Which Way Will DTC Wind Blow?

I love Fridays! It's the day when I get to read a new post by Bob Ehrlich, fellow blogger and Chairman of DTC Perspectives. Sometimes, I am honored that Bob mentions me by name as he did last week when we debated the definition of the word "decimate" as it applies to direct-to-consumer (DTC) ad spending (see here).

[I just wish that Bob would link out from his blog to the relevant post in my blog so that his readers can see exactly what I said in context. Oh well, you can't have it all. Sigh!]

This week, Bob takes on the issue on DTC's impact in general and broadcast/mass media DTC in particular. I have discussed this issue many times and I believe Bob was thinking of me when he said "The long term viability of DTC effectiveness is under debate among industry watchers, particularly the use of mass media." I forgive him for not mentioning me by name because I too have also referred to him without mentioning his name (see "DTC Spending Will Be Decimated in 2009, Experts Say").

[BTW, Bob is not the ONLY expert who predicts that DTC spending will be "decimated" (or worse) in 2009. For more on that, see the January, 2009 Pharma Marketing News article "The Future of DTC Advertising." You can get this article FREE if you are a subscriber (subscribe here).]

Bob cites yet ANOTHER study that claims that DTC advertising is losing its "punch." He mentions an MSNBC article and the study, but does not provide the links. Here they are -- MSNBC report: "Direct-to-consumer drug ads losing their punch"; The study itself: "Lack of Impact of Direct-to-Consumer Advertising on the Physician-Patient Encounter in Primary Care: A SNOCAP Report".

The study's results are summarized in the abstract:

"One hundred sixty-eight clinicians in 22 practices completed forms after 1,647 patient encounters. In 58 encounters (3.5%), the patient inquired about a specific new prescription medication. Community health center patients made fewer inquiries than private practice patients (1.7% vs 7.2%, P<.001). Predictors of inquiries included taking 3 or more chronic medications and the clinician being female. Most clinicians reported the requested medication was not their first choice for treatment (62%), but it was prescribed in 53% of the cases. Physicians interpreted the overall impact on the visit as positive in 24% of visits, neutral in 66%, and negative in 10%."

BTW, pharmaceutical marketers themselves have done studies that revealed even more astonishing results. CommonHealth, a leading pharmaceutical advertising agency, for example, did a study from which it concluded that DTC advertising is rarely referenced by patients when visiting physicians. Their study says this happens only in 0.6% of visits! However, CommonHealth did not go so far as to say that DTC advertising is ineffective. They KNOW it's effective (based on data I haven't seen). They just claim not to know how it works. See "Advertisers Don't Know How DTC Works. Say wha?"

"The Colorado study, flaws and all, may still be correct in concluding that DTC ads are becoming less effective," Bob said. I leave it up to you to read all of Bob's comments, but the one comment that I'd like to focus on is highlighted in bold in this quote from Bob:

"The issue of effectiveness, however, is measured by many controlled studies. Most DTC ads are measured for ROI by the leading market research houses. As far [as] I know they still deliver the 2 to 1 payback on average. Therefore making any conclusions on DTC effectiveness from one small study is dangerous. I would rather trust that drug marketers, who have a lot of data on ROI, are making rational choices. The brands that continue to spend are very likely to have a positive ROI. Management in these times is going to demand objective evidence of DTC effectiveness."

Show Me the Data!
Again, Bob does not reference any evidence when he says "As far [as] I know..." and "...who have a lot of data on ROI..."

Maybe Bob is privy to some inside, proprietary data that we "industry watchers" do not have. He is, after all, an "insider" and, according to Rich Meyer, author of World of DTC Marketing blog, Ehrlich has a "conflict of interest" in the matter -- not that there is anything wrong with that. Bob's main business, after all, depends upon DTC advertising. And, these days, I do not wish to see anyone's business suffer.

But, please, show me the ROI data!

