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The explosion of direct-to-consumer advertising for prescription drugs is no secret. Ad expenditures by Rx drug marketers in consumer media surpassed $1.24 billion last year. What's not as well known is that a lot of the advertising isn't connecting with consumers. So says a healthcare ad agency's national survey, reported in this issue's Special Report. If not corrected, it could foreshadow a spending reversal. There is a remedy: better ads.

The survey of 1,000 men and women by Campbell Mithun Esty's CME Health found surprisingly few consumers responded favorably to ads for 18 Rx brands. For 15 of those brands, this survey discloses, consumers were twice as apt to strongly dislike the ads as to strongly like them. People who suffered or had family members who suffered from a specific ailment were no more inclined to think favorably of a drug relative to them because of its advertising.

Patients were most likely to give ads a neutral rating, indicating a lack of interest or involvement. Said a CME executive: "The hurdle most pharmaceutical marketers have yet to clear is developing advertising that people actually like or [that] will influence behavior."

Granted it's only one survey, but it's potentially devastating news for the DTC ad industry. Who is going to continue funding sales messages that don't register? As consumers, we've seen a good deal of this Rx consumer-media advertising, especially the TV commercials, and can attest it often falls short or actually turns viewers off with the concluding quick run-through of potential side effects.

There are successes out there. The advertising for Viagra from Pfizer -- profiled in the Special Report -- is well received after the initial flurry of free (and not always kind) publicity. But by and large, the creative often show a distinct lack of imagination or inspiration. It can be difficult to be creative while crossing the t's and dotting the i's of the fine print required by the Food & Drug Administration. But unless more pharmaceutical advertisers and ad agencies start succeeding creatively, and do it soon, this influx of $1 billion-plus in annual ad dollars has the potential to start quickly dropping back to earlier levels.

There's a symptom of something wrong here, and the industry must attack it.