for attention."

Rather than focusing intently on acquiring new business, the agency's strategy has been to connect existing clients with current healthcare events. With a client base that ranges from working on tobacco control, insurance issues, chronic care, and pulmonary health, GYMR has been primed for linking its business to what is happening around it. McCabe reports one client that didn't receive regulatory approval for a product as its only significant loss for the year.

Karen Waller, former MD of Burson-Marsteller's DC healthcare practice, was brought on board this year as SVP of GYMR's pharmaceutical practice.

31 Rogers & Associates $2,306,049 - up 412%

Rogers and Associates attributes its substantial 412% growth rate to its extensive experience in crisis communications and allocating budgets.

About one-third of the agency's budget for government clients was specifically allocated for handling healthcare issues. The agency has accounts with both the state of California and the county of Los Angeles.

Free of any dramatic changes in the past year, Rogers didn't lose or hire any staff, nor did it gain any new clients. Rather, its focus on existing clients proved to be the biggest force behind a solid year. Business with the California Children & Families Commission and the California Department of Health Services' Tobacco Control Section were the biggest profit drivers.

Moving forward, the agency intends to seek business from clients who are in need of help in areas where Rogers excels. "As there are tremendous issues facing the healthcare industry - spiraling costs, Medicare reimbursement, healthcare reform, and other quality-care issues - it is incumbent on us to find clients where we can play a significant role in providing strategic communications, says the firm's president, Lynne Doll.

53 Vollmer $685,613 - up 240%

Vollmer Public Relations is of the belief that healthcare bears the pressures of sour economic times better than other industries. The agency planned accordingly as the economy began to dip by making "a more concentrated effort to increase our emphasis on our healthcare practice, says Helen Vollmer, president. Growth was reported of 240%, upping the agency's ranking to 52 from 94 in 2000. Conveniently, the company's headquarters in Houston is located five miles from Texas Medical Center, the world's largest medical facility.

Belmont Village Assisted Living Centers and Interfit Health Services are cited as Vollmer's biggest profit drivers for the year. While it did not enter any new sectors, services were provided to clients that had not been in previous years. Namely, web design, content and virtual marketing, and trade show services.

The agency acquired Tanox, a biopharmaceutical company specializing in monoclonal antibody research, as a client. Neurobehavioral Healthcare Systems, a company dedicated to treating patients with neurological injuries in California and Texas, was another significant win for Vollmer. Lost business included Park Pharmacy and

No new or lost staff members were reported.

55 MGA Communications $646,339 - up 209%

Unlike the majority of agencies that performed well this year, MGA Communications reported its stellar growth rate of 209%without even touching the pharmaceutical sector. "We have not aggressively pursued pharmaceuticals or biotech yet, says Stacy Lewis, SVP."We expanded our current focus on hospital groups and services into the all-important area of nursing recruitment. The firm attributes its success to staying committed to the "old fashioned healthcare markets.

Lewis cites diversification in hospitals, facility expansion, and staffing shortages as the three pillars of opportunity in working in the hospital sector of healthcare PR. "Corporate communications is critical in situations like this, says Lewis. "The aging population creates so many media relations opportunities in healthcare."

In addition to growing its existing clients' business, new accounts came from HealthOne, a network of seven hospitals, and Micromedex, a business-to-business medical content provider. The two accounts were the practice's biggest profit drivers for the year.

MGA only lost one of its nine healthcare staffers last year. It offset the loss by hiring a new account supervisor.

91 BRW LeGrand $212,620 - up 113%

This MS&L affiliate experienced 113% growth in 2001, improving its ranking from 117 in 2000 to 90. "Our business objectives were focused on establishing our brand as an agency with long-term experience in the life sciences industry, says Lisa Miller, life sciences team leader.

"We provided expanded services to clients, such as business intelligence, partner strategies and alliances, primary research, CEO counsel, and IR integration."

Early in the year, the firm made a decision to define its healthcare group as a "life sciences practice. BRW won an account with Heska, a company dedicated to R&D of therapeutic treatments for companion animals, as a result of its new definition. New business was also acquired from Applied Precision, a microscopy equipment developer.

The firm attributes its significant growth rate to its commitment to acting on its staff's interests and abilities. Animal health, proteomics, alternative healthcare, nanotechnology, agri-pharmaceuticals, and nutraceuticals are among the areas responsible for increased profitability this year.

No new full-time staffers were brought on board, but outside consultant support was brought in on an as-needed basis.

