Direct-to-consumer drug advertising has entered its next evolutionary phase. The banal images of smiley, happy people in physician-targeted advertising later translated into consumer ads are out.
Star power is in.
Pharmaceutical companies are now turning to celebrities, humor and other marketing techniques to help their ads stand out from the clutter. The efforts are giving hard-to-remember product names such as cholesterol-lowering Zocor and hair-loss treatment Propecia top-of-mind awareness.
"There are no prohibited areas anymore," says Anne Devereux, president-chief operating officer of Merkley Newman Harty Healthworks, New York, whose DTC clients include Bristol-Myers Squibb Co.'s diabetes drug Glucophage.
"Clients are now comfortable enough with DTC that they're asking us to push the creative limits," she says.
Client comfort extends beyond new creative frontiers. Drug companies are using prime-time TV to promote allergy drugs such as Schering-Plough Corp.'s Claritin and so-called "lifestyle" drugs, such as Pfizer's erectile dysfunction treatment Viagra, and more.
And TV use is soaring. According to Competitive Media Reporting, pharmaceutical DTC spending for network, cable, spot and syndicated TV hit just over $1 billion for the 12 months ended November 1999, up 50.2% from the comparable period ended November 1998.
Of the 10 drugs that generated the most DTC ad spending through the first 11 months of 1999, seven were either allergy treatments (Claritin, Pfizer's Zyrtec, Glaxo Wellcome's Flonase and Schering-Plough's Nasonex) or lifestyle products (Viagra, Merck & Co.'s Propecia and Hoffmann-La Roche's weight-loss drug Xenical), according to consultancy IMS Health.
DTC advertising has been extended to drugs such as SmithKline Beecham's Paxil, which treats social anxiety disorder and Johnson & Johnson's Procrit, which eases anemia caused by chemotherapy. Also, AstraZeneca Pharmaceuticals' even greatly increased support behind breast cancer drug Nolvadex.
There no longer seems to be unwritten limits on which type of drugs will generate DTC efforts.
Ads for Glaxo's Wellbutrin that began last fall featured two formerly taboo issues: depression and loss of sex drive. The effort from Consumer Healthworks, New York, which did not mention Wellbutrin by name, focused on the drug's ability to treat depression without causing sexual side effects.
"Our society has matured to the point where they can hear these things," says Mark Anzalone, senior VP-managing director of the DTC unit of Gerbig, Snell/Weisheimer & Associates, Columbus, Ohio.
In some cases, DTC pharmaceutical marketing has helped bring about that maturity by providing a comfortable-to-use dialogue to discuss previously closeted conditions. Campaigns for Pharmacia & Upjohn's Detrol and Alza Corp.'s Ditropan have sought to make the softer-sounding "overactive bladder" a more popular term than "incontinence." Pfizer's Viagra efforts have tried to reclassify impotence as erectile dysfunction or ED.
Former presidential candidate Bob Dole boldly sat before the cameras to raise awareness about ED and its treatment.
Though the advertising initially gave fodder to late-night comedians, it quickly worked to destigmatize the condition.
"If it's the right celebrity, I can't emphasize enough how much impact it can have," Mr. Anzalone says, adding it can put a human face on a medical condition. "People refer to Viagra as the thing Bob Dole takes."
His job partly done, Mr. Dole was gradually phased out of ads last year. Some industry observers say Pfizer hoped to broaden its target beyond the World War II generation.
Mr. Dole followed "Good Morning America" host Joan Lunden as a celebrity making a DTC pitch. Ms. Lunden made her debut in ads for Claritin in 1998. In a sense, she is to the top-selling Rx allergy drug as Michael Jordan is to Nike. In a testament to how effective the Claritin marketer believes she is, Schering-Plough launched four new spots starring her in February in advance of this spring's allergy season.
"Depending on the seriousness of the category, I think you get a credibility effect (with a celebrity)," says Matt Giegerich, president of the Quantum Group division of Claritin agency CommonHealth, Parsippany, N.J.
