TOP 50: HEALTHCARE PR CONSULTANCIES - An industry in perfect health.

1996 was a bumper year in healthcare PR as many agencies saw dramatic increases in fee income. The pharmaceutical industry showed renewed confidence in PR as companies realised that cost constraints on prescribers drug budgets were not having as devastating an effect as feared and saw sales and profits rise. There was also more work from the NHS as trusts and authorities recognised the need for good relations with the local community.

1996 was a bumper year in healthcare PR as many agencies saw

dramatic increases in fee income. The pharmaceutical industry showed

renewed confidence in PR as companies realised that cost constraints on

prescribers drug budgets were not having as devastating an effect as

feared and saw sales and profits rise. There was also more work from the

NHS as trusts and authorities recognised the need for good relations

with the local community.

The top players have benefited from this boom in healthcare PR. Medical

Action Communications has managed to clear the pounds 5 million hurdle,

but it has just been overtaken at the top of the table by

Burson-Marsteller which saw a 32 per cent rise in fee income last year

up to pounds 5,082,312.

Shire Hall continues to occupy third place. And Interscience, which is

taking part in the league tables for the first time this year, has

stormed into fourth place with a fee income of pounds 2,563,776. Hill

and Knowlton has maintained its hold on fifth place, but Shandwick has

fallen from fourth to sixth, while still managing to increase its

healthcare fee income by 44 per cent.

More good news for PR practitioners last year was that healthcare

companies put more of their budget into PR instead of advertising and


As a result, PR agencies continued to be eyed longingly by their cousins

in advertising and marketing. NHS specialist PR consultancy Elliott and

Cater was one which linked up with a marketing agency, in this case the

Milton Marketing Group, during the course of the year.

Another major factor driving growth was the increase in the number of

audiences with whom companies needed to communicate. The UK market is

becoming more like the US as patients become more powerful and demand

more knowledge and choice. Disease education programmes are now a

feature of many agencies’ work. Greenlines Healthcare Communications,

for example, has a publishing unit which has grown thanks to this kind

of work and last year the agency handled disease education programmes

for Jannsen-Cilag on schizophrenia and Boots on asthma.

With this increase in the number of target audiences, agencies are also

turning to new media. ’Electronic communications media can be the best

way of supplying up-to-date patient information on demand,’ says Gareth

Zundel, group director at Harvard PR. Complete Pharma for Glaxo Wellcome

and Munro and Forster for the Department of Health were other agencies

using the Internet on behalf of clients. Interscience even set up a

separate subsidiary, Interscience Innovations International, to provide

a a new technology and Internet service for healthcare


Changes in the NHS are providing plenty of work for agencies.

Burson-Marsteller was asked by many clients to advise on developments in

the NHS, and Munro and Forster launched a newsletter, Health Service


Crisis management work in the NHS also grew for agencies such as

Jonathan Street PR and Milton Cater as the sector came under increasing

public and media scrutiny.

Communications to NHS professionals have become more complex as

pharmaceutical companies find they need to talk to those responsible for

purchasing drugs as well as those who prescribe them. In this context,

pre-marketing is becoming more important as drugs companies seek to

inform opinion leaders, purchasers and patients about products in

development. Shire Hall formed a new company, 4D Communications,

specialising in pre-marketing, and other agencies including Medical

Action Communications, Shandwick and Ruder Finn reported an increase in

pre-marketing activity.

A new area related to pre-marketing is patient recruitment for clinical

trials. Cohn and Wolfe launched a communications package called Inform

aimed at increasing recruitment and retention in clinical trials and

produced some spectacular results. Deputy managing director Martin Ellis

says fee income for work in this sector amounted to pounds 350,000.

Ruder Finn was also active in recruitment for clinical trials.

Biotechnology was another growth sector. This industry is still in its

early stages and Shire Hall, for example, did a lot of work introducing

emerging biotech companies to the City.

