PHARMACEUTICALS: Restrictive legislation makes it difficult to promote
new drugs, regardless of their benefits
HOSPITAL PR: Communicating changes to NHS and private hospitals without
incurring the wrath of the public
PRICE FIXING: Small pharmacies come under threat by cut price OTC
medicines being offered by retail giants
As PR agencies seek to build global brands, a mass of industry
regulations stand between pharmaceutical companies and patients with a
growing interest in their own healthcare. Robert Gray reports on the
international ethical and OTC markets
One can draw an interesting parallel between what has already taken
place in the hi-tech sector and what is now happening in the
pharmaceutical industry. While IT giants such as Microsoft, Compaq and
IBM now target the consumer directly as well as the corporate market,
the same holds true for the manufacturers of ethical drugs (that is,
prescription only medicines rather than over the counter products) -with
the important distinction that unlike the technology companies they
cannot exhort consumers to buy their particular brand.
Under the Association of the British Pharmaceutical Industry’s (ABPI)
code of practice pharmaceutical manufacturers may only talk to the
public about the benefits of a particular class of drug as part of a
disease awareness campaign. It is with doctors and other medical
professionals that they must establish the specific benefits of their
products if they are to see them used widely - thereby recouping the
often huge costs that go into research and development of an ethical
‘It’s become more difficult to promote to prescribers, and particularly
GPs,’ says Manning Selvage & Lee director of healthcare Europe Howard
Godman. ‘The culture has changed. They’re getting cost- conscious and
branded products are taking a hit as they look at their value against
In a climate where cost-benefit analysis is of growing importance,
pharmaceutical companies often need to make a financial as well as
therapeutic case for their drugs. A product may find favour with a
doctor even if it initially costs more than another treatment for the
same condition, when it can be shown that in the long term it will be
cheaper because, for example, it reduces the number of visits a patient
has to make to his or her medical centre.
‘Sometimes it’s a case of constructing an argument that a new medicine
has a place, even if it’s more costly,’ says Charlene Bargeron, managing
director of pharmaceutical communications specialist Greenlines.
The question of targeting consumers when promoting an ethical product
remains a vexed one. The consensus is that the ABPI is right to bar
pharmaceutical companies from promoting their brands to the public. But
at the same time one has to acknowledge the growing interest the public
is taking in personal healthcare issues.
There is a continuing trend towards patient empowerment and, to some
extent, the drugs companies are being put under pressure to provide more
information on diseases and how they can be treated.
‘We mustn’t do anything to encourage patients to go to their doctors
and ask for specific brands,’ says Fusion Communications managing
director Neil Kendle.
‘I think that’s absolutely right. But everybody is accepting that times
have changed and that patients have a right to be involved in
therapeutic decisions,’ he adds.
All well and good but for the owners of ethical brands, communicating
with the public can be something of a minefield. As well as being
limited to talking about classes of drugs rather than specific product’s
names, manufactureres cannot allude to a benefit. A drug either has a
therapeutic benefit or not. If a benefit is claimed in media relations
material or literature for the public it has to be substantiated by the
results of clinical trials. Moreover, it is vital that drugs companies
do not raise false expectations among disease sufferers.
‘One of the key ways to overcome regulatory barriers is to use the
independent voice of third parties such as patient groups and medical
professionals,’ says Harvard Public Relations associate director Barbara
On behalf of its client Ferring Pharmaceuticals, Harvard works closely
with ERIC (the enuresis research and information centre) on the
implementation of a bedwetting information programme comprising case
studies and treatment advice.
Patient empowerment has meant that such support groups have recently
acquired a great deal more clout than ever before. In fact, in America
some of the pre-eminent patient organisations have become known as
advocacy groups, reflecting their lobbying power and the influence they
bring to bear on the medical profession. Persuading a patient support
group to champion a product or class of drug can be a tremendous fillip
for a pharmaceutical brand owner.
