Invasive Compliance: A Bitter Pill to Swallow

A World Health Organization (WHO) report—"Adherence to Long-Term Therapies"—estimates that between 30 and 50% of medicines prescribed for long-term illness are not taken as directed. "It is undeniable," says the WHO report, "that many patients experience difficulty in following treatment recommendations."

No doubt this lack of Compliance and Adherence represents lost income to pharmaceutical companies. Yet, the industry spends very little marketing effort to capture this income by improving compliance and adherence. There are, of course, some exceptions. See the Pharma Marketing News article "Accomplishing Adherence," which chronicles Shire's effort to boost adherence in the attention deficit hyperactivity disorder (ADHD) market. [Also see this article: "Effective Pharma Adherence Programs Start With The Patient" and this post to Pharma Marketing Blog: "Accomplishing Adherence: Highlights from a Conference."]

NOTE: Shire's drug Vyvanse--the follow-up to its ADHD drug Adderall--was just approved for use in adults. Right on the heels of that news, Shire announced that 2008 sales of Vyvanse would be at the lower end of its expectations.

As Shire's experience demonstrates, it's not easy to get a good return on investment from a compliance/adherence marketing/patient education campaign. That's why the vast majority of pharmaceutical marketers continue to focus on the "low-hanging fruit," ie, new prescriptions (new patients).

That doesn't stop academic researchers, entrepreneurs and communications experts from coming up with new ideas and gimmicks to improve compliance and adherence. The latest effort comes from researchers at the Georgia Institute of Technology (GIT) who have developed a sensor necklace (see prototype photo on left) that can record when its wearer has swallowed pills, and send reminders if necessary (see "The Necklace that Nags").

Of course, someone will have to come up with a MUCH BETTER looking necklace before I would ever wear such a device!

But that is not why I think this gadget will never make it out of academia: it relies on tiny magnets being placed within pills! As the magnetized pill slides down your gullet, the senors on the necklace detect it and identify the medication. Then it sends the info wirelessly to some database for confirmation.

As pointed out in the Newsweek article, pharmaceutical companies will have to be convinced to insert magnets into their pills. Yeah, that will happen! As I pointed out above, pharma marketers cannot even be convinced to do non-invasive compliance programs to increase their bottom lines. I just cannot see them going gaga over this necklace-magnet-in-the-pill "invasive compliance" thing.

Why not? Well, there are several reasons. Perhaps the most important is this: in an era when there is great concern about the foreign ingredients in our medications (see, for example, "Eighty Percent of Drug Safety Problems Originate Overseas"), inserting tiny magnets made in China into pills certainly is not a good idea.

Also, did I mention the ungainly necklace? Even if it were re-designed, I can't imagine me ever wearing a necklace. My sons tried earrings for a while, but not even they ever wore a necklace! Maybe if it were a religious necklace, like a Saint Christopher on a gold rope, I might wear one. But, again, too weird for pharma.

Sorry, GIT, my advice is nice try, but "git" back to the drawing board!

What's Behind AstraZeneca's New Push for FDA Preview of DTC Ads?

Reuters reports that AstraZeneca (AZ) is "urging U.S. lawmakers to revive a program for drugmakers who want to voluntarily submit their television commercials for regulatory review" (see "AstraZeneca pushes for reviews of TV drug ads").

AZ suggested that funding for this program should come pharma companies or, since there has been lawmaker opposition to this (see "FDA Won't be Previewing TV DTC Ads!"), from taxpayers like you and me.

Why is AZ so keen on this idea?

Some have suggested that it is merely a PR ploy, which had its genesis way back in November, 2005 when I first reported on AZ's proposal. Back then I noted that AstraZeneca stunned attendees at an FDA public hearing on DTC with an announcement proposing "a mandatory requirement for pharmaceutical companies to submit all direct-to-consumer (DTC) advertising to the U.S. Food and Drug Administration's (FDA) Division of Drug Marketing and Communication (DDMAC) for review prior to its use" (See "AstraZeneca's Risky Proposition").

At that time, a Pharma Marketing Roundtable member commented: "Knowing that the FDA is woefully understaffed for this type of effort, it's a 'can't lose' offer on Astra Zeneca's part! However, it'’ll play well in the popular press so my sense is that it was a smart move on their part."

But writing letters to lawmakers is not so visible to the public as to be an effective PR ploy. There must be another reason why AZ is so keen on this idea.

I think that AZ and other drug companies want the FDA to pre-approve TV ads because there are several advantages that the industry will gain, including the "loophole" that pre-approved ads can very rarely be recalled after the fact. That will drastically cut the number of warning letters the FDA issues to drug makers. Although these letters are mere slaps on the wrist and are ineffective -- ie, akin to closing the barn door after the cow has left -- they are bad publicity.

IMHO, AZ's call for FDA preview of DTC is designed more to prevent BAD publicity, than to create GOOD publicity.

Also, if the money comes from the industry rather than the public, the industry will have even more control over the FDA than it currently has (see "Pay-(FDA)-Per-(Pre)View of DTC"). On the other hand, if FDA gets taxpayer money for this, the drug industry can save some money and still reap the benefits.