Which Way Will DTC Wind Blow?
Interestingly, however, Ehrlich is hedging his bet on DTC viability, which is smart. DTC Perspectives recently announced the creation of the OTC (Over-the-Counter) Perspectives Division:

"OTC perspectives will serve the unmet needs of OTC Marketers, and provide educational conferences, industry forums and publications all designed to focus on the myriad of emerging issues OTC Marketers face in today's economic crisis and complex regulatory and consumer environments. The OTC National Conference June 4-5, 2009 in Boston will be the first conference of its kind created to address these unique and urgent needs." (See press release here).

It's good to know which way the DTC wind is blowing according to "DTC experts" and I wish Bob all the luck in the world and will offer to help him promote his OTC conference.*

Another direction the DTC wind may be blowing is online. Bob is agnostic when it comes to media, but he doth protest too much when he complains that "media gurus [is he referring to me again?] tell us mass media is dying. They want to see the drug industry adopt the new forms of communication such as social media and one-on-one marketing," Ehrlich says. "On the other hand, mass media is still the dominant form of most big sending DTC plans."

And that is proof enough that mass media is not dying as far as pharma marketers are concerned? I don't understand this because we started this whole discussion with studies that demonstrate that the current DTC model is not working and Bob himself said "One would expect that influence of drug ads has been reduced over time." How far should a medium's effectiveness be "reduced" before we consider it "dead" or "dying?" It's "decimate" vs. "annihilate" all over again!

Bob does not ignore "targeted communications" as he refers to Internet marketing. I give him that. But maybe he should hedge his bets further and start up a division called eMarketing Perspectives.™

[*Note: My publication, Pharma Marketing News, is a Media Partner for DTC Perspectives' "DTC National Conference." Being a Media Partner means that I get a free press pass to attend the conference in exchange for listing the conference on Pharma Marketing Network's Conference Calendar among other promotions.]

At Last! A Company with a Great Drug Pipeline...

With all the bad news out there about anemic drug pipelines and subsequent laying off of R&D personnel at major drug companies, it's good to see that at least one company has a great pipeline.


By "Company" I mean publisher of a pharmaceutical industry trade magazine. And by "pipeline," I mean a cover image representing a drug pipeline.

So far, I've collected 3 different covers showing three different ways of visualizing drug pipelines. The first one -- shown on the left in the triptitch above (click on it for an enlarged view) -- is the recent cover of Pharmaceutical Executive Magazine showing a pipeline that resembles a kitchen sink drain pipe. I blogged about this previously, saying that I thought it was not the kind of pipeline that inspires me (see "Pharmaceutical Executive Magazine's Drug "Pipeline" Looks More Like a Money Drain!").

The middle image is how the publication R&D Directions sees drug pipelines -- somewhat similar to PE's, this publication uses the faucet end of the kitchen sink as a symbol of a drug pipeline.

Both these images show pills coming out of one end. At least the R&D Directions image has a pill coming out the good end, not the waste end as in the PE image. In the future, I think we shouldn't use pills at all. As traditional pharma companies BUY biotechs to beef up their pipelines, many new generation drugs they bring to market may be biologic injectable compounds and not pills at all.

By far the BEST image representing a drug pipeline is the one on the cover of the January 2009 issue of MedAdNews (on the right in the image above). It looks like the kind of pipe you imagine when you hear the word "pipeline," ie, the Alaska oil pipeline -- a huge and imposing structure, carefully engineered to bring me a product I need and desire.

So, kudos to MedAdNews for bucking the kitchen sink pipeline trend.

The image, however, is a bit confusing. Who are those little white androygnous gnomes with the magnifying glass?

What are they looking at?

It looks suspiciously like ... wait for it ... the top view of a kitchen sink faucet!!!

Pharma's Workforce Being Double Decimated!

First, I heard that Pfizer would cut jobs in two waves in 2009. In the first, Pfizer said it would cut 10% of its 81,900 staff - about 8,000 jobs. If the second cut is also 10%, that would be about a 20% cut overall.

Now I also hear that AstraZeneca and Sepracor are also planning to cut about 20% of their workforces (see here).