     Rank                              Agency Name   Healthcare   Change
     2001                                     2001         2000        %
1    Fleishman-Hillard                  60,050,000   35,080,000       71
2    Ketchum                            49,265,000   42,092,000       17
3    Porter Novelli                     41,100,000   40,853,000      0.6
4    Edelman Public
     Relations Worldwide                40,427,331   38,883,571        4
5    Ruder Finn Group                   33,268,000   32,100,000        4
6    Ogilvy Public
     Relations Worldwide                29,562,958   35,649,300      -17
7    Weber Shandwick Worldwide          28,244,697   31,893,863      -11
8    MS&L                               28,189,631   28,136,737      0.2
9    GCI Group/APCO Worldwide           24,542,462   21,459,204       14
10   Burson-Marsteller                  20,701,000   23,694,000      -13
11   Hill & Knowlton                    18,677,000   20,775,000      -10
12   Chandler Chicco Agency             14,933,990   12,576,088       19
13   Cohn & Wolfe                       14,632,000   12,365,000       18
14   Noonan/Russo Communications        13,240,000   12,390,000        7
15   Golin/Harris International          8,495,754    8,456,073      0.5
16   Publicis Dialog                     5,307,443    3,969,400       34
17   MCS                                 5,291,049    3,818,778       39
18   Cooney/Waters Group                 4,856,890    4,080,227       19
19   FischerHealth                       4,567,260    5,395,134      -15
20   PResence EURO RSCG                  3,503,391    3,730,647       -6
21   Equals Three Communications         3,298,496    2,098,181       57
22   Spectrum Science
     Public Relations                    3,224,629    3,056,980        5
23   Public Communications               3,159,272    3,657,287      -14
24   Dorland Sweeney Jones
     Health Communications               3,079,000    4,522,000      -32
25   Rowland Communications Worldwide    2,970,000    2,595,000       14
26   GYMR Public Relations               2,829,857    1,279,529      121
27   Lippert/Heilshorn & Associates      2,629,491          N/A      N/A
28   Belsito & Company
     Medical Communication               2,557,797    2,000,340       28
29   DeVries Public Relations            2,499,747    2,321,202        8
30   Morgen-Walke Associates             2,384,840          N/A      N/A
31   Rogers & Associates                 2,306,049      450,370      412
32   Duffey Communications               1,946,638    1,871,767        4
33   Signova                             1,775,676    1,158,090       53
34   Communications Strategies           1,749,981    3,570,380      -51
35   Makovsky & Company                  1,565,000    1,727,000       -9
36   Magnet Communications               1,563,000    2,149,000      -27
37   Padilla Speer Beardsley             1,483,643      934,517       59
38   James A. Fyock & Associates         1,457,946    1,656,539      -12
39   The Ruth Group                      1,437,340          N/A      N/A
40   Seyferth Spaulding Tennyson         1,315,069    1,037,500       27
41   Stanton Crenshaw Communications     1,260,000    1,750,000      -28
42   M Booth & Associates                1,233,509    1,106,653       11
43   Kupper Parker Communications        1,098,112    1,095,994      0.2
44   Carter Ryley Thomas                 1,054,761    1,253,493      -16
45   Perry Communications Group          1,050,854    1,509,850      -30
46   Hyde Park Communications            1,038,000          N/A      N/A
47   Ronald Trahan Associates            1,011,204    1,047,352       -3
48   The Kamber Group                    1,000,000          N/A      N/A
49   Middleberg Euro RSCG                  868,405    1,100,000      -21
50   PRX                                   831,280      493,286       69
51   Gerbig, Snell/Weisheimer              755,000      690,000        9
52   PR21                                  696,024      476,976       46
53   Vollmer                               685,613      201,759      240
54   Robin Leedy & Associates              680,996      496,122       37
55   MGA Communications                    646,339      209,218      209
56   Jasculca/Terman & Associates          644,652      636,371        1
57   The Rasky/Baerlein Group              627,330      961,254      -35
58   Katcher Vaughn &
     Bailey Communications                 615,000      595,000        3
59   Thomas Rankin Associates              565,935      383,215       48
60   KCSA Public Relations                 550,000          N/A      N/A
61   Richard French & Associates           547,006      348,901       57
62   Dye, Van Mol & Lawrence               545,784      828,383      -34
63   Sawchuck Brown Associates             515,000          N/A      N/A
64   Ruane Communications                  512,550      200,000      156
65   G.S. Schwartz & Company               498,000      250,000       99
66   CKPR                                  479,000      915,000      -48
67   Widmeyer Communications               465,000          N/A      N/A
68   McNeely Pigott &
     Fox Public Relations                  464,841      723,021      -36
69   Ackermann PR                          461,108      541,547      -15
70   Pantin/JGR/Public Relations           458,367      442,545        4
71   The Nixon Group                       453,752      638,526      -29
72   Paine PR                              451,843      583,192      -23
73   Dittus Communications                 449,000          N/A      N/A
74   Edward Howard & Co.                   419,400      641,000      -35
75   Strategic Objectives                  375,760      191,088       97
