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The videotape, in an innocuous black case, could be the latest highlight reel of almost any agency.

But it's not.

It's a 90-second montage put together by the head of the healthcare division of one of the world's leading ad shops, a compilation of clips from direct-to-consumer pharmaceutical ads. One after another, the images and voice-overs of various commercials come like rapid-fire.

People walking in a field (near water, on a trail, in park).

People talking about their ailments (symptoms, pains).

People advising the viewer to seek help (talk to your doctor, see your doctor, ask your doctor).

The point of the tape is to show that almost every DTC drug ad out there looks pretty much the same. At least the elements of the production are similar.

Moreover, it's not the only tape of its kind in existence. At least three other agencies have put together such a tape, and yet another has a reel of every DTC pharma ad that appeared on the air in 2002, just to get an idea of what's happening in the category.

What's happening? Not much.

And that's the problem.

"It's a question that's haunted the industry since the inception of DTC," says Terry Gallo, president of Havas' Euro RSCG Life Adrenaline, New York, the consumer advertising division of healthcare shop Euro RSCG Life.

"Pharmaceutical advertising is a different world," Ms. Gallo says, "and we can't rest on our laurels of having done great advertising, per se, elsewhere."

The question is how to take DTC advertising to the next level creatively.

Some of the bigger pharmaceutical companies-the Pfizers, the Mercks, the Novartises-are looking to emulate the advertising success of another large company that churns out a variety of products, Procter & Gamble Co. No coincidence, then, that one of the trends is the emergence of more people with package-goods backgrounds coming aboard at both drug marketers and their agencies.

"The types of things that might be very old hat in the package-goods world really haven't been used that effectively in pharmaceuticals," says Stu Klein, president of the Quantum Group, a Parsippany, N.J., agency that does drug advertising under WPP Group's CommonHealth banner. "The principles of package-goods marketing are terrific. It typically presents a very logical reason for consumers to ask their doctor for a brand. But we have to stay away from some of the trappings, especially things like `We're No. 1.' What does that mean? Being the No. 1 laundry detergent ... certainly doesn't translate to pharmaceuticals."

Agency people still see DTC as somewhat of a fledgling entity that can be a growth area. Getting to that next level is the dilemma.

"We're happy with our advertising, and we use several agencies across the board," says one marketing chief for a major drug company. "But, yeah, there's clutter. And it's not just an agency issue. Our people here work closely with agency account teams, but-and this is not just an issue with us but with everybody-you're just not seeing that breakthrough advertising in the category. Not yet, anyway."

"It's a road map," says Andrew Kay, VP-global sales and marketing for Novartis. "Just like putting together a marketing platform means going from place to place, so does this. Remember, a lot of this is all still new."

That's true. DTC advertising in its current form has only existed since Food & Drug Administration restrictions were relaxed in 1997. But even with the DTC ads now running, this is a category far different from running a beer ad or a car commercial.

7 messages in 1 ad

"The average DTC spot has seven messages in it before it even moves," Mr. Klein says. "We work extensively with a research company that tracks these things. One of the things they've made clear to us is that because of the number of messages conveyed in a typically branded DTC spot, it's almost impossible to reach the kind of breakthrough [recall] numbers that traditional ads can hit."

But Rx marketers and their agencies agree there's a way to start taking DTC ads to a new creative level by focusing on compliance.

"What you've done so far in DTC advertising is you've put the product out there and you've told people what it can do, or what illness it will help with," says Mike Guarini, managing director of WPP 's Ogilvy Healthcare, New York. "You've gotten the people to go get the medicine. Now you have to talk about compliance, which is getting them to stay on the drug. So if there's some room to grow [creatively], that's where it might be."

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