Drugs companies and patient groups also can, and often do, team up
effectively to increase awareness of a disease. A good example of this
is the Poster Awareness Campaign for Epilepsy (PACE), a joint initiative
between Marion Merrell Dow and the International Bureau of Epilepsy,
promoted by Burson-Marsteller. The campaign centred on a pan-European
poster painting competition that drew entries from over 200 people with
The entrants were asked to produce posters on the theme of
‘independence’ in epilepsy. Delegates to the fourth European Conference
on Epilepsy and Society ‘Epilepsy Now’ in the Netherlands picked the
winners who were given cash prizes and saw their work reproduced in
poster and postcard form and displayed in clinics, pharmacies and
doctors’ surgeries as the centrepiece of the awareness drive.
Cohn and Wolfe has recently tackled awareness-raising in the ethical
sector by applying the classic consumer marketing technique of
advertorials. On behalf of its client Glaxo Wellcome, which recently
launched Pylorid, a treatment for h.pylori the bug associated with
stomach ulcers, the agency produced full-page advertorials for Hospital
Doctor and Pulse - a new departure for the medical journals.
In the over the counter sector, meanwhile, manufacturers are having to
pull off a communications balancing act that allows for innovative
consumer marketing that does not detract from a responsible corporate
The trend towards self-medication that has seen consumers take more
control over the medicines they take has also brought a growing
awareness of the names behind the products. Unsurprisingly, drugs
companies are reluctant to take risks with their names.
‘It is imperative that the pharmaceutical companies don’t lose their
white coat authority,’ says Pippa Sands, deputy managing director of
Biss Lancaster and head of its new healthcare and consumer PR company
‘That said, some of the techniques that one might use for an ordinary
household product can be interpreted to suit the need of a
pharmaceutical brand. But marketing to the consumer requires a certain
kind of language and flexibility which is wholly inappropriate for the
As with brand owners in other sectors, many of the pharmaceutical
companies have sought to create global products. This has proved more
difficult to achieve than is the case with products such as sportswear
or fizzy drinks.
In part this is due to the nature of the products and the regulations
governing their advertising and promotion. But in the OTC market there
can be a tendency for consumers to stick with remedies with which they
are familiar - so building a global brand takes a lot of time and
‘The multinationals are really trying to take their brand names and make
them work in other countries,’ says Proprietary Association of Great
Britain commercial affairs manager Alison Williamson. ‘But it’s tough in
the European OTC market where a lot of the products have grown up over
generations and have become traditional names.
‘There aren’t that many over the counter products that have been
globalised. If you look at the US some of the popular product names
there are very different to the ones you get in Europe.’
Robin Wright, managing director of Edelman Medical Europe, takes the
view that global marketing departments, especially at US pharmaceutical
companies, still have a ‘lack of understanding about Europe per se and
its different regions and cultures’.
While Jonathan Levy, a partner in Advisa Medica which has been doing
international work for client Boehringer Mannheim, believes
globalisation is easier if you’re ‘working on a common brief for
everyone, even if the local affiliates complain’.
It is a theme which has been developed by Burson-Marsteller associate
director Jennie Talman. ‘Despite the lack of harmony in European OTC
marketing legislation the growth of international brands is inevitable
in the long term,’ she says.
And, given the complicated messages that need to be conveyed, public
relations is sure to play an important role in establishing
international pharmaceutical brands and their values in the eyes of the
consumer - whether that consumer be in Milwaukee, Manchester or Madrid.
Internet: Spreading knowledge on the Web
Last year specialist pharmaceutical PR consultancy Complete Pharma
splashed out on an ‘expensive server’ enabling it to serve its clients’
Internet needs. Now, according to managing director Scott Clark, it is
working with all its major clients on ‘Internet investigation’.
As Complete Pharma’s clients include many of the world’s leading
pharmaceutical companies, including Glaxo Wellcome and Pharmacia and
Upjohn, one can assert categorically that pharmaceutical companies are
now taking the Net very seriously as a communications medium.
The first fruits of Complete Pharma’s work is the International Prostate
Cancer Reporters Club, a Web site for medical editors and correspondents
carrying news and research on the condition.
The site, which launched at the end of October, was created for client
Zeneca to help position it as an authority on prostate cancer. The
company has two treatments for the disease: Zoladex 10.8 and Casodex.