Can this be called the decimation of pharma's workforce?

The literal definition of decimate is "cut by 10%." 10% here, 10% there, pretty soon we’re talking workforce “annihilation,” which is the “popular” definition of decimate! Since I am a proponent of the literal definition (see here as it applies to DTC spending in 2009), I call this workforce reduction “double decimated,” meaning cut by 10% two times!

Whether you believe in the literal definition of “decimated” or the “popular” one, you’re going to see a lot of people out there looking for a life after pharma.

The last time I saw this happen, most of the laid off people ended up in jobs that depended upon the pharmaceutical industry. That is, they became pharmaceutical marketing consultants or found jobs with pharma vendor or service provider companies.

This time, however, I don’t think those companies will be hiring. They’ll also be Pfiring, just like Big Pharma. Life after pharma may not be anything like it was before.

Let's Focus on Effectiveness, Not Dollars Spent as a Measure of DTC Success

Last Friday, I noted that Bob Ehrlich of DTC Perspectives re-estimated that DTC ad spending will decrease by 10% in 2009 compared to 2008. I described this as "DTC Spending Will Be Decimated in 2009, Experts Say." In his blog, Bob takes exception to my use of the word "decimate" and says "I do not consider that level as fitting the common understanding of the term 'decimated.' That term fits what has happened to banks stocks, housing prices, and my financial portfolio."

Just an interesting aside about the word decimate before I get to the real point of this post.

The word decimate means...and to some of us means nothing else..."to cut down (an assembly of people, usually and army or hostages) by a tenth"...not "two tenths" or fifty percent or any other degree or number and neither 'enormously' cut down/diminished/destroyed/reduced nor "totally destroyed", nor anything else than its singular meaning (see here).

So a purest, like me uses decimate to mean a reduction by 10%, whether it's Roman Legions or DTC spending dollars.

Revisionists have this view:

"The popular meaning of decimate, 'to destroy,' now predominates because the need for a word meaning 'to kill one person in ten' -- the original, if archaic, definition of decimate -- has greatly diminished. Even so, the popular meaning is not accepted by everyone, and it is often better to use annihilate, exterminate, destroy, or devastate."

This blog definitely does NOT represent the popular view or the lowest common denominator view or the majority view. So it is natural that I would not use the "popular" definition of decimate.

Decimate, annihilate, toMAYtoe, taMAHtoe, let's just call it a bad omen -- I think Bob would agree with that.

Bob, however, is an optimist and he ended his post with this prediction: "Let me boldly predict that by 2012 we will see the $5.7-$6.0 billion spending level reached for DTC up from $4.8 estimated in 2008."

I included Bob's prediction in my famous DTC Ad Spend chart below. The red bars are based on information from TNS, the black bar is my prediction (and more or less Bob's) for 2009, and the blue bar is Bob's most optimistic prediction for 2012.

That's a pretty healthy recovery and I hope I live long enough to see it.

But there's a BIG question mark between 2009 and 2012 that we need to think about. And if you think about it, you might learn a thing or two.

One thing to think about is what the DTC spending MIX should be in order to have a recovery. Bob says he is "media agnostic" (actually he said "I am dispassionate about all media") and "Media is just a tool to get more awareness and eventually scripts."

Oh Bob! I feel sorry for you.

For many people, the media is the message (where have we heard that before?). I like to think media has a message.

TV's message is "mass, waste, low ROI." For many marketers it also has the message "glamour" and "I made it to the big time!"

Unfortunately, not too many pharmaceutical marketers are getting the message from the consumer, which is "interactivity, dialog, and empowerment." You get none of these things from TV, which dominates the typical DTC budget (see chart at left, click on it to enlarge).

Before I get to evangelizing about "my" favorite media, let me say this: Why do we want the dollar amount of the DTC budget to keep increasing? That's the goal of ad agencies, not product managers -- or it shouldn't be. The goal should be increasing effectiveness in getting your message to the right audience. Bob understands this, at least in principle. "Spending will evolve each year to more targeted media as it should," he says. Yet, if we look at Internet spending over the years, it has not budged as a percent of spending.