HITS THE TARGET
Properly chosen, a celebrity can have strong resonance with a drug's target audience. In March, American Home Products' Wyeth-Ayerst unit launched a DTC effort aimed at post-menopausal women starring model Lauren Hutton. The unbranded effort from Rubin Ehrenthal, New York, is for estrogen replacement drugs Premarin and Prempro. TV spots feature Ms. Hutton as voice-over tells viewers to ask their doctors about what can be done "to protect your health during and after menopause."
"Working with Lauren is a creative way to reach more than 20 million baby boomer women who will reach menopause within the next decade," says an AHP spokesman.
Merck & Co. made a bid to reach middle-aged men when it launched a campaign starring National Football League coach Dan Reeves for Zocor in December. In spots from Ogilvy & Mather, New York, Mr. Reeves talks about how he had heart trouble six weeks before the 1999 Super Bowl; after he recovered, Zocor helped him prevent a recurrence.
Mr. Reeves may only be the initial celebrity in Zocor advertising. In December, O&M placed a classified ad in entertainment trade magazine Variety searching for a celebrity who takes Zocor to star in a DTC campaign. Merck may have turned to celebrities to give the drug a lift as it battles to keep up with hot-selling market leader Lipitor, co-marketed by Pfizer and Warner-Lambert Co.
Bristol-Myers Squibb also used a sports celebrity in an ad campaign that launched in March, though not for a specific drug. The corporate image effort features Tour de France winner Lance Armstrong, who used Bristol-Myers Squibb drugs to battle cancer before recovering to resume his cycling career.
Glaxo used a different, non-testimonial approach to celebrity endorsement last winter in its campaign for new flu drug Relenza. The effort from Saatchi & Saatchi, New York, featured Wayne Knight playing the role of "The flu" (see story on Page S-2).
CELEBRITY AND HUMOR
The initial spot ended with a female flu victim escorting Mr. Knight out of her home. But that ran into trouble with the U.S. Food & Drug Administration, which felt the ad incorrectly implied that Relenza can eliminate the flu when it can only mitigate its effects. Glaxo then redid the ads to end with a scene of Mr. Knight mocking the woman's husband for thinking soup might help.
FDA's objection to the Relenza ads was unusual for a celebrity DTC spot.
In fact, some industry observers say celebrity ads more easily pass muster with the FDA than other types of DTC work.
"It can simplify the process of getting creative approved because you have a relatively straightforward creative product," Mr. Giegerich says.
However, there is some concern the growing use of celebrities could backfire.
"If everyone uses a celebrity, then how do you break through?" says Lynn O'Connor Vos, CEO of Grey Healthcare Group, New York.
In the Relenza campaign, Glaxo uses two of the newer creative techniques in DTC: celebrity and humor. Until recently, humor was largely absent.
"It was taboo," Mr. Anzalone says. "Do not make fun. It is not acceptable."
An unbranded campaign for Merck's Propecia that launched last fall from Young & Rubicam, New York, takes a tongue-in-cheek approach to hair loss as it encourages men to seek help for the problem. The spots ask, "Thinking about hair loss?" Then they show worried men unable to escape images of baldness, such as a dome-shaped building or painting of a bald eagle.
In one spot, a waiter asks a worrier, "Would you like some pate?" The man is so on edge about his receding hair line, he thinks the waiter asked if he would like "a toupee."
Pfizer also took a somewhat light-hearted approach to DTC in February when it launched a Valentine's Day campaign for Viagra. The TV effort from Cline, Davis & Mann, New York, sought to capitalize on the romantic mood of the month; it featured a couple in a romantic moment and told viewers to "be sweet" and "be playful."
The FDA, however, forced the ads off the air, charging they were too suggestive about Viagra's ability to improve one's love life.
As humor and other techniques advance the creativity of DTC ads, says Nancy Ostrove, chief of the FDA's Division of Drug Marketing, Advertising and Communications, the agency will do what it can to adapt to the changes as long as consumers are protected.
"We will obviously work with the industry to the extent we can," she says. "We're not going to object to something unless it's violative."