Agencies also reported more international work. Hill and Knowlton and

Shandwick both established global healthcare practices as agencies

recognised that clients wanted programmes which crossed international


Where this increasing internationalisation of healthcare PR leaves

smaller independent agencies remains to be seen. Health Network has

concentrated on building up a network of affiliates as it took clients

into central and Eastern Europe and the Middle East. Complete Pharma

went the other way, setting up a subsidiary, Synapse, so it could

concentrate on UK work without diluting its international brand


With the need to communicate to a greater number of audiences,

full-service agencies are pointing out the benefits of having consumer

and corporate specialists. Ruder Finn puts a lot of its success in

healthcare down to being able to offer corporate expertise as well. As

this trend continues the smaller agencies will be forced to become even

more specialist or to take on staff from a greater diversity of


Top Healthcare Consultancies: 1-20

Rank  Company                      UK          %         Total    Staff

1996                       Healthcare    Overall         UK PR

                               Income     Income        Income

1     Burson-Marsteller     5,082,312         38    13,374,505      189

2     Medical Action

      Communications        5,070,000        100     5,070,000       62

3     The Shire Hall

      Group                 3,462,868        100     3,462,868       54

4     Interscience Pan

      Europa                2,563,776        100     2,563,776       24

5     Hill and Knowlton     1,945,800         12    16,215,000      232

6     Shandwick             1,934,240          8    24,178,000      379

7     Complete

      Pharma PR             1,725,861        100     1,725,861       29

8     Holmes and

      Marchant              1,575,910         47     3,353,000       57

9     Fusion

      Communications        1,482,118        100     1,482,118       21

10    Grayling              1,305,794         22     5,935,426       93

11    Munro and Forster

      Comms                 1,222,808         70     1,746,869       44

12    Manning, Selvage

      and Lee               1,079,660         37     2,918,000       42

13    Edelman PR

      Worldwide             1,056,876         22     4,803,983       59

14    Charles Barker          948,125         15     6,320,836       75

15    Advisa Medica           878,560         95       924,800       11

16    Medical Imprint*        800,000        100       800,000        9

17    Greenlines

      Healthcare Comms(1)     710,725        100       710,725       13

18    Cohn and Wolfe          694,656         20     3,473,278       52

19    Ludgate Group           649,899         10     6,498,989       69

20    Harvard PR              647,100         18     3,595,000       50

Rank   Company              Agency type


1      Burson-Marsteller    Full service with healthcare practice

2      Medical Action

       Communications       Healthcare specialist

3      The Shire Hall

       Group                Healthcare specialist

4      Interscience Pan

       Europa               Healthcare specialist

5      Hill and Knowlton    Full service with healthcare division

6      Shandwick            Full service

7      Complete

       Pharma PR            Healthcare specialist

8      Holmes and

       Marchant             Full service

9      Fusion

       Communications       Healthcare specialist

10     Grayling             Full service

11     Munro and Forster

       Comms                Consumer and healthcare

12     Manning, Selvage

       and Lee              Full service with healthcare division

13     Edelman PR

       Worldwide            Full service with healthcare division

14     Charles Barker       Full service with healthcare division

15     Advisa Medica        Healthcare specialist

16     Medical Imprint*     Healthcare specialist

17     Greenlines

       Healthcare Comms(1)  Healthcare specialist

18     Cohn and Wolfe       Full service with healthcare division

19     Ludgate Group        Financial and corporate

20     Harvard PR           Healthcare, technology and consumer

Top Healthcare Consultancies: 21-50

Rank  Company                      UK        %         Total    Staff

1996                       Healthcare  Overall         UK PR

                               Income   Income        Income

21    Euro RSCG

      International Comms     612,696        9     7,208,186      139

22    Milton Cater *1         585,000      100       585,000        8

23    Jonathan Street PR      555,228      100       555,228       11

24    Lynne Franks PR         550,292       18     3,057,180       52

25    Ruder Finn UK           548,422       85       645,202       19