‘This is not a way to get around the ABPI code of practice,’ says Clark,
who insists that claims still have to be backed up by clinical trials.
Access to the site is restricted to prevent unauthorised use. Onlybona
fide medical journalists are given a password.
Clark adds that it is important to use the ‘interactivity’ offered by
the Net rather than viewing it simply as a means to display an
electronic corporate brochure. Pharmaceutical companies can, he says,
boost their standing among the medical profession by helping facilitate
the treatment debate.
Another recent Internet development has seen German media giant Burda
Medien launch its Health Service Online Web site to doctors in Germany.
Burda plans to make it available across Europe late this year.
The site will include information on medical products, conferences,
research and discussion forums. Also within the pharmaceutical sector,
the well-regarded publication Chemist & Druggist now has its own page on
But it’s not all plain sailing in cyberspace. Fusion managing director
Neil Kendle says one of his clients has been having problems with
someone who has been disseminating material on the Net criticising one
of its products.
Pharmaceutical companies should see the Internet as a chance to
communicate proactively with their target audiences. But they should
also be ready to respond quickly should anyone take it upon themselves
to traduce one of their drugs on the network.
OTC medicine: Price-fixing battle rages on
Asda’s move last October to discount by 20 per cent the retail prices on
its branded vitamins has sparked what promises to be a battle royal.
The move was in contravention of resale price maintenance on
medicaments, the legal price-fixing agreement which allows manufacturers
and wholesalers to set minimum prices for over-the-counter medicines
like analgesics, antiseptic creams and health food products.
As was widely reported at the time, vitamin companies Seven Seas and
Roche served an injunction on Asda, causing the supermarket chain to put
its prices back up. But by then Asda had already done enough to persuade
the Office of Fair Trading to announce a review of resale price
maintenance on medicaments.
‘We challenged retail price maintenance and will continue to challenge
it because we feel it wasn’t allowing us to offer the lowest possible
prices for medicaments,’ says Asda PR manager Sue Finnegan. ‘It’s the
last area where retail price maintenance exists, which shows it is an
When it last looked at ethical/proprietary products in 1970, the
Restrictive Practices Court made the Medicaments Order which allowed the
products to be exempted from the usual rules governing resale prices. At
the time the court argued that price fixing should be permitted for
medicaments as a way of protecting small dispensing chemists.
Today a broad alliance of manufacturers, wholesalers and small retailers
still believe strongly that RPM is needed as a safeguard for maintaining
the role pharmacies play in giving health advice to the local community.
Earlier this year, seven important industry bodies including the
Proprietary Association of Great Britain, Royal Pharmaceutical Society
of Great Britain and National Pharmaceutical Association banded together
to form the Community Pharmacy Action Group (CPAG).
In February CPAG hired Charles Barker to help it communicate its
arguments for keeping the status quo. The consultancy may also help the
individual organisations comprising CPAG to put forward their views to
‘There’s a common concern that the removal of RPM on non-prescription
medicines could impact on public health,’ says Charles Barker account
director Sue Ashe.
If the OFT can show their has been a prima facie change in circumstances
since 1970 the Restrictive Practices Court will be asked to look at the
situation again. Should this happen, it seems inevitable that a drawn
out battle between CPAG and Asda and its allies lies ahead. The outcome
of this struggle will determine how much consumers are asked to pay for
OTC medicines in the coming years.
Cipramil: Introducing a new name in anti-depressants
When Danish pharmaceutical company Lundbeck was preparing to launch its
SSRI antidepressant Cipramil to GPs in the UK last year it faced
something of a recognition problem. Although it had a well established
reputation for mental illness products on the Continent and among
psychiatrists in the UK, it was a virtual unknown among doctors
providing primary healthcare.
Moreover, it was entering a class which includes Prozac, the drug that
has almost become a byword for depression treatment.
Realising that a rigorous communications programme was necessary if its
drug was to make an impact, Lundbeck hired Burson-Marsteller to put
together a launch campaign. The nub of the programme was to make capital
out of Lundbeck’s credibility within the secondary care market ( among
psychiatrists) in order to get GPs interested in Cipramil.