Obviously, pharmaceutical marketers should increase their spend in interactive and new media. I suggest that they simultaneously decrease their spending on TV -- it's becoming less and less effective as several pharmaceutical company CEOs have said publicly.

If the mix were to significantly shift away from TV to Internet, I predict that DTC spending would remain below $5.0 billion through 2012 -- because marketers will get more bang for their bucks on the Internet than on TV.

It's just too bad that we look at dollars spent as a measure of success and growth when we should be looking at effectiveness, aka ROI. Imagine a chart that plotted DTC effectiveness over the years. Now imagine what it could look like between now and 2012.

---

P.S. OK, let's get back to predicting dollars spent on DTC advertising in 2009 compared to 2008. That was a question in my "Future of DTC Survey," the results of which will be published in the January, 2009 issue of Pharma Marketing News (see a preview here). Subscribe now and get it FREE by e-mail.

The following chart shows what respondents to my survey believe (click on it for an enlarged view):

New Media, Old Regulations: Like Oil and Water, They Don't Mix!

I just learned that oil and water do not mix!!! Unbelievable! Who knew? You can try this experiment and find out for yourself.

Know what else don't mix? New media (aka, social media) and Old FDA regulations.

My new friend, John Murray, a former regulatory professional employed by pharmaceutical companies, now a consultant and blogger (see here), gave a great example of this "failure to mix" phenomenon in a comment to my post "The Real Reason Why Pharma Hates Social Media Marketing":

"Posts or comments in any blog that end up having product mentioned or discussed causes that blog, or at least that post, to be a form of labeling," said Murray. "That means, for most companies, that that content needs to go through a medical, legal, regulatory review before dissemination. More importantly, labeling (in this case promotional labeling) and advertising must (and I mean must) be submitted to FDA on what's called a 2253 form "at time of initial dissemination" according to the regulations. This requirement in and of itself makes it near impossible for companies to do any real time blogging related to any of their products, and also requires them to pre-review comments on a pass-fail basis."

What this situation requires, IMHO, is some good NEW-fashioned DETERGENT! I've pointed out many times before that the FDA MUST update its regulations and guidelines to keep up with technology -- see, for example, "Where's DDMAC's Head At?"

Regulations, which reflect how regulatory agencies intend to assure that the law is followed, can be changed. Now that Obama -- who carries a Blackberry! -- is president, perhaps he will nominate a similarly techno-savvy FDA Commissioner who will spearhead the revision of FDA regulations and guidelines so that they are in sync with today's world. One caveat: the drug industry may fight tooth and nail against any revisions. You never know what can happen when a government agency sets out to make substantial changes in how it regulates.

We can help by putting pressure on both the FDA and the industry to come up with guidelines for pharmaceutical marketing via the Internet. I suggest that my ePharma Pioneer Club™ members (and would-be members) get together and draw up some examples for the FDA/industry or suggest a public hearing on the matter.

I only note, with regret, that I was a member of an FDA-hosted public hearing about the Internet way back in 1997! Nothing ever came out of it, except for the Internet Healthcare Coalition that I founded to fill in the gap and develop a set of self-regulatory standards. Even that was better than a sharp stick in the eye, which is what ePharma social media marketing pioneers are faced with today.

Obama, Following PhRMA's Lead, Bans Gifts (from Lobbyists)!

It's not only the drug industry that is cleaning up its act by banning gifts. Now, the Obama administration has banned gifts from lobbyists to anyone serving in the administration, according to this article in the Wall Street Journal.

"But wait," you may say, "you're not comparing apples to oranges. It's not a fair comparison. Pens and free dinners DO NOT influence physician prescribing, whereas we all know that gifts from lobbyists DO influence administration officials and senators!"

Ah, but we are reading tea leaves here. It could be all oranges to the Obama people!