26    Scope Ketchum

      Communications          525,830       11     4,780,270       70

27    Fleishman-Hillard (UK)  478,868       24     1,995,282       28

28    Countrywide Porter

      Novelli                 477,500        3    15,916,671      233

29    Clear Communication     446,880       80       558,600       11

30    Sante Communications*   421,202      100       421,202       10

31    Citigate                406,662        5     8,133,248      122

32    The Public Relations

      Business                301,753       17     1,775,016       36

33    Cameron Choat and

      Partners                289,500       15     1,930,000       36

34    GCI Group London        287,014        7     4,100,200       72

35    Financial Dynamics      250,575        3     8,610,830       55

36    Keene Communications    243,568       16     1,522,300       27

37    Staniforth PR           232,836       15     1,552,237       34

38    Harrison Cowley         201,317        6     3,355,278       77

39    Key Communications      167,203        4     4,180,065       65

40    Golley Slater PR        162,544        8     2,031,795       37

41    Fishburn Hedges         156,871        4     3,921,775       44

42    Health Network          139,911       25       559,644       16

43    Infopress               126,000       10     1,260,000       25

44    Square Mile

      Communications          123,908        9     1,440,787       23

45    Consolidated

      Communications          103,066        5     2,061,322       42

46    Westminster

      Communications           85,600        4     2,140,000       37

47    College Hill Associates  80,261        2     4,013,051       45

48    De Facto Consultants     76,782       11       698,017       18

49    Attenborough Associates  75,780        5     1,515,595       25

50    Grant Butler

      Coomber (GBC)            61,891        5     1,237,815       31

Rank  Company


21    Euro RSCG

      International Comms       Full service

22    Milton Cater *1           Healthcare specialist

23    Jonathan Street PR        Healthcare specialist

24    Lynne Franks PR           Consumer

25    Ruder Finn UK             Healthcare and corporate

26    Scope Ketchum

      Communications            Full service with healthcare division

27    Fleishman-Hillard (UK)    Full service with healthcare division

28    Countrywide Porter

      Novelli                   Full service with healthcare division

29    Clear Communication       NHS specialist

30    Sante Communications*     Healthcare specialist

31    Citigate                  Full service with biotech.division

32    The Public Relations

      Business                  Full service

33    Cameron Choat and

      Partners                  Full service with healthcare division

34    GCI Group London          Full service with heatlhcare division

35    Financial Dynamics        Financial and corporate

36    Keene Communications      Full service

37    Staniforth PR             Full service

38    Harrison Cowley           Full service

39    Key Communications        Full service

40    Golley Slater PR          Full service

41    Fishburn Hedges           Financial and public affairs

42    Health Network            Full service

43    Infopress                 Full service

44    Square Mile

      Communications            Corporate and financial

45    Consolidated

      Communications            Full service

46    Westminster

      Communications            Corporate and public affairs

47    College Hill Associates   Financial

48    De Facto Consultants      Healthcare and bioscience

49    Attenborough Associates   Full service excluding financial

50    Grant Butler

      Coomber (GBC)             Technology and consumer

All figures relate to the year ended 31 December 1996.

Fee income = PR fees + mark up.

All figures are certified by an auditor except those marked *.

(1) Formerly Greenlines PR.

1 Burson-Marsteller

pounds 5,082,312

Burson-Marsteller leapfrogged over Medical Action Communications in 1996

to the number one spot with a 32 per cent growth in UK income. However,

the increasing international focus of the practice groups meant that

over 70 per cent of the group’s overall healthcare work was

international in scope last year.

According to Aileen Thompson, local practice leader, healthcare, a

majority of the group’s growth in domestic healthcare income is the

result of growing existing key clients such as Zeneca. In particular the

practice has increased the level of crisis and issues management

consultancy for existing clients.

However, there were also some significant new client wins in 1996

including work for a cardiovascular product from Reckitt and Colman and

a brief from Glaxo Wellcome to develop a communications programme for

people living with HIV/Aids.