BTW, don't expect FDA pre-view of TV DTC ads to actually IMPROVE these ads. Many of them will still be silly, creative fluff like the Lincoln-Beaver Rozerem ads that have won so many awards (see "Rozerem Ads Dis Lincoln, Show Beaver").

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P.S. Meet up with me and 100 other interesting pharma marketing professionals on Wednesday evening, June 4th, 2008 at the Princeton Marriott for a night of great food, speakers, networking, and fun. For more information, see 4th Annual (2008) Networking Dinner Reception.

Networking to Survive the Pharma Recession
A conversation with John Mack, President, VirSci Corporation and Publisher of Pharma Marketing News.
A FREE Pharma Marketing Talk LIVE Podcast and Online Chat!

John will give an update on the agenda for the event and his plan for maximizing attendees' networking success. Q&A Session Included! Call in or particpate in the live chat during the show to ask questions. Airs LIVE on Thursday, May 1, 2008 at 1 PM Eastern US.

SPECIAL OFFER TO PHARMA MARKETING BLOG READERS: Save $30 off the regular registration fee (valid through May 8, 2008): USE THE DISCOUNT CODE 'BLG598' when registering.

Pharma Online Ad Bellwether WebMD Foresees Ad Slowdown

"WebMD Health Corp. on Wednesday lowered its financial guidance for 2008, citing a softening ad marketplace," reported Online Media Daily (see "WebMD Dampens Financial Prognosis On Ad Slowdown").

This is WebMD's second cut in its revenue guidance since February. In the beginning of the year, it forecast 2008 ad revenue in the range of $415 million to $430 million; now it forecasts a range of $380 to $395 million, which is about an 8% dip. And it's only April!

Although eMarketer predicts that pharmaceutical companies anticipate spending more in 2008 on Internet advertising (Web sites, search and e-mail marketing) and less on traditional media, the prognosis from WebMD suggests that pharma ad money is NOT where their mouths are. WebMD, after all, relies "heavily" on pharmaceutical advertisers for revenue.

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Don't Let the Bad News Get You Down!

However this "softening" of the marketplace plays out, I believe the current situation requires that vendor companies, consultants, and agencies who do business with pharmaceutical companies need to work smarter as well as harder to keep clients and find new ones. Part of working smarter is expanding your business network.

That is why I am doing my bit by hosting the 4th Annual Pharma Marketing Networking Event/Dinner Reception on June 4, 2008 at the Princeton Marriott. Join over 100 of your colleagues for great food, interesting speakers and fun!

This event is in the evening from 6:00 PM to 9:30 PM during the week (Wednesday). Therefore, it does NOT require you to leave your office during business hours and you'll still get home early enough to get a great night's sleep!

It costs less than 10% of what it would cost you to go to a regular industry conference -- a lot less than that if you consider the fee for a room at hotels. My event does not require that you stay overnight in a hotel!

Most importantly, I am going all out to help you network with all interesting pharma marketing and sales people I expect to be there. I have a unique idea that rewards one lucky attendee a $200 gift certificate for meeting up with a minimum number of attendees. It's a contest! For details, please see the agenda.

HURRY! Register by May 5, 2008 to get the reduced EARLY BIRD SPECIAL RATE!

Violative Viva Viagra Video - Still There!

On April 16, 2008, the FDA's DDMAC asked Pfizer to "immediately cease dissemination of violative promotional materials for Viagra" -- namely a video on the Viagra Web site that shows a group of men in a Nashville studio playing instruments and singing the following song:

"Hey fellas, check this out... First time I saw her, she set my world.. .y'know she set my world to reeling and as the years go by, for this country guy... well, we never lost the feelin'. Well, this bily goat, I played my last note...can't wait...I can't wait to get home. ..Viva Viagra!"

"The video," says DDMAC in its letter to Pfizer CEO Jeff Kindler, "then ends with an audio voice over that states 'Talk to your doctor about Viagra, America's most prescribed treatment for erectile dysfunction.' This video is misleading because it makes representations and suggestions about the use of Viagra for erectile dysfunction, but fails to disclose any risk information for the drug."

Kindler, in a comment to Pharmalot, said "Due to a technical error by the website, the safety information contained in a companion banner complementing the video was not displayed as instructed. Pfizer discovered the error, notified the website of the error, and our understanding was that the website corrected its error immediately."

Bull!

The video is still there without any "complementary" banner other than "Learn about the benefits of VIAGRA" at the end. The risk information is STILL missing. It's also missing when you download the video from the site and run it locally, which I have done.

Just another example of a Web 2.0 trick that can be performed right under the FDA's nose (see "Web 2.0 Pharma Marketing Tricks for Dummies").

Hello DDMAC! It's been about a week since you sent that letter. What's you next step? You end your letter by saying: "Failure to correct the violations discussed above may result in FDA regulatory action, including seizure or injunction, without further notice."

We're prepared to wait until Hell freezes over, which may happen before the FDA ever takes such an unprecedented action.

The Real Value of Blogs for Marketing Is...

I cannot believe how much blogosphere space is being devoted to the Zyrtec "guerrilla marketing" campaign. The guerrilla aspect of that campaign is the attachment of at least one hundred flyers to urban telephone poles and construction site scaffolds.