The Real Reason Why Pharma Hates Social Media Marketing

Many, many ePharma Pioneers -- smart people who have long evangelized "e" for pharmaceutical marketing communications -- keep up the pressure on the pharmaceutical industry to get more involved with social media marketing. I have documented this in many of my posts to Pharma Marketing Blog (see here) and in Pharma Marketing News articles (see a compilation here).

Michael Maher, Senior Partner at Greater Than One -- an interactive agency with many pharma clients -- is the latest person to hop on the pharma social media marketing bandwagon. In an article published today in Adotas (see "Pharma Companies and Social Media Marketing"), Maher states his case:

"There is no need for pessimism about the ability of pharmaceutical companies to use social media in their online marketing mix. The common belief is there are too many regulatory hurdles around reporting adverse events, presenting fair balance efficacy information, and avoiding endorsement of off-label usage. While it certainly isn’t as simple for pharma as it is for CPG, technology or entertainment marketers, many drug companies are beginning to use social media very effectively."

Maher has some good advice and examples of how pharma marketers can get involved with social media. His examples, however, fail to impress me because all the sites are either run by non-pharma third parties (iguard, cafepharma) and are not product-related (except for the OTC alli site, which seems to have an authentic online community bulletin board).

There are no lessons here for marketers of branded Rx products who wish to set up product blogs and such, but who shy away from doing so because of "regulatory hurdles around reporting adverse events, presenting fair balance efficacy information, and avoiding endorsement of off-label usage."

If, for example, Pfizer were to set up a blog about fibromyalgia and Lyrica -- its drug for the treatment of fibromyalgia -- it would open itself up to the receipt of adverse events submitted by self-identified patients. Pfizer would have to report all these to the FDA even if they did not publish the comments in the blog. The marketers of alli are not concerned with adverse event reporting because its not required for OTC products like alli.

Pfizer does not have a fibromyalgia or Lyrica blog, but it does have an unbranded Web site called "FibroCenter," through which it solicits open-ended "Shared Stories and Tips" from visitors.

This is interesting because there's a form on the site that allows people to just tell their stories, adverse events and all. Perhaps Pfizer is not concerned about AEs because most people filling out these forms want the reward of being mentioned on the site and they are not likely to mention side effects.

But if you think that Pfizer will just publish patient stories as submitted, you are mistaken. Storytellers give up all rights to their story, including the right to review edits made, according to the site's consent form, which states:

"I grant my consent to use my name, biographical data and relevant medical history by Pfizer Inc in any Permitted Use identified below. Pfizer may at its/their sole discretion make any and all changes in, additions to, and deletions from the story and/or tips in 'Share Your Story and Tips.' Such alterations include, but are not limited to cuts, edits, additions, changes, rearrangement, adaptation of the story and/or tips to different formats, and other changes, additions and deletions necessary to make the 'patient testimonial' commercially viable [my emphasis]. With reference to the alterations referred to above, I hereby waive any and all claims I may now or hereafter have to the rights of integrity, disclosure and withdrawal and any other rights that may be known as or referred to as 'moral rights.' I understand that the selection and editing of the portions of the interviews to be used for any purpose shall be in the sole discretion of Pfizer Inc. "

I don't have a problem with this -- Pfizer is not claiming this is a social media site where patients can tell their stories in their own words. It does, however, give me some insight as to why pharmaceutical companies are not ready to do that.

It is obvious that in a top-down organization such as a pharmaceutical company, there is a great need to "control" the stories it publishes, and not just because it has to obey regulations. The stories have to made "commercially viable." I suspect this means that everything in the story must be consistent with Pfizer's marketing goals, which makes sense from a commercial point of view. But this is precisely why most companies -- and not just drug companies -- will never fully embrace true social media, which calls for unfettered and unedited user-generated content. It has nothing to do with adverse event reporting -- that's just a red herring.

Rate Your Readiness for Social Media Marketing

Was a Rat Harmed in the Filming of This Pfizer Commercial?