Biotechnology remains a slow burn sector, although B-M reports

increasing work in this area. 1996 also saw B-M move into the hospitals

sector, although the significant growth in this area won’t have made

itself felt in the 1996 figures.

2 Medical Action Communications

pounds 5,070,000

Medical Action Communications (MAC) maintained its record of achieving

double digit growth as it grew fee income by 13 per cent to take it

beyond the pounds 5 million mark. There was new work with existing

client Glaxo Wellcome, highlighting the group’s corporate commitment to

anti-infectives. ’We developed a programme for them giving worldwide

contact with opinion leaders,’ explains managing director Stephen


The agency also developed an Intranet programme for anti-diabetic

product Romozin, enabling Glaxo operating companies around the world to

access key information.

A new client win was Japanese pharmaceutical company Takeda. The agency

is developing a European programme supporting Takeda’s activity in

target markets and preparing markets for the launch of a new

cardiovascular drug.

Earlier this month MAC announced its merger with US-based Quintiles

Transnational Corporation in a deal worth around pounds 22 million.

3 The Shire Hall Group

pounds 3,462,868

Shire Hall enjoyed another positive year as it grew fee income 48 per

cent. Growth in international business - accounting for 40 per cent of

income - was one of the prime drivers. ’Clients wanted to benefit from

the work we are doing in the UK,’ says chief executive Margot James.

Bristol-Myers Squibb, for example, asked the agency to carry out an

international education programme for cancer. There was also

international work for Novo Nordisk on its diabetes and growth hormone


The formation of Oxford-based consultancy 4D Communications,

specialising in pre-marketing, also helped grow international business.

’Quite a few other companies are involved in medical education but they

tend to be mainly publishing organisations - we’re coming at it from a

marketing and commercial standpoint,’ says James. Biotechnology work

continued to grow, based on the joint venture formed with US company

Noonan Russo two years ago.

Thirty new jobs have been created in the agency in the last 18


Senior appointments included Sarah Harwood, formerly in marketing at

Glaxo Wellcome, as associate director with responsibility for new

business; Carol Beaumont, formerly of The Medicine Group, as managing

director of 4D; and Professor Brian Edwards, previously director of the

West Midlands Regional Health Authority, as non-executive director.

5 Hill and Knowlton

pounds 1,945,800

Last year H&K established a global healthcare practice. Noel Hall,

previously managing director for the UK, was appointed head of strategic

planning for Europe. Sarah Rogers, formerly with Fusion, became head of

the ethical division in the UK.

The healthcare practice is increasingly working on integrated campaigns

with other H&K divisions. For example, the consumer division helped

launch Zeneca’s new migraine product Zomig at the Edinburgh Science

Festival using virtual reality. One of the reasons the agency was

appointed on Glaxo Wellcome’s global anti-infectives programme, says

Hall, was because of its joint work with its corporate division and

recommendations concerning brand reputation. Other wins included London

International Group for Durex; the EC for a programme on the health

benefits of olive oil; and Roche’s pounds 1 million global HIV and Aids

programme in 1997.

6 Shandwick

pounds 1,934,240

1996 is described as a ’mind-blowing and expansive year’ for Shandwick

by Averill Gordon, who joined the agency in July as director,


’The main factor driving growth is our global capabilities,’ says


New global accounts included Ciba Vision and Ares-Serono, the Swiss

pharmaceutical company which is a leader in infertility treatment. The

agency also won the account to launch Boots’ entry into new markets


Shandwick formally set up a global healthcare taskforce in July to brief

practitioners around the world on implementation programmes.

Biotechnology was a growth area. Besides Ares-Serono, Shandwick also won

Baxter Biotechnology, promoting the company to opinion leaders in cancer

in Europe.

A new area was medical devices, where companies are realising the value

of PR, says Gordon. New clients in this area included St Jude, which

produces heart valves and pacemakers.

- Shire Hall created 4D Communications to develop its pre-marketing

sector with the aim of educating patients, the public and GPs about

products in development.