For my initial take on this, see "Zyrtec Telephone Pole Ad Campaign: Guerilla or Gorilla Marketing?"

Here are some of the blog and other "Web 2.0" posts touting this campaign:

• "Zyrtec slaps down Claritin in guerrilla marketing war" -- eDrugSearch. "Compared to the shlock we usually get from Big Pharma, it’s a breath of fresh air..."
• "simple = better." -- BrandFlakesfor Breakfast. "No stunning photography. No gorgeous models. No design. Just a simple message. Absolutely love this street campaign for Zyrtec."
• "Live From New York: It’s Zyrtec Guerilla Marketing!" -- Envisioning 2.0. "Overall, this is a very, very clever campaign that’s sure to generate a lot of buzz for Zyrtec."
• "Can A Sharpie Poster Push More Sales Than A Glossy Ad?" -- AdRants. "It was cool to see how simple copy scribbled with Sharpie on plain white paper taped to telephone poles around the city had the ability to cut through the clutter of its competitors' glossy ads."

My question is this:
If hundreds of these flyers were nailed to telephone poles and no-one in the blogosphere wrote about it, would it make a sound?

Answer: Nope!

I have no idea if any of the above bloggers who had favorable things to say about this campaign were paid to write their posts and spread the image around the blogosphere. I do know, however, that without these blog posts:

• You and I may not have heard of this "guerrilla marketing" campaign, and
• The media, which is sure to pick up on this soon, will not have heard of it nor thought it justified a story.

To my knowledge, there has not yet been a story about this written in the major media. What I expect is that the PR people will continue to work the blogosphere, use that "buzz" as leverage to point out how new and different this is so they can convince a reporter to write about it!

Another question:
If hundreds of these flyers were nailed to telephone poles and NOT ALSO seen in full-page magazine ads and on TV DTC ads, would it make a sound?

The first time I saw this "guerrilla campaign" was actually as a standard full-page DTC ad in Time Magazine! Not very guerrilla.

I have no doubt that I will soon see it also on TV. Here's how it might play on TV:

We see a young woman walking through her neighborhood tacking flyers on poles and trees. A guy walking his dog notices her and wanders over to a flyer after she leaves. You hear nothing but ambient sounds -- no music, no voiceover. The camera zooms in to the ad as the guy plucks a tab off the flyer.

Since TV ads cost a fortune, I cannot envision that the advertisers will not take the opportunity to present the 30-second message you get when you call the number on the tab. So, in my TV version of this ad, the guy uses his cell phone to call the 1-800 number and we hear the message. End of ad.

So, how effective is this "guerrilla" campaign? If it were just the several hundred flyers posted to poles, trees, and scaffolds without the blogosphere buzz and without the full-page ad in Time Magazine, it could not be effective at all!

The blogosphere, however, is a crucial new "buzz building" component of the PR campaign, which these days lays the foundation of a true DTC campaign (see, for example, "PR Marketing: Mystery Wrapped in a Riddle").

It's also questionable whether it can be effective with just added buzz provided by the blogosphere. I contend that it needs the usual suspects -- traditional media, print, TV -- to truly be effective. But then, it no longer is "guerrilla marketing" is it?

Zyrtec Telephone Pole Ad Campaign: Guerilla or Gorilla Marketing?

This morning, I posted a note about a Zyrtec print reminder ad (see "Zyrtec Reminder Print Ad -- Is It Legal?"), which seemed to be a follow-on to what Fard Johnmar called "a clever guerrilla marketing campaign once reserved for consumer packaged goods companies and underground musical acts."

The "guerrilla" aspect of this campaign involves hiring Zyrtec ad agency minions to nail flyers to telephone poles as illustrated in the print ad. Fard stepped out of his office in NYC and actually saw one of these flyers!

Of course, there are no telephone poles in NYC and the flyer Fard saw was attached to some scaffolding at a construction site.

I don't know about you, but I walk on the other side of the street from construction sites when I pedest in the Big Apple! You never know when the errant construction crane or bucket of cement is going to come tumbling down on you!

There ARE plenty of telephone poles out here in the suburbs, but I NEVER see anything posted on them. Except for teenagers crashing their cars into them, we suburbanites and country folk never get close and personal with telephone poles.

There are two things I'd like to know about such "clever guerilla marketing campaigns":

• Who's the audience? Most people who can afford OTC Zyrtec are not cruising the streets taking phone numbers off flyers!
• How much is McNeil paying riffraff to plaster our cities with this debris? Which brings me back to Jack Friday's question: Is it legal?

I suspect that pasting unauthorized ads on scaffolds and nailing them to telephone poles is definitely NOT legal in most US cities!

So, the print ad showing a flyer attached to a telephone pole IS legal, but the real-world notices that Fard is seeing are NOT legal! And the print ad tells us exactly who the culprit is!

P.S. If hundreds of these flyers were nailed to telephone poles and no-one in the media or blogosphere wrote about it, would it make a sound?

If hundreds of these flyers were nailed to telephone poles and not ALSO seen in full-page magazine ads and on TV DTC ads, would it make a sound?