Burson-Marsteller developed the concept of a ‘Head-to-Head’ roadshow - a
series of eight meetings in different locations across the UK based on
the format of the BBC television programme Question Time.
The meetings were chaired by broadcaster Nick Ross, who is identified
with mental health issues through his involvement with the schizophrenia
charity Sane, and took place in May/June and September/October 1995.
The panel of four speakers consisted of nationally recognised
psychiatrists and GPs with an interest in depression. They were asked to
discuss the problems facing clinicians in diagnosing and managing
‘We wanted to have a forum that was interactive and topical, where we
could get a lively dialogue going between the experts and the GPs,’ says
B-M senior account executive Anita Charles.
The meetings also enabled GPs to make contact with the psychiatrists in
their area - for some it was the first time they had met.
In all, about 400 GPs came to the eight Head to Head roadshow events. An
added attraction was that the event was given Post Graduate Education
Authority (PGEA) approval - which meant that doctors were awarded
continuing professional development education points for attending.
B-M followed up the roadshow by sending a newsletter on its contents
and the main issues relating to the drug to every GP in the country. The
newsletter featured very discreet branding for Lundbeck.
The Head to Head tour created awareness of Lundbeck and paved the way
for the launch of Cipramil. Since its launch in the latter part of last
year, sales of the drug are understood to have topped pounds 1 million.
‘When a large pharmaceutical company like Eli Lilly launches a new
product it doesn’t have to worry about its name being recognised,’ adds
Charles. ‘But in Lundbeck’s case it needed to make its name known to
Case study: Swallowing the Diflucan pill
Pfizer Consumer Healthcare found itself in an unusual position last
October when it was awarded an OTC licence for its vaginal thrush
treatment Diflucan 1. The product was only launched as an ethical in
1988, and at a mere eight years old was still seen as a relatively new
medicine to be making a POM to P switch.
Furthermore, it is radically different from the other thrush treatments
available from pharmacies - including Bayer’s market-leading Canesten -
which are all applied intra-vaginally, either in cream or pessary form,
whereas Diflucan is taken orally with only a single capsule required to
treat an occurrence of the condition.
At pounds 12.50 for a pack containing a solitary capsule, Diflucan 1 is
the most expensive OTC pill on the market and twice as expensive as its
direct competitors. So it was vital for Pfizer to communicate the
‘specific benefits’ of its product.
‘The proposition we were trying to communicate was that now you can
swallow a capsule for fast treatment of vaginal thrush,’ says Pfizer
Consumer Healthcare marketing director Malcolm Phillips.
Cameron Choat and Partners was brought on board to target the women’s
media, especially publications with a high readership among Pfizer’s
core target market of 25-35 year old ABC1 women. One of the key points
was to illustrate the ‘pride and status in use’ of opting for Diflucan
Cameron Choat organised a consumer press launch at the Medical Society
with an expert in genito-urinary problems on hand to answer questions on
thrush and other vaginal problems.
A series of down-the-line radio interviews with the expert were also
arranged using broadcast consultancy Radio Lynx.
A Thrush Advice Bureau was established, in essence a telephone hotline
to a recorded message giving advice on thrush and details of where to
get a booklet on the condition. The bureau received a good deal of
editorial coverage and in January had 700 calls.
‘When we launched the product we saw there was no research done on how
thrush makes women feel psychologically, although plenty on the physical
symptoms,’ says Cameron Choat account director Sarah Birkmyre.
To rectify this, the consultancy drew up a list of questions on the
psychological impact of thrush which Pfizer then paid to have
researched. The findings, which underlined that some women can feel
depressed and dirty when experiencing the condition, were used as the
basis for generating further coverage and to underscore the importance
of successful treatment.
‘We’ve had superb coverage,’ says Phillips. Publications such as
Company, Cosmopolitan, Bella, Best and Woman have all given coverage to
Advertising for Diflucan 1 broke at the start of this year but by
December 1995 the product had already, claims Pfizer, achieved a 15 per
cent market share by value on the back of the PR surrounding its entry
into the over the counter market.