Pfizer wants people in the UK to know the dangers of purchasing fake medicines on illegal Web sites. So it created a video to depict that danger. The still image on the left is from a scene in that video, which is the centerpiece of the Web site www.realdanger.co.uk, aka, "The real danger of counterfeit medicines."

In the video, a guy takes a couple of counterfeit pills from a plain, unbranded box and then regurgitates a dead rat!

As Jim Edwards points out in his blog (here), the video "also raises an awkward question for Pfizer, where do its medicines come from? CEO Jeff Kindler told investors in October that he expected Pfizer to be “in” 137 cities in China by the end of 2008. It wasn’t clear whether those cities would contain factories, R&D sites or offices for sales rep managers."

According to a story in the New York Times ("Drug Making’s Move Abroad Stirs Concerns"):

"The critical ingredients for most antibiotics are now made almost exclusively in China and India. The same is true for dozens of other crucial medicines, including the popular allergy medicine prednisone; metformin, for diabetes; and amlodipine, for high blood pressure.

"Of the 1,154 pharmaceutical plants mentioned in generic drug applications to the Food and Drug Administration in 2007, only 13 percent were in the United States. Forty-three percent were in China, and 39 percent were in India."

Meanwhile, Cleveland Clinic cardiologist Steven Nissen, who may be a contender for the job of new FDA Commish, warned in a letter to Nature that "Currently, about 1,600 facilities in China manufacture drugs or components of drugs marketed in the United States. Recent high-profile cases -- such as contaminated heparin -- poignantly illustrate the risks inherent in globalization" (see the entire letter here).

The Pfizer UK Web site claims that "One in 10 UK men interviewed recently admitted to purchasing prescription-only medicines from unregulated sources, without a prescription. What they probably don’t know is that it’s estimated that between 50 and 90 per cent of medicines sold in this way have proven to be counterfeit which means they are taking a real gamble with their health."

My guess, of course, is that Pfizer is concerned about counterfeit Viagra pills sold online (probably the most important "unregulated source"). Only men were interviewed about buying drugs online it seems.

Any way, here's the video. You also can find it on YouTube by a search on "Rat Pfizer," which works much better than "Real Danger," which doesn't work at all!



P.S. BTW, when I first saw the video -- before realizing the guy would vomit up a dead rat -- I was slightly turned off by the scene showing a close-up of the water faucet. The water seemed "off," not as pure as it should be. Unfortunately, after throwing up the rat, the guy takes a gulp of the water, which many flouride-in-drinking-water conspiracy buffs will tell you is contaminated with sodium flouride, aka RAT POISON! See "WHY DO THEY DUMP RAT POISON IN YOUR DRINKING WATER?" Just a little interesting aside.

"FDA a Failed Agency" says Dr. Steven Nissen, Contender for FDA Commissioner

You may recall that Steven Nissen, MD, Chairman of the department of cardiovascular medicine, Cleveland Clinic and outspoken critic of the US Food and Drug Administration (FDA) was one of the leading choices for FDA Commissioner in my recent survey (see here).

Well, Nissen is one of the "six leading voices" who have told Nature magazine what the president Obama needs to do to move beyond the Bush legacy. Nissen focused, of course, on the FDA in his letter to the editor, which opened with this statement:

"After an unprecedented series of revelations about drug and device safety issues, many observers consider the Food and Drug Administration (FDA) a failed agency."

He also suggests that the next FDA commissioner "should serve a fixed six-year term to insulate the agency from political influence. Moreover, the system by which pharmaceutical companies fund a major portion of the FDA's budget through user fees requires re-evaluation."

Nissen's letter reveals that he is a man with a plan when it comes to the FDA. He may just be chosen to lead that agency for the next 6 years!

CNTO411 Blog to Go Dark

You heard it from me first:

Rumor has it that Centocor's CNTO411 blog soon will be taken down because they can't find anyone to take the place of Michael Parks, Centocor's former Vice President of Corporate Communication. Michael was the creator of CNTO411 and shared editorial duties with his colleague, Melissa Katz -- who also left Centocor.