Zyrtec Reminder Print Ad -- Is It Legal?

Jack Friday (aka "Insider") over at PharmaGossip blog asks if the Zyrtec print reminder ad shown on the left is legal (see "DTC -- Is It Legal?"). This consumer print ad was found in the April 21, 2008 issue of TIME Magazine.

Sure it's legal! Why not?

Jack is probably thinking that it violates Principle #10 of PhRMA's Guiding Principles for Direct To Consumer Advertising for Prescription Medicines that calls for the elimination of so-called "Reminder Ads," which are usually 30-second TV commercials that mention a drug's name without stating the health conditions for which the medicine is approved and without listing the major risks associated with the drug.

Here's why this Zyrtec print ad is not illegal: Reminder prescription drug ads are perfectly legal from a regulatory point of view, PhRMA's DTC Guideline #10 only applies to TV ads and NOT to print or Internet ads (or ads posted on telephone poles), PhRMA's DTC guidelines are not legally binding, and Most importantly, Zyrtec is NOT an Rx product -- it is OTC and can be sold without a prescription!

Why would the Zyrtec marketers resort to a reminder print ad for their OTC product when they are not required to list all the major side effects as would be required in an prescription non-reminder drug ad? In my review of Rx and OTC print ads (see "Print DTC: How Does It Measure Up?"), ordinary OTC print ads are notoriously lacking side effect information.

Obviously, the Zyrtec marketers want you to call 1-800-4-ZYRTEC, which I did.

I wonder how many people like me actually called the 1-800 number? I was hoping for a live person to answer so I could claim to have found the missing Claritin! Unfortunately, all I got was a recorded audio ad that directed me to the Web site, which directed me to sites where I could buy Zyrtec online! You can hear the recording by clicking here.

Considering that Americans -- especially gun-totting, religious, small town Americans -- are not that fond of reading, this is a good ploy. Of course, they could have just put the Zyrtec Web site URL in the ad and eliminated a step. That would have been a good strategy if we all had iPhones with built-in Internet access.

P.S. A post on Adrants suggests that this print ad follows on to a guerilla marketing tactic that actually posted flyers on phone poles in Boston! I doubt this is a true story -- more likely a Web 2.0 plant by crafty Zyrtec marketers.

Internet vs. Sales Reps: Which Do Docs Prefer?

Verispan's 2007 ePromotion Annual Study estimates that "ten percent of doctors opted for electronic detailing instead of in-person sales calls with pharmaceutical reps," according to PharmaExec.com.

PharmExec.com published some other "hard to ignore" numbers from this study:

• 47 percent of doctors feel that e-promotion is the same as face-to-face detailing
• 21 percent feel that feel that e-detailing is superior to live detailing
• 50 percent said that they would be somewhat likely to prescribe a drug they learned about through e-detail
• 44 percent expect to boost their e-promotion involvement in the coming year

Merck Leads the Way
The Verispan audit singles out Merck, whose spending on ePromotion activities has more than quadrupled over the last 3 years, reaching almost $83 million in 2007. In fact, Merck currently leads the industry in ePromotion investment, accounting for over 20% of industry spending for this promotional method. It appears that Merck is walking the walk as well as talking the talk when it comes to using technology to improve marketing and sales ROI (see "Merck Rejiggers Its Marketing Mix: Will Other Pharma Companies Follow?").

Verispan defines ePromotion as video details, online events and virtual details. It's all about product information. But what about other information of interest or value to physicians that is not all about the brand?

TNS Healthcare is interested in what drives physicians to be loyal to a drug brand (see, for example, "Reinventing the Sales Model"). They have found, for example, that US primary care physicians value physician education and information services provided by pharmaceutical companies as much as the quality of sales reps' visits (66% vs. 68% of physicians surveyed value the former vs. the latter, respectively).

Internet vs. Sales Reps
But how valuable is the Internet as a source of this information vs. sales reps? TNS surveyed physicians in 6 countries (US, UK, France, Germany, Spain, and Italy) to find the answer to this and other questions.

The survey showed a wide variation in the value that primary care physicians place on the Internet vs. pharma sales reps as a source of education and information services (see chart, click for an enlarged view).


In the US, Internet services, while not as popular among physicians as other aspects of the relationship, did show a move to be valued by more physicians in 2008 vs. 2007 (42% vs. 37%, respectively).

"Given the amount of attention and spending devoted to Internet services generally, it is surprising that the Internet does not represent an area of greater physician demand," said Jonathan Kay, President, Portfolio, TNS Healthcare. He made his comments during a recent webinar.

You can learn more about the TNS physician survey and what it means for developing a more customer-centric sales and marketing strategy in the upcoming April, 2008 issue of Pharma Marketing News. Subscribe today and get it free!

Meanwhile, see a summary of the 2007 TNS US survey here.

Creativity Outside of Pharma Marketing

Have you -- like me -- been spending way too much time at your job? Are you ignoring some of the other pleasures life has to offer?

This post is just a break from my routine to show off what I have been doing lately outside of my job -- watercolor!

