From patient to consumer

Sara Calabro discovers that healthcare PR strategies are now going beyond science in order to address consumers.

Sara Calabro discovers that healthcare PR strategies are now going beyond science in order to address consumers.

"To the healthcare PR ear, the concept of direct-to-consumer advertising makes us chuckle, because that's what we've been doing for years," says John Quick, director of Hill & Knowlton's New York healthcare practice.

Despite Quick's confidence that it was diligent PR efforts that groomed the market toward being receptive to DTC advertising (and not DTC advertising that created the need for more and better consumer-focused PR strategies), he admits that the joint disciplines have created "a phenomenon where consumers are educated and willing to ask for medications." He calls this "a major social change," and one that requires more "consumer marketing savvy."

Evident in the increasing convergence of consumer and healthcare PR strategies by pharmaceutical companies, Quick is not alone in his belief. In October, Pfizer chose Weber Shandwick's consumer marketing group - not its healthcare group - to lead the global business for its blockbuster erectile dysfunction (ED) treatment, Viagra. Porter Novelli had been handling the account from its healthcare practice.

Pfizer's decision to switch to a consumer-driven focus came as the company prepared itself to face competition in the ED space for the first time. In August, Levitra, codeveloped and copromoted by GlaxoSmithKline (GSK) and Bayer, received FDA approval, and just last month, Eli Lilly's Cialis got the nod as well.

Shortly after Levitra was approved, GSK and Bayer announced a sponsorship deal with the National Football League (NFL), hired former football player and coach Mike Ditka as spokesman, and launched an educational awareness campaign about men's health. Although Ogilvy PR - which has had the global Levitra account since January 2002 - continues to run the business out of its healthcare group, GSK and Bayer have also retained Alan Taylor Communications, a consumer-focused PR agency specializing in sports, to work on the NFL portion of the campaign.

Cialis is handled by MS&L, jointly, by the agency's healthcare and consumer groups. Says Michal Fishman, director of US pharmaceuticals PR for Pfizer, "When you are the only drug on the market, you have the opportunity to raise awareness for your name. Now we have opportunities to not only raise awareness for our name, but differentiate ourselves from the other ED medications."

Michael Rinaldo, SVP and senior partner in Fleishman-Hillard's healthcare practice, adds, "When a product first comes to market, you need a strong healthcare component in order to develop trust. If you don't create that initial brand credibility with the physician community, you're not going anywhere. Ultimately, doctors are putting their reputations on the line when they recommend a product."

Understanding the disease category

Regarding the groundwork laid for Viagra by Pfizer's communications team, prior to shifting to a consumer-heavy approach, Fishman admits, "Pfizer did such a great job of getting people to understand the disease category of Viagra. But even with all that education and household recognition, there is still a tremendous number of under-diagnosed sufferers of ED out there. We need to find out what is preventing so many men from coming forward and getting treated for this."

These barriers - the ones that prevent patients from seeking treatment - are not limited to ED. In the same way that a man might be embarrassed to admit to his ED, others are hesitant to get treated for cholesterol because they think it correlates with being overweight. Or someone suffering from irritable bowel syndrome (IBS) might keep it quiet because they find the symptoms uncomfortable to discuss.

Dorothy Wetzel, VP in the consumer marketing group, US pharmaceuticals for Pfizer, points out, "You can't address these barriers through advertising because people can always tune that out. We have to come up with creative ways to get them to really listen."

Rinaldo adds that sometimes pharmaceutical companies confuse "brand visibility with brand motivation. Someone seeing a DTC ad might gain initial interest, but they are still always going to want to hear what their doctors and peers are talking about."

In order to capitalize on the opportunity to deliver consumers this much needed information, says Wetzel, PR pros must overcome the challenge of "speaking in the consumer's language."