If true, this is just as I predicted in a post that caused a "sh*t storm" (see "Corporate Blog is an Oxymoron").

Adherence Programs: Start by Understanding Patients

The 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.

Technically, adherence is defined as the % of doses taken as prescribed for the entire period of study. That's subtly different from "compliance," which is the % of doses of a drug taken as prescribed while the patient is actively taking drug. The word "compliance" implies that physicians should dictate treatments to patients, who will either do as they are told (comply) or do wrong.

Leaders in the pharmaceutical consumer relationship field reject compliance as an unworkable concept which fails to recognize not only changes in how we all consume health care, but also the vast differences in how individuals relate to their condition and their medications.

Assuming most medicines are effective, it is imperative that they be taken as directed. Thus, better "adherence" benefits patients as well as drug companies, which lose a lot of money if patients are not taking their products as prescribed. These days, when access to physicians is limited, pharmaceutical marketers need to find other ways to bring in income other than through new prescriptions -- they need to improve adherence.

The WHO states that there is no single intervention strategy, or package of strategies that has been shown to be effective across all patients, conditions and settings. "Consequently," says the WHO report, "interventions that target adherence must be tailored to the particular illness-related demands experienced by the patient. To accomplish this, health systems and providers need to develop means of accurately assessing not only adherence, but also those factors that influence it."

Unfortunately, the approaches that many pharmaceutical companies continue to use to drive improved adherence depend upon a mass market, one size fits all approach. What's needed is a true consumer relationship marketing approach.

That is the subject of an upcoming Pharma Marketing Talk interview with Greg Caressi, Senior Vice President, Healthcare & Life Sciences, Frost & Sullivan, who will briefly discuss the benefits of utilizing a targeted approach when designing a pharmaceutical adherence and loyalty program. For more information about that interview, see here.

This interview is in an introduction to the complimentary eBroadcast on the same topic (see "Targeting and Tailoring your Adherence Program to Optimize Performance"). The eBroadcast will include a panel of experts, including Greg Caressi, Dr Andrea LaFountain, Founder and CEO of Mind Field Solutions, and Greg Zych, Marketing Manager, McKesson Patient Relationship Solutions.

Note: Pharma Marketing News -- my FREE monthly newsletter -- is a paid Media Partner for this eBroadcast. I plan to attend and summarize the discussion in an upcoming issue of the newsletter.

DTC Spending Will Be Decimated in 2009, Experts Say

In November 2008, I predicted that direct-to-consumer (DTC) spending by the pharmaceutical industry will decrease by 11% in 2009 (see chart on left and post here).

At that time, Bob Ehrlich of DTC Perspectives was predicting a 6-8% decrease.

"John," Ehrlich said in a comment to my post, "the difference between our estimates is really just one brand being advertised or not. So, if we get one additional launch or one brand decides to stop DTC then that will determine who is closer. So toss a coin on you or me."

It appears that Ehrlich has now revised his estimate upward. "I expect a decline of about 10% [my emphasis] in total DTC in 2009 as drug marketing budgets are cut to protect profit," says Ehrlich in today's post to his blog.

BTW, the majority (56%) of respondents to my "Future of Rx DTC Advertising" survey believe DTC spending will decline in 2009 and a full 22% believe it will decline by more than 10%! If you haven't taken this survey yet, please do and let me know what you think. After taking the survey, you will be able to see a de-identified summary of the results to date. The survey is online here.

It's not as rare as you may think for Bob and me to agree.

The difference between us is that Bob sees the DTC glass half full and I see it half empty.

Whatever. What's important is to look at what's in the glass and decide if it's drinkable or not!

Recently, a few drug company CEOs seem to think the DTC Kool Aid -- at least the broadcast TV version -- is not as potable as it used to be (see here).

Bob thinks this is mostly due to economics -- "Despite some political considerations most big drug companies will make DTC television decisions entirely on a financial return basis," he says.