I've been taking a watercolor class every Wednesday night at a local community college since the fall and I have finally created something that I feel proud of (see image). I may even frame it and hang it!

Yes, I'm a frustrated artist! Maybe many pharmaceutical marketers out there -- especially those working within creative ad agencies -- are also frustrated artists seeking to do something truly "creative."

If you've been reading this blog, you know I've often criticized the "creative" behind DTC advertising and the awards given to ads for their creativity versus their bottom line utility. It's OK to be creative in your job, but DTC ads are not pieces of art!

So, I have one piece of advice to all you creative people out there working in DTC agencies: don't put all your creative energy into your daytime jobs. Find another outlet for your creativity that has nothing to do with your work. At first, you might consider it a waste of time. But if you stick with it, you may just find that it's relaxing to take a break and may even put your day job into a different perspective!

Who knows, it may even lead to more creative DTC advertising.

Just a thought for a Friday.

P.S. Speaking of creative agencies, if you are attending Med Ad News' 19th Annual Manny Awards on Thursday, April 17, 2008 in NYC, I hope to see you there! My lovely wife and I will be attending (I'm a guest of Med Ad News, but I'm paying for my wife's attendance). I'm looking forward to the "most creative agency" award. I will try and determine if anyone in the winning agency is a closet artist (watercolor, oil, whatever)!

Chantix Road Rage - Revisited

Depressed mood, agitation, and "suicide ideation" have been reported among some users of Chantix and the FDA recently issued a public health advisory on the smoking-cessation drug (see "FDA Issues Public Health Advisory on Chantix").

While the FDA rightly focuses on this important possible side effect, it is ignoring the more troubling "road rage" side effect that seems to be much more common and dangerous to innocent bystanders than is suicide, which, after all, solves the victim's nicotine addiction problem once and for all!

Of course, the most famous case of Chantix-induced rage was the story of Carter Albrecht, a prominent Dallas musician who was shot to death by a neighbor who was threatened by Albrecht's attack on his front door.

Very few reports about Chantix-induced road rage, however, have made it to the front pages or network TV news. Can it be happening "under the radar" so to speak?

Imagine, if you will, driving in Texas and becoming the focus of an enraged, armed, Chantix-totting Texan in a Ford F150 pickup. Just because you cut the idiot off trying to change lanes!

But that is likely to be a rare event. First of all, the rage and suicide ideation side effects probably occur in less than 15% of the millions of Chantix users. What's the chance that you or I will run into one of these 300,000 or so possessed souls? It's 1 in a thousand, that's what. Although that's infinitely more likely than being struck by lightening or winning your state's lottery, I don't see the need to stop driving -- except, perhaps, in Texas.

No, no, no. Real Chantix-induced road rage is NOT the problem. But using Chantix as an EXCUSE for real road rage IS a problem.

What's happening is that certain drivers -- UPS delivery people, school bus drivers, cabbies in NYC, interstate truckers, MTA bus drivers, and all those other drivers with "How's my driving? Call XXX to complain" bumper stickers -- are using Chantix as an excuse when they are caught giving little old lady drivers the finger or passing them across the double yellow line in a school zone!

Yes, the little old ladies out for a leisurely drive in our vast homeland countryside are in ever more danger of being victims of road rage perpetrated by Chantix users with a ready-made excuse: "Chantix did it!"

Such was the case when Charlotte Simmons of Clarksdale County, New Mexico encountered Peg Williams, a school van driver for the upper Clarksdale school district, last Wednesday morning.

Charlotte was innocently on her way to the local Acme to do some shopping. As per her normal routine, Charlotte came to a FULL stop at the stop sign at the corner of Blevitt Drive and Scyamore, about 1 mile from her home. Close behind her in the van was Peg. A little TOO close, thought Charlotte, who lingered an extra few seconds before making a right turn onto Sycamore.

Peg didn't stop and also made the turn, coming right up to Charlotte's rear end. Imagine Charlotte's fear if you will. It increased substantially, however, when Peg started honking her horn and kept doing it for about 2 miles or about 5 minutes continuously.

"What does that crazy person want?," asked Charlotte to herself. "I'm going the speed limit", which was 25 miles per hour.

What happened next nearly caused Charlotte to have a heart attack. As they approached a 15-MPH school zone, the van revved its engine, crossed the double yellow line, and passed Charlotte who tried to keep calm and focus on her driving. But she couldn't ignore Peg who leaned over and with a crazed look on her face "flipped the bird" at Charlotte.

Of course, Charlotte immediately called the 1-800 number on the back of Peg's van when she got home and put her groceries away. The operator who answered thanked Charlotte for her report and promised that action will be taken.

Peg, realizing that Charlotte would call her superiors, immediately devised a plan of defense. Thank God she was prescribed Chantix ten days before the incident. Although she stopped taking the drug after 3 days -- it gave her nightmares -- her lawyer (who she contacted immediately) told her that was immaterial. What mattered was that she was prescribed a medication with strange, well-documented side effects that could be used as an excuse for Peg's road rage. An employer cannot fire someone for medical reasons.

At her disciplinary review, Peg successfully played her Chantix card and got away with a slap on the wrist -- she had to take one "anger management" class but could keep driving.