- Despite a 13 per cent rise in fee income, Medical Action was narrowly

beaten to the number one slot by Burson-Marsteller’s new look practice

group. However, new work was won with Glaxo Wellcome and leading

Japanese pharmaceutical company Takeda.

7 Complete Pharma PR

pounds 1,725,861

An 80 per cent rise in fee income meant another very good year for

Complete Pharma.

A major account win was pharmaceutical company Abbott, handling

gastrointestinal, prostate cancer, BPH and hospital products. For

Swedish pharmaceutical company Astra there was new international work on

respiratory products to support its bronchial therapy range. Last year

the agency also won its first OTC work, from existing client SmithKline

Beecham, for Panadol.

’We won this because of my experience in the OTC area in the US and

because of our good track record with SmithKline Beecham,’ says MD Scott


To develop UK work without diluting the agency’s international brand

image a subsidiary agency, Synapse, was created in April. Some clients,

such as SmithKline Beecham, are shared, but Synapse mainly has its own

clients. These include a hay fever product for Hoechst Marion Roussel, a

schizophrenia treatment for Lundbeck and an Orion Pharma product for

central nervous system disorder .

CPR has also embraced new media such as the Internet and CD-ROM. Last

year it created a Web site for Glaxo Wellcome which has registered tens

of thousands of hits.

11 Munro & Forster Communications

pounds 1,222,808

While not enjoying as much growth as some rivals, Munro and Forster had

a busy year in healthcare. Client wins included Leo Pharmaceuticals for

psoriasis product Dovonex and 3M Healthcare (asthma). The agency was

also involved in campaigning work, including No Smoking Day and a folic

acid campaign for the HEA. ’In 1996 for OTC medicines we increasingly

used skills and techniques more associated with issues and campaigning,’

says director Julie Flexen.

’We also started using more mainstream consumer brand building

techniques,’ says Flexen. It mounted a major campaign for Zantac 75

focusing on indigestion at Christmas.

Clients increasingly looked to M&F for advice on the implications of

changes in the NHS on the pharmaceutical industry. As a consequence, the

agency started producing a newsletter called Health Service Interface,

distributed to clients and their salesforces.

17 Greenlines Healthcare Comms

pounds 710,725

A name change from Greenlines PR, reflecting the increasing breadth of

activities including a flourishing publishing unit, coincided with

Greenlines Healthcare Communications’ move up the chart from number 25

in 1995 on the back of an 86 per cent rise in fee income.

The agency did more work in the area of disease education, with major

new programmes for Jannsen-Cilag in schizophrenia and Boots in


Other new work included the launch of a prostate product for Yamanouchi,

and anaesthetics for Astra.

’Our key area of strength is POMs and communicating to healthcare


We’re also running quite a few programmes where we’re targeting

patients,’ comments managing director Charlene Bargeron.

To give the agency NHS expertise, Lynne Herbert was recruited from Guy’s

and St Thomas’ Hospital Trust. In the autumn, Andrew Day was made a

director, strengthening the senior management team.

22 Milton Cater

pounds 585,000

Elliott and Cater joined healthcare specialist the Milton Marketing

Group last May to become Milton Cater. ’We wanted the backing in order

to grow, and they wanted to acquire a PR consultancy to complete their

portfolio,’ explains managing director Claire Cater. ’We now find we can

draw on the skills across the group, including a design agency in

Windsor. For a health promotion campaign we can offer everything from

media relations to literature and events and the people to staff


Account wins for this NHS specialist included Kent and Canterbury NHS

Trust, and Lambeth, Southwark and Lewisham Health Authority. Crisis

management work continued to grow in Kent and Canterbury, starting with

work on smear test rescreening and moving on to media relations


Another new client was the Hale Clinic in London, reputedly the largest

complementary therapy clinic in Europe. As a result a couple of

individual therapists appointed the agency to handle PR for one-off


A further account win was the European Institute of Health and Medical

Sciences, a new division of Surrey University, bringing together

faculties and specialists linked to health. Media relations, corporate

identity, marketing and strategic advice was offered on projects

including nurse education, training of doctors overseas and research for

drugs companies.

