But First, Call Your Drug Company

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No doubt you've seen the ads: A television spot for an antihistamine features a woman windsurfing through an undulating ocean of wheat. In a print ad for a drug that treats baldness, a man leans forward to scrutinize his pate in the bathroom mirror.

Advertisements for prescription drugs, $917 million worth in 1997, have become standard fare on the airwaves and at the newsstands, and are proving to be phenomenally successful with consumers-at least by some measures, according to Prevention magazine's Survey of Consumer Reactions to Direct-to-Consumer (DTC) Advertising, released in July. Fully one-third of the 163 million adult Americans who have seen or heard a DTC television, print or radio drug ad have spoken to their doctors about the medication. Of those, 15 million asked their doctor for the drug, and 80 percent actually left the office with a prescription order. Drug companies are hoping this is the start of a beautiful friendship, but the Prevention survey suggests that these DTC ads are going to have to do a better job of educating consumers if they are to be truly effective.

As Americans' distrust of the healthcare system and dissatisfaction with HMOs continues to grow-coupled with the trend toward more self-care-drug companies are reaching beyond their traditional liaisons with doctors and establishing relationships with the patients themselves. Whereas once only doctors received information from drug companies about new products, now patients have the chance to review that material themselves, and then ask their doctors about the products.

While some physicians may still be getting used to the idea of patients playing an active role in such healthcare decisions as to which drug to take, the Prevention study indicates that this is a trend from which there's no turning back. Americans are more likely now than a year ago to treat themselves for a variety of ailments, including fever, heartburn and muscle pain, the study reveals. In addition, an April survey by Men's Health (like Prevention, published by Rodale Press), reported that 44 percent of adults put no trust in the healthcare system. And a 1997 study by the Kaiser Family Foundation and Harvard University found that 63 percent of consumers think traditional health insurance companies are more interested in their bottom lines than in the health of their patients; 54 percent believe the same of HMOs.

As a result, consumers say they need to educate themselves about medical conditions and their treatment options, says Anne Devereux, president of Consumer Healthworks, a division of Omnicom Group, the advertising conglomerate, whose clients include Bristol-Meyers Squibb and Schering Plough. "Almost all the patients we spoke to in focus groups were looking for more information," Devereux says. And DTC ads are just what the patient ordered, it seems: Three-quarters of consumers feel that these ads enable them to be more involved with their own healthcare.

But while these Rx ads supply more practical information than do most traditional spots-including giving consumers reasons why the product may not be right for them-they are still not clear enough, the Prevention study found. Only 21 percent of consumers who saw the DTC ads think they are very clear. Indeed, many viewers who saw an ad for a brand-name drug later said they did not know what the drug was for-even if they themselves had the symptoms described in the ad.

Such shortcomings may simply be growing pains for the nascent medium, says John Kamp, senior vice president of the trade group American Association of Advertising Agencies. "The audience has to catch up. We're going from a time when there were no ads for prescriptions at all to now-and these ads are kind of strange." The strangeness is at least partially due to the fact that many companies are fearful that their ads will be censored by the federal Food and Drug Administration. So they censor themselves and that, believes Devereux, limits the creativity that might give these ads the sophistication of, say, a Coke or Nike spot.

In fact, as Kamp points out, the ads were even stranger prior to August 1997. Until then, the FDA, wary of the possible fallout from allowing drug companies to target consumers directly, made it virtually impossible for TV spots to do anything more than mention a drug's name. Such restrictions led to confusion over just what a drug treated: early spots for Claritin, for example, tagged "A clear day with Claritin," led many viewers to mistake the antihistamine for an antidepressant.

Since the FDA restrictions were loosened for broadcast media a year ago, ads can now say what a drug is for, but must also include a detailed explanation of possible complications as well as how to get more information via toll-free numbers, print ads or Web sites.

Ironically, the Prevention study reports that consumers find the new ads less clear and useful. Only 28 percent of the people who saw the expanded ads felt strongly that they educated viewers about the risks and benefits of prescription drugs; 24 percent thought the ads made the drugs appear harmless; and only 23 percent thought the ads helped people make decisions about their medications.

Manufacturers are well aware of the limitations of educating the public in the brief time a TV ad allows. Notes Jim Coyne, public relations manager at Astra, which produces the medication Prilosec, "In the space of a 45-second ad-and with the obligations we have to give the benefits and balance the risks from side effects-you can't begin to educate an audience about all the drug's indications."

While this would appear to be a serious drawback both from a consumer advocacy and a marketing standpoint, it ain't necessarily so, says Ed Slaughter, market research director for Prevention. "Maybe you don't evaluate the success of an ad for Provachol [a cholesterol medication] the same way you do an ad for Frosted Flakes. For a box of cereal, you want consumers to pick it up and throw it in the shopping cart. For Provachol, you want them to talk to their doctor."

And doctors aren't the only ones consumers are talking to-thanks in part to the FDA. The agency's regulation on including a toll-free number is a blessing in disguise for drug firms. Consumers who call the numbers make direct contact with the pharmaceutical companies-a relationship marketer's dream. Rob Dhoble, president of Omnicom's Acuity HealthGroup, a marketing firm that helps its clients mine their databases, likens this connection to a patient-doctor relationship, adding that the opportunities for marketers are substantial.

Acuity cites a 1998 survey by VHA, a nonprofit healthcare membership organization, and Deloitte & Touche, which indicates that 25 percent of consumers changed physicians within the last two years. So since patients may no longer enjoy the luxury of maintaining a long-term relationship with their primary-care physicians, drug companies have the chance to step into the breach, exploiting their own staying power by devising mini-health plans that cater to an individual's healthcare needs. And the breach is a lucrative place to be because 80 percent of all medications sold are for long-term conditions, according to Prevention.

Still, as the Prevention survey shows, in this age of consumer advocacy and skepticism about what any medical institution has to offer the public, advertisers are going to have to do a better job of communicating with consumers before they dial those 800 numbers.

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