Imagine that story repeated thousands of times. As more and more people get away with road rage using Chantix as an excuse, the world becomes a much more dangerous place for the rest of us -- even those among us who have quit smoking WITHOUT taking a drug!

Lesson for you road rage warriors out there whose jobs depend upon safe driving habits: get a prescription for Chantix now -- even if you do not smoke. You never know when it will come in handy.

Any resemblance between the people and circumstances depicted in this story and real people is purely coincidental. Furthermore, the author does not have any financial ties to Pfizer and will not benefit from increased sales of Chantix (as far as I know).

Doctors (and Patients) were Smarter than Exubera Marketers

I can't help reading this story about Exubera reported in the WSJ Health Blog and thinking: "Thank God that physicians (and patients) don't fall for ALL the BS pharmaceutical marketers throw at them."

Pfizer said this morning that it’s adding a warning about lung cancer to the labeling for its inhaled insulin Exubera. The number of cases is low — six out of 4,740 patients treated with the drug, compared with one case out of 4,292 comparable patients who did not receive the drug. (see "Lung Cancer Warning May Be Last Gasp for Inhaled Insulin").

Of course, Pfizer says that "all patients who developed lung cancer had a prior history of cigarette smoking, and that there were too few cases to determine whether the development of lung cancer is related to the use of Exubera" (see Pfizer's statement).

But assuming the 4,292 "comparable" patients in the control group also have the same number of smokers, I'd be pretty scared right now if I were using Exubera and smoking. Probably scared enough to quit the study and stop using Exubera -- but not quite scared enough to quit smoking!

Exubera failed miserably not because physicians or patients thought it could cause lung cancer, but because it did not live up to the hype of marketers -- who only were able to get a few DTC commercials going on TV and stories written in the press about Exubera before it was pulled from the market by Pfizer. You can read more about the failure here: "Exubera: A Titanic Failure! What the survivors are saying."

But imagine a world where Exubera was still on the market and this bit of news comes out. Would Pfizer caution diabetic smokers to quit smoking -- using Chantix, of course -- before bonging away on Exubera? I think it could have happened! Which is why I say thank God that it was such a lame device that both doctors and patients were not impressed!

More conjecture: What did Pfizer know about this "side effect" of Exubera BEFORE it decided to pull it form the market? Any hint whatsoever that increased chance of lung cancer could be a side effect might have been the determining factor for pulling Exubera off the market. If true, I suppose Pfizer would have said so and gained some credibility. Who knows?

DTC Marketers Heading for Skid Row!

A new "D" may need to be added to "DTC" (direct-to-consumer) advertising, as in DDTC -- DEPRESSED DTC!

Richard Meyer over at the World of DTC Marketing is a bit depressed himself and seemed stunned after doing an informal survey of his peers working the DTC marketing gig in pharmaceutical companies (see here). He finds they are under pressure to justify their budgets. We may even see some of these DTC marketers out on the street without jobs!

"DTC marketers are busy redoing PowerPoint presentations to try and justify ANY spend. Hardest hit will be the Internet," says Meyer.

"I got nominated for an award at the DTC convention later this month," one DTC marketer told Meyer, "and once I have that I can move on and get out of DTC. There just aren't enough good senior managers who understand the value of marketing here anymore".

Where I came from -- NYC -- there was a saying that relates to awards: "That and 15 cents will get you a ride on the subway." Which would imply that such awards actually have value. But the saying goes back to when I was a kid and it DID cost 15 cents to ride to anywhere in NYC on the subway. Now? Fuggetaboutit!

Are Your Heading for Skid Row Yourself?
All the awards in the world won't get you your next job on their own and you can't expect to live on praise for a job well done. You must get out there and network if you expect to keep your job or find a new job. CREATE opportunities rather than wait for them to come to you! That is why Pharma Marketing Network is AGAIN hosting a networking event for pharmaceutical marketing professionals.

Pharma Marketing Network has hosted several successful networking events in the past. The last one in April, 2006, was attended by over 100 people! (See photos, sponsors, and attendee list here.)

We expect this year's event to be as, if not more, successful. In order to ensure that, we encourage you to take a few minutes to answer the Networking Event Preferences Survey that will help us design a networking event that is perfect for you!

At the end of the survey you will have the opportunity to get your name on the short list of people we will contact PRIOR to announcing the event. We will also offer you a 15-25% discount for early bird registration. If you have recently been laid off from the pharmaceutical industry, you may qualify for an additional discount.

Meyer was inspired to do his own survey after I asked the question "Is the Pharma Industry in a Recession?" More than 150 people have responded to my poll below and 62% of them say "yes." What do you think?

Is the Pharma Industry in a Recession?
	Yes
	No
	Not sure
	Not yet, but soon
	May not be a recession, but it's hurting!

Soon-to-be Laid Off Schering-Plough Employees: Read This

As reported in today's Newark Star-Ledger, Schering-Plough's New Jersey employees will bear the brunt of Fred Hassan's plan to fire, terminate, let go with extreme prejudice, 5,500 people in S-P's workforce:

"Schering-Plough's chief executive said yesterday the budget ax will fall first and hardest in New Jersey as the drugmaker cuts more than $1 billion in spending after the abrupt collapse of its top-selling cholesterol medicines.