23 Jonathan Street PR

pounds 555,228

Formed in January 1995 and appearing for the first time in the

Healthcare Top 50, Jonathan Street PR was previously a trading agency

within the NHS. Fee income grew from pounds 397,795 in 1995 based mainly

on ad hoc and crisis work which is what the agency specialises in.

’We have a large number of regular clients, mainly NHS trusts and also

health authorities. General medical and surgical hospitals are at the

forefront of media attention, as are health authorities which are

holding the purse strings,’ says managing director Jonathan Street.

’There was a lot of nervousness last year among trusts and health

authorities because of the political spin on health stories. Clients

were not spending less in the run up to the election, but they were

keeping their heads down and an eye out for anything that could cause

political ructions,’ says Street.

High profile crisis work included work on behalf of local health

authorities with regard to the homicides by ex-psychiatric patients in

Camden and Derbyshire, and Queen Charlotte’s Hospital at the time of the

controversial twins abortion case.

- Crisis management work proved lucrative for Milton Cater as it stepped

in to handle work on the smear test rescreenings for the Kent and

Canterbury NHS Trust. Other wins included Lambeth, Southwark and

Lewisham Health Authority and complementary health specialist, the Hale


- A policy of recruiting people with a broad range of cultural

backgrounds helped Complete Pharma increase its international work and

an office was opened in Miami to cover Latin America.

25 Ruder Finn UK

pounds 548,422

’Our main area of growth was corporate pharmaceutical work,’ says

Jacqueline Sanders, who was recruited as head of healthcare at Ruder

Finn from Fleishman-Hillard in September last year. ’We have a lot of

expertise in this area as a result of our work with Novartis and the

merger of Ciba Geigy and Sandoz Pharmaceutical.’ The agency also worked

on Novartis’ transplantation business.

Glaxo Wellcome used the agency for work on its international asthma

campaign and a new diabetes drug. Other account wins included urge

incontinence and corporate work for Lorex Synthelabo, and cystic

fibrosis products for Zeneca and Meronem.

’About 18 months ago the agency was doing a lot of project work. We

drove through very good results for clients and now they have more

confidence in us and we are able to win bigger business,’ says


The agency did more work in patient recruitment for clinical trials, for

example in pancreatic cancer for Novartis. ’We’ve also noticed greater

recognition of the role PR can play early on in the product life


One of the cases we’re currently working with is Knoll Pharmaceuticals,

trying to build better understanding of obesity,’ says Sanders.

Staffing grew from nine to 14 and Alison Denham was recruited in October

from Ketchum as account director.

34 GCI Group London

pounds 287,014

Formed in September 1995, GCI’s healthcare division showed its potential

as a significant contributor to the agency’s overall fee income by

developing its work with major clients in 1996.

The agency was one of the few retained by Novartis following the merger

of Ciba Geigy and Sandoz, and was invited to handle the whole of

Novartis’ HRT portfolio without pitching. After winning the Pepcid AC

account towards the end of 1995, GCI developed the Johnson and Johnson

MSD business by doing professional relations work with pharmacists and

advisory groups.

Searle Pharmaceutical was another client that increased its business

with GCI, with work in women’s health including nurse training


Catherine Warne (nee Raba) heads up the healthcare division, which has

grown from two to nine staff since it was set up. Warne says: ’One

factor in our success is that we give clients the opportunity to work

with our sister company Grey Healthcare Advertising so we can offer the

benefits of working jointly or working exclusively with clients.’

- Staffing grew dramatically in 1996 for GCI. Jennifer Funnell was

recruited as account director from Citigate and Isobel McFarlane, an

issues management expert, has recently joined the healthcare division

full-time, having been with GCI for a couple of years.

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