Shrewd advertising allowed one marketer to turn a homemade concoction into a fortune. Lydia E. Pinkham began marketing her Vegetable Compound in print ads after she launched it in 1875. Because the product allegedly treated an array of "female" problems, Ms. Pinkham used a made-by-women-for-women appeal, billing the product as "invented by a woman [and] prepared by a woman." The product became a huge seller by the turn of the century.
In the 1800s, both patent medicines and "ethical drugs"—what are now referred to as prescription drugs—were advertised to physicians. Patent medicines were also advertised to consumers, fueling their widespread use. In 1905, the American Medical Association formed a Council on Pharmacy & Chemistry, which served as an oversight body, judging what qualified as a legitimate drug. The council in turn developed a directory of drugs in use at the time. Medical publications consulted the directory when weighing whether to run ads promoting certain drugs.
Medical journals did not accept ads for drugs not listed in the directory, and the council did not clear any drug that was supported by ads directly aimed at the public. In 1906, the federal government formed the Food & Drug Administration, which took over supervision of drug promotions. Pharmaceutical companies submitted to AMA and FDA oversight and advertised ethical drugs to physicians only. Over time, a specialty developed that continues to be prominent: medical professional advertising.
In the 1920s, as mass advertising for consumer products took root, some pharmaceutical companies dabbled in advertising for over-the-counter products. In keeping with the trend at the time, these ads were heavy with text about product benefits, and advertisers were careful not to arouse the anger of the medical profession.
For example, E.R. Squibb & Sons in 1921 sought to create a print campaign that would give the company a corporate brand identity as well as plug individual products such as sodium phosphate, magnesia dental cream and cold cream. Squibb, which had never before targeted the public, turned to N.W. Ayer & Son. The resulting campaign, itself a prototype for later pharmaceutical advertising, was careful to portray Squibb as an altruistic company working to benefit people. It also contained a slogan that became a long-standing tagline for Squibb: "The 'Priceless Ingredient' of every product is the honor and integrity of its maker."
Later, TV came to play an important role in over-the-counter advertising. In 1952, Whitehall Laboratories' Anacin brought home the agony of a headache by depicting a hammer clanging inside a human head. A mother who had a headache asked her children, "Can't you play somewhere else?" The tagline: "Fast, fast, fast relief." Ted Bates & Co.'s Rosser Reeves, who also devised "How do you spell relief? R-O-L-A-I-D-S" for Warner-Lambert, created the spot.
TV provided a prime medium for another OTC heartburn treatment, Miles Laboratories' Alka-Seltzer, which used humor to deliver its message. In the 1960s and 1970s, a trio of agencies—Jack Tinker & Partners, Doyle Dane Bernbach and Wells, Rich, Greene—created memorable ads that established the brand through images such as two tablets fizzing in a glass of water and rhymes such as "Plop, plop, fizz, fizz, oh what a relief it is."
After Tinker, DDB held the account for only a short period but created the "Spicy Meatball" and "Wedding Night" ads. The account then went to WRG in 1970, which offered two classics of advertising-"I Can't Believe I Ate the Whole Thing" and "No Matter What Shape Your Stomach's In."
By the 1990s, much of the focus of pharmaceutical advertising had changed from its mid-century emphasis on OTCs to the burgeoning arena of direct-to-consumer ads. Many common OTC drugs today were prescription products earlier. Chlor-Trimeton, for example, a medicine for hay fever, was a prescription drug until 1976.
Drug companies first began to test the FDA's tolerance for DTC advertising in 1981 when Merck & Co. introduced a DTC ad for its Pneumovax pneumonia vaccine. Creative was handled by medical advertising agency Kallir, Philps, Ross.
As DTC advertising progressed, agencies often found themselves at odds with the FDA over the ways in which possible side effects should be presented, and the FDA frequently insisted that ads be revised. As a result of the controversy, the FDA declared a two-year moratorium on direct-to-consumer appeals in which actual brand names were mentioned; "seek-help" ads, however, which simply encouraged people to see their doctor for a particular problem, continued to be allowed.
In 1997, marketers and agencies received a boost when the FDA loosened its tight rein on broadcast DTC spots, requiring them to list only major side effects. The new FDA guidance also stated that TV or radio spots must direct consumers to "your doctor" and provide toll-free numbers, Web sites and accompanying print ads that could offer consumers additional information.
The move was seen as a landmark in pharmaceutical ad history and unleashed a boom in DTC ads. TV ad spending in the category jumped from $309 million in 1997 to $1.1 billion in 1999, according to consultancy IMS Health.
By far the most aggressive example was Schering-Plough's campaign for Claritin, a non-sedative antihistamine. When the FDA relaxed restrictions on DTC advertising, Schering moved quickly to pump $322 million into the marketing of Claritin. Messner Vetere Berger McNamee Schmetterer/Euro RSCG handled the ad effort.
But FDA rules still placed firm restrictions on content. If a marketer named a brand, it could not explain what the medication did; if it offered an explanation, it could not name the brand. Schering chose to establish the brand without explaining its benefits. Viewers found the spots frustrating at first, however, the FDA further relaxed restrictions, permitting greater specificity.
DTC ads also contributed to the success of Viagra, which used Sen. Bob Dole to pitch the product in unbranded spots from Cline, Davis & Mann. But even that category, which Pfizer had to itself for six years, changed. Two new competitors came on the market in late 2003 in Levitra, from GlaxoSmithKline & Bayer, and Cialis, from Eli Lilly and Icos Corp.
Their success—taking a combined 17% of the market away from Viagra through mid-2004—not only prompted changes in Viagra’s advertising, but also changes in its agency. Pfizer dropped Cline, Davis & Mann in favor of McCann Erickson; its new campaign, appearing in August 2004, was comparable to those of Levitra and Cialis, using sexy, sultry spots to portray Viagra as more of a lifestyle drug.
As DTC advertising grew, it created a seismic shift in the agency world. Medical agencies specializing in professional ads were at the forefront of the boom, but as the genre developed, marketers began to turn to Madison Avenue's blue-chip shops to handle growing DTC accounts, where billings sometimes topped $100 million a year.
At the outset of the 21st century, virtually all of the major ad networks and holding companies had acquired agencies that specialized in medical advertising.
By mod-2004, DTC advertising accounted for more than $3 billion in annual spending and was one the country's few, if not only, surging ad categories. At one point in early 2004, nearly $500 million in accounts were in review. In fact, the rapid expansion of DTC advertising spurred the FDA to step in again. In February 2004, the agency announced three new draft guidelines for the industry, telling pharmaceutical companies to revamp and reduce the brief summaries in print ads and encouraging more disease awareness spots on TV.