"Fred Hassan said the global cost-cutting plan announced late Wednesday was still under development, but workers in the United States -- particularly employees at the company's Kenilworth headquarters -- would bear the brunt of the projected 5,500 layoffs.

"'The way it's going to fall on the U.S., unfortunately, it's going to fall on New Jersey,' Hassan said in a telephone interview. 'That's the way the situation has unfolded.'"

"That's the way the ball bounces, the cookie crumbles! Too bad for you! But, hey, I'm OK!"

A lot of families will be in trouble at the worst possible time as the entire US economy may be heading for a recession (according to Warren Buffet, Ben Bernanke, and other "insiders").

Not all who are axed will be seeking jobs at other pharmaceutical companies, many of which are cutting back as well, but these are qualified people who can help pharmaceutical vendors work smarter and find potential clients within the drug industry. I propose, therefore, to help these people network with vendors -- ad agencies, medical communications companies, solution providers, technology companies, etc -- and possibly find at least some leads to a new career.

4th Annual (2008)
Networking Dinner Reception
An evening of networking, food, and information sharing
http://www.networkreception.pharma-mkting.com

I invite all soon-to-be laid off employees of S-P to sign up to attend the networking dinner reception. You can find out more about here and sign up for early-bird discount registration via the Networking Event Preferences Survey.

Don't Take the Axe Laying Down!
You must get out there and network if you expect to find a new job and generally CREATE opportunities rather than wait for them to come to you! That is why Pharma Marketing Network is AGAIN hosting a networking event for pharmaceutical sales and marketing professionals.

ALL LAID-OFF SALES AND MARKETING EMPLOYEES OF MAJOR PHARMA COMPANIES WILL BE GIVEN A SPECIAL DISCOUNT!

P.S. We are looking for a venue for this event in New Jersey, probably somewhere between Princeton and Parsippany. You can help us choose the location and venue by responding to the Preferences Survey. Thank you and good luck!

Is DTC Bankrupting Pharma?

These are troubling times for the U.S. economy in general and for the pharmaceutical industry in particular. The Wall Street Journal Health Blog asks "Will 2008 Set a Pharma Layoff Record?" Last year, pharmaceutical advertising DECREASED by by 4.1% compared to 2006 (see "Pharma Ad Spending Shrinking!"). Meanwhile, 60% of respondents to a poll of readers of Pharma Marketing Blog say the drug industry is currently (54%) or soon will be (6%) in a recession.

There are many drug industry deficiencies that can be blamed for the present state of affairs: generic drug competition, lack of new drugs in development, increased regulatory scrutiny, decreased access to physicians, etc.

But no one is mentioning the extraordinary wasting of money due to ineffective Direct-to-Consumer (DTC) advertising!

No one except me that is! Last week, I posted speculation about the ROI of Speracor's Lunesta DTC advertising and related that to the drop-off in its share price (see "Lunesta Moth Being Mothballed as a Result of Negative Marketing ROI").

It's Either DTC or Jobs: What Do You Expect Pharma to Jettison?

I think everyone would agree that now is not the time to waste money. Most companies will save money by laying off people (eg, Schering-Plough). Some companies, like Sepracor, will also cut back on DTC advertising (see "Sepracor Not So Keen to Spend Big on DTC for Its Next Product!").

It seems to me that there is a lot of negative ROI fat in DTC -- especially TV based DTC. Smart marketers will take $ out of TV and invest in more cost-effective media such as the Internet.

If the industry cut only 25% of the TV DTC budget and diverted 25% of that savings to the Internet, the total spending on Internet-based pharma marketing would increase by about $200 million -- which is 4X what it is now (see "Pharma Recession, Part Deux: Online Ad Spending Sinking!")! The industry would still save about $600 million, which is almost enough to bring one NEW drug to the market or save the jobs of about 1200 sales people!

P.S. Some notes from the field: ie, Sepracor message board at CafePharma

Thread: Displaced % Still Unemployed? [In December, 2007, Sepracor eliminated about 300 sales positions in an effort to pare down its costs.]

"We had layoffs because upper management spent to (sic) much money and over extended themselves in the ablility (sic) of lunesta. Less DTC and more managed care would have been a good idea. In addtion (sic), they overhired and had several launch failures that had nothing to do with the field."

Thread: Negativity

"Executive Name (2008 Salary/ 2008 Target Bonus)

Barberich $960,000/80%
Adams $1,050,000/100%
Corrigan $545,000/50%
Southwell $530,000/50%
Koven $525,000/50%
Scumaci $520,000/50%
Iwicki $500,000/60%

While they cut budgets and try to slash our merit increases because sales came in below target, they take HUGE pay raises and bonuses, not to mention stock options that we don't get......"

Thread: New Name for Company [PG-13 edited version]

"Stupricor
Crapricor
Dumbricor
Idon'tgiveadamnricor
Thiscompanywillgodowninpharmaloreacor
downthecrappercor
BANKRUPTICOR"

Need More Moth? Try This!

