Alternatives to DTC, Part 1

Recently, the following items have appeared in my radar screen:

1. Last week I was visited by two entrepreneurs who showed me a wireless PC device they plan to put into doctors offices for pharma-sponsored patient information. Coincidently(;-) someone posts an inquiry to the PHARMA-MKTING online discussion forum about putting an interactive device in front of hospital inpatients (think of the device as like a laptop with wireless LAN), the purpose of which is to put patient education content and targeted patient advertising (as well as entertainment content) on the device.
2. An article in today's Wall Street Journal ("For Mild Depression, Some U.K. Doctors Prescribe Reading") talks about empowering patients with information rather than drugs (they coined a new phrase for this: "bibliotherapy").
   
3. Recent "Guiding Principles" from the pharmaceutical industry suggest that DTC advertising mention non-drug alternatives such as diet, exercise and other lifestyle changes and that pharma companies should do more to promote health and disease awareness (see "PhRMA Finalizes DTC Principles").
4. I just finished reading an advance copy of the book "Generation Rx," which claims that Americans are overmedicated and advocates more disease awareness campaigns and adoption of healthy lifestyles by Americans.

All this attention to "disease awareness," "bibliotherapy," and the dangers of "polypharmacy" vs. healthy lifestyle is a direct result of the backlash against direct-to-consumer (DTC) advertising of drugs.

No doubt, DTC TV advertising is losing its appeal to the pharma industry as a result of the VIOXX debacle. Reports were circulating back in May that pharma would be cutting back on TV DTC ad spending (see "Pull Back from DTC on TV?"). Recent numbers confirm that TV DTC budgets were decimated in the first quarter of 2005 (see "Drugmakers cut back on television ad spending"): "The industry spent $388.5 million on consumer drug ads on network TV in the first quarter, down about $44 million from last year, says Nielsen Monitor-Plus."

The Disease Awareness Alternative
Some experts think that the "upside" is that money not spent on TV DTC will be looking for other places to go -- and probably not to drug company investors or to patients in the form of lower drug prices. Under the new guidelines from PhRMA, the money may go to disease awareness campaigns, which are best done through the Internet or print.

Devices such as the web-enabled wireless tablets mentioned above, which can deliver web-based sponsored pharma disease awareness content, may get a boost if pharma has an extra $400 million or so per year to invest in alternatives to TV DTC.

The "Bibliotherapy" idea, which encourages doctors to recommend "self-help" books to patients with mild depression rather than drugs, is not a totally new idea. Back in the "dotcom era" many health web sites endorsed the idea of physicians "prescribing information" as well as drugs. In 2003, the state of Georgia and the National Library of Medicine implemented a Health Information Prescription pilot program (see "The Health Information Prescription").

Doctors often prescribe medication after seeing a patient. But what if that doctor also wants to direct the patient to up-to-date, reliable, consumer-friendly information about a health question? Under a pilot program to be launched in Georgia March 18th, physicians all over the state of Georgia will be able to do just that.

The American College of Physicians-American Society of Internal Medicine Foundation (ACP-ASIM Foundation) has teamed with the National Library of Medicine (NLM), an arm of the National Institutes of Health, to create the "Health Information Prescription" program.

Now, doctors throughout Georgia will have customized prescription pads that they can use to point patients to first- rate online health information in NLM's MedlinePlus database (www.medlineplus.gov).

Prescribing information instead of drugs, however, is a new idea, which resonates with Greg Critser, the author of the aforementioned book, Generation Rx (I will be reviewing this book in a future post). Critser believes that Americans are overmedicated, especially with anti-depressants and especially children.

So, will we be seeing more ads about erectile dysfunction (ED), what causes it, and who is likely to have it? I wouldn't hold my breath. Marketing departments will still be in control of disease awareness spending and the marketing of ED treatments has more to do with performance enhancement than with treating ED. The target audience of "performance-enhancement junkies," epitomized by Rapheal Palmiero ("Seems that Viagra wasn't the only performance-boosting drug Palmiero took." - Barron's), are not interested in disease awareness messages.