76   Conkling, Fiskum & McCormick          368,026      403,681       -9
77   Anne Klein & Associates               355,500      301,000       18
78   Patrice Tanaka & Company              337,826      922,000      -63
79   Berry Associates Public Relations     327,094      392,618      -17
80   DCS Group                             326,045      395,192      -18
81   Jackson Spalding                      281,502          N/A      N/A
82   Bishoff Solomon Communications        280,324      381,120      -26
83   Gogerty Stark Marriott                250,792       34,713      622
84   Creative Response Concepts            249,444      223,548       12
85   Guthrie/Mayes Public Relations        243,000      238,000        2
86   Marcus Thomas                         240,195      373,052      -36
87   Agnes Huff Communications Group       240,000          N/A      N/A
88   TateAustin Public Relations           225,000          N/A      N/A
89   BCF&M                                 217,956          N/A      N/A
90   The Standing Partnership              217,513      773,862      -72
91   BRW LeGrand                           212,620      100,000      113
92   Bohle Company                         211,073          N/A      N/A
93   Caponigro Public Relations            210,281       65,375      222
94   Eric Mower and Associates             200,000      600,000      -67
95   Sacunas & Saline                      193,698      177,074        9
96   IMRE Communications                   184,714          N/A      N/A
97   Jacobs & Prosek Public Relations      168,625      313,709      -46
98   DW Turner Public Relations            167,110      138,890       20
99   Triad Communication                   163,660      217,255      -25
100  Southard Communications               150,000          N/A      N/A
101  Pan Communications                    149,880       92,000       63
102  Tellem Worldwide                      146,000          N/A      N/A
103  Pierpont Communications               142,391       88,000       62
104  Carmichael Lynch Spong                139,000       27,000      415
105  Ashton Partners                       137,701      103,055       34
106  John Bailey & Associates              130,000      114,513       14
107  Michael James & Co.                   128,166      142,869      -10
108  Schenkein                             125,500      231,700      -46
109  Dome Communications                   125,000       78,000       60
110  Paul Werth Associates                 118,690          N/A      N/A
111  Marx Layne & Company                  114,994          N/A      N/A
112  Goff & Howard                          96,950       95,000        2
113  Morrissey & Company                    94,537      231,547      -59
114  Optimum Public Relations               92,000          N/A      N/A
115  Toplin & Associates                    92,000      264,000      -65
116  Cerrell Associates                     87,500          N/A      N/A
117  Saphar & Associates                    86,558       35,476      144
118  Public Relations Network               84,884          N/A      N/A
119  Barkley Evergreen & Partners           78,000       72,000        8
120  Collins & Company                      72,032          N/A      N/A
121  The Bivings Group                      63,500      131,400      -52
122  Jack Horner Communications             60,000      184,890      -68
123  HLB Communications                     59,355      192,634      -69
124  The Headline Group                     58,335      180,000      -68
125  L.C. Williams & Associates             58,168       79,978      -27
126  David Grossman & Associates 55,838                     N/A      N/A
127  Solem & Associates                     55,038          N/A      N/A
128  Singer Associates                      52,371          N/A      N/A
129  Clifford Public Relations              50,705          N/A      N/A
130  PRACO Public Relations
     & Advertising Company                  50,000       50,000        0
131  Cooksey Communications                 47,302          N/A      N/A
132  Dublin & Associates                    46,174       14,496      219
133  The Phelps Group                       42,000       84,000      -50
134  Rossman Martin & Associates            40,221          N/A      N/A
135  Smith & Harroff                        36,000          N/A      N/A
136  Zeppos & Associates                    34,280          N/A      N/A
137  JMC Marketing Communications & PR      33,398       43,101      -23
138  Lane Marketing Communications          30,186        1,400     2056
139  Valencia Perez & Echeveste             26,500      107,213      -75
140  Emmanuel Kerr Kilsby                   25,000       16,000       56
141  Reputation Management Associates       20,000       10,000      100
142  Metzger Associates                     15,518          N/A      N/A
143  LVM Group                              12,424       19,810      -37
144  Millennium Communications              10,300          N/A      N/A
145  Witeck Combs Communications             9,000          N/A      N/A
146  CooperKatz & Company                    8,259          N/A      N/A
147  Clarity Coverdale Fury                  4,300          N/A      N/A
148  INK Media Relations/PR                  3,250          N/A      N/A
     TOTAL HEALTHCARE                  525,063,904  482,084,251        6
SOURCE: PRWeek/Council of PR Firms Agency Rankings 2002
DISCLAIMER: No audit was required for inclusion in the rankings. While
every effort has been made to ensure the accuracy of these figures,
PRWeek cannot accept liability for, nor make financial guarantees based
upon, the information in these charts

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