A friend, who shall remain anonymous, wrote:

"I notice you’ve been giving attention to the Lunesta mascot.

"Their problem is, they got the wrong Luna Moth.

"You may recall a Michael Chabon best-seller from a few years ago, The Amazing Adventures of Cavalier and Clay, about (in some regards) two creators of comic books during the Golden Age. One of their characters was 'Luna Moth.' After the success of the novel, Chabon went on to produce an actual comic book series that included stories about Luna Moth.

"Some of the images are, let’s say, more dream inspiring than Lunesta’s chosen icon."

Vytorin Ads Trump Peter Rost on Fox Business News

This morning, Peter Rost -- Pfizer whistleblower and anti-drug industry blogger -- appeared live on Fox Business News, which as we all know is "Fair and Balanced." Unfortunately, they gave much more air time to the two Fox hacks, who tripped all over themselves trying to put a positive spin on the Vytorin debacle, than to Rost.

Here's the video (parts 1 and 2):




Rost managed to get a few points across, but his "fair balance" perspective was about as prominent as "fair balance" in the DTC ads Fox was talking about.

All through the piece, Fox showed various Vytorin ads and scrolled down pages of the product Web site. This product placement, I believe, was much more attention-getting than Rost!

You'll also hear tidbits like this: "TV is a great place to sell these products and get the message out." and TV networks "certainly would not support a drug that had sketchy results to be promoted on television. They understand the power of their platform." "Right," said the host. Peter, however, did not get a chance to respond to that!

Peter, in the future you may want to stick to 60 minutes!

New Lunesta Print Ad: 70% LESS Moth!

"It's way too recognizable," Adrian Adams, Sepracor’s ceo, told Ed Silverman, Pharmalot's journalist blogger, about the Lunesta moth mascot.

Recall that I had previously predicted the moth would soon be mothballed (see "Lunesta Moth Being Mothballed as a Result of Negative Marketing ROI").

"You'll continue to see it for some time to come," Adams told Ed (see here).

Yes, but as I said and what I stand by, you'll be seeing a LOT less of the moth -- 70% less to be precise! To prove this, you only need to compare an old Lunesta print ad with a new one (see image below).I did the measuring and the math and you can see the result!

There are other differences between the old and the new ad campaign, some of which I pointed out in my previous post. Here are a few more:

1. Not only does the moth in the old ad occupy a larger percentage of the ad space, it also appears in the center of the image where it is impossible to miss it. In contrast, in the new ad, the moth is up in a corner far away from the main focus of interest: the face of the man who is awake and obviously happy. BTW, who the hell wakes up like that, good night's sleep or bad?!


2. The new ad is bright and colorful; the old is dark and foreboding!


3. The new ad has a much larger and centrally located benefit message, whereas the old one de-emphasized the benefit message, which was printed in a small font size equivalent to the fair balance, side effect information.

Do you think the new Lunesta ads will sell more Lunesta?

If you do, then you would be thinking contrary to that of David Lapinski, Associate Director, Commercial Analytics at Sepracor who said "DTC does not sell the product. Awareness doesn't generate sales."

He also confirmed that we will see "less and less" of the luna moth. But he was not talking smaller. less prominently placed moths in print ads. He was saying that there will be less Lunesta DTC advertising overall! (See "Sepracor Not So Keen to Spend Big on DTC for Its Next Product!")

Who are you going to believe? The CEO of Sepracor or your own eyes?

Exciting News: FDA approves new use for CRESTOR

I just received this e-mail from AstraZeneca, which indicates how it is currently using eMarketing to reach out to me and untold millions of other people about CRESTOR. I believe it is an innovative way to use eMarketing to beat the competition!

Dear John,

We're writing you because you've asked us for more information about CRESTOR® (rosuvastatin calcium) in the past. Well, today there's even more reason why CRESTOR, along with a gullible mind, is a smart choice for adults with high cholesterol. Now CRESTOR is approved to slow the progression of Vytorin and Zetia, as part of a treatment plan to lower cholesterol to goal and to further depress the stock price of Merck and Schering-Plough.

Vytorin, or "bad cholesterol drug" as we call it, represented the progressive buildup of bullshit via TV DTC over time. Vytorin can be prescribed for no good reason, which may get worse over time. But by learning more about CRESTOR, you'll be able to have a meaningful conversation with your doctor about how to slow his prescribing of Vytorin.

Should you be concerned?
There are a number of factors that can contribute to re-emergence of Vytorin as a competitor. If you have high susceptibility to cute TV commercials and other idiotic factors, such as family history of lack of education, the re-emergence of Vytorin is something you may need to be concerned about. Talk to your doctor to find out if you have any of these factors that make you susceptible to the buildup of images of Vytorin ads in your brain.

Sincerely,

AstraZeneca, The Maker of CRESTOR

Pharma Ad Spending Shrinking!

"As concerns about the economy mount, some ad agencies and media-buying firms already have begun some belt-tightening" (WSJ: "Spending Trimmed for Slower Times").

A chart that accompanied the above article in the print version but not included in the online version, showed that the pharmaceutical industry's ad spending in 2007 DECREASED by 4.1% compared to 2006. The source was TNS Media Intelligence.