Wendy Lund, director of MS&L's New York healthcare practice, agrees, and notes the importance of delivering information about a product in an approachable way, primarily to reporters, who can sometimes be "very squeamish" about certain issues. "[Reporters] want to make sure that their readers are going to be receptive, so as PR people, it's our job to give them the information they need in an appropriate way that makes sense. Incorporating a consumer approach can help reporters tell stories in ways that convey how conditions may actually affect or disadvantage people's lives."

Earlier this year, MS&L's healthcare practice made the decision to bring representatives from the agency's consumer group to pitch for Galderma Laboratories' prescription acne treatment Differin. After enjoying leadership in the category for a time, Differin's market share was declining, as competition from other prescription retinoids, antibiotics, and OTC products hit shelves. After winning the account, MS&L's healthcare and consumer units created an education and awareness program for teens and parents to emphasize the importance of addressing acne by demonstrating the personal impact it has on suffers.

Carmen Rasmusen, a finalist on American Idol, was chosen as a teen celebrity spokesperson because of her own struggle with acne, while adults were addressed by Dr. John Koo from the University of San Francisco because of his dual training as a psychiatrist and dermatologist. MS&L coordinated a webcast and satellite media tour featuring Rasmusen and Dr. Koo, as well as multiple media appearances for the spokespeople. At the same time, MS&L's healthcare group focused on reaching out to the scientific community about new guidelines pertaining to updates in acne-treatment protocols.

Lund says the agency made the call to incorporate its consumer group because "they had experience with reaching out to teens." She explains, "Talking to a teen about skin care is very different from talking to a 50-year-old man about ED. As 30- to 40-year-old PR professionals, we needed people involved who we knew could get into the teen mindset."

Strategy starts at the agency

MS&L involving its consumer group on an account that required healthcare expertise is an example of how the development of PR plans should take place, says Peter Pitts, associate commissioner of external relations at the FDA. "Agencies should be the ones to see [the need for consumer approaches] first, and call attention to it," he says. "In theory, rather than having the client say, 'We should shift it this way,' the strategic aspect of communications should be coming from the agency."

Laura Schoen, president of global healthcare for WS, agrees, adding that the ability to recommend an approach across the healthcare and consumer practices is the difference between big and small agencies. "What differentiates big agencies from boutiques," she says, "is the ability to expand and cross-pollinate to address client needs. If we do not make use of that huge point of differentiation, it is hard for clients to justify choosing a big agency."

Pitts calls corporate communications departments that knowingly appoint firms for their abilities in consumer marketing "smart." He asserts that the growing need for incorporating consumer approaches when marketing healthcare products cannot be ignored, because its origin lies in a changing consumer rather than a passing trend.

"The introduction of DTC advertising began to blur the line between medical and consumer audiences," says Pitts. "Consumers have become more educated, and more amenable to sophisticated messaging."

Wetzel attributes the widening span of her responsibilities in recent years - as a consumer person working at a pharmaceutical company - to this educated consumer of which Pitts speaks. She says her team's workload was able to expand in scope because of Pfizer's knowing that "the consumer needs to be understood in a variety of ways. Healthcare is becoming more top of mind to consumers." As a result, consumers are "more involved in trade-offs. They're asking themselves, 'Do I want to have surgery, or increase my amount of exercise?' and, 'Do I want a generic or branded drug?'"

Fishman claims it is this change in patients' outlooks that has caused the pharmaceutical industry to evolve its marketing plans accordingly, rather than the industry dictating the change.

Another external factor contributing to the trend is an increasingly competitive marketplace. Whether it be a competing product getting approved, an expiring patent, a dry pipeline, or company-wide budget cuts due to difficult economic times, it has become imperative that marketing teams pull out all the stops to generate results.

"Clients are very concerned with ROI, and they are becoming more aggressive in terms of using every tool available to them," says Schoen. "You cannot always play by the same rules in healthcare that you can with packaged goods, but there are some techniques that can be adapted to pharmaceuticals. Our consumer colleagues bring a certain savvy and know-how to making brands top of mind."

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