Yes, in good times it's easy to spend money even knowing the return stinks, but in bad times you'll take heat for wasting money -- but it's still the same waste of money it's always been! You know what I mean. When you got tons of dollars coming in, you don't stop and analyze every cent going out. You may not be spending those cents as wisely as you should, but what the hell! You're on TV! Now, when prescriptions are decreasing and you're laying off R&D people, other people (ie, investors) are going to be looking at those cents and you better spend them wisely. Face it. CEOs only respond to investor concerns. The TV DTC budget is a fat purple cow as far as they are concerned. Off with its head!

Bob makes a point that drug companies will now get better bang for each buck (or cent) they spend on TV DTC..."we may see big DTC brands spending less than in 2008 but getting more GRP’s in 2009."

Probably. Will investors buy into that argument though? That's like Pfizer re-organizing their research effort to make it more efficient. In the end, however, investors demanded cuts, not efficiency. And off came some R&D "heads!"

Yet Bob also suggests that some drug companies may cut TV DTC because of "better ROI in other marketing tactics." And among those other tactics is eMarketing! Now is the time for all good ePharma Pioneers^TM to come together, join my ePharma Pioneer Club^TM, and give aid to the failing pharma marketing industry! More on that later!

Life After CNTO411 Blog for Michael Parks: Pitch360

You may have noticed that Centocor's corporate blog, CNTO411, has been dormant for several months, which I pointed out previously (see "New Year's Resolutions for Pharma Marketers" and "Corporate Blog" is an Oxymoron"). But what you may NOT know is that the creator of that blog, Michael Parks, no longer works for Centocor, although he is still listed as the Editor (see here).

Parks, nevertheless, is moving on with his new life as a "PR hack" for hire -- not that there's anything wrong with that -- for small companies. His new company, Pitch360, "gives a big voice to small companies," says Parks. I wish Michael the best of luck in his new endeavor and not just because he treated me to a BBQ dinner at Dave's Famous BBQ -- wait, I think we went Dutch!

Any way, here's the press release:

Michael Parks, former Vice President of Corporate Communications for Centocor, Inc., an operating company of Johnson & Johnson (J&J) today announced the launch of a public relations consultancy, Pitch360 Incorporated (www.pitch360inc.com) . Pitch360 is a public relations, marketing communications, and issues management consultancy that leverages its vast pharmaceutical and biotechnology experience to transform the way companies communicate to their customers, key stakeholders, and mainstream and social media.

“After nearly 15 years serving the pharma industry and growing from that experience, I wanted to design a consultancy that specifically caters to the next generation of companies that promise breakthrough therapies for patients,” said Michael Parks, Founder and President of Pitch360 Inc. “In particular, small companies can now bypass the trial-and-error process of their predecessors and immediately put breakthrough strategies to work for their business.”

Created with the changing needs of the industry in mind, Pitch360 uses its relationships with a wide variety of stakeholders in the pharmaceutical and biotech industry to stay ahead of ‘status quo’ thinking so that they can bring forward ideas that rise above that of their competition. Through well established networks of healthcare providers, experts in government, regulatory and policy matters; creative media talent, as well the healthcare, business, mainstream and social media; Pitch360 has the tools and experience necessary to provide breakthrough strategies that companies can implement to deliver on their business objectives.

“In today’s economy, companies are looking for value and innovation,” said Mr. Parks, “Pitch360 provides affordable communications solutions using breakthrough strategies that will deliver outstanding results.”

Pitch360 has a wide variety of services available for companies and not-for-profit groups, including strategic counseling, issues management, and investor relations and delivers these services with outstanding customer service and support. Pitch360 provides specialty services for companies of all sizes.

Michael will be a guest on Pharma Marketing Talk in February. Stay tuned for that.

The Secret Lives of DTC Critters

I've often commented on the bees, beavers, moths, and other "critters" seen in direct-to-consumer advertising (DTCA). Usually, like you, I wonder why pharma marketers use animated animals and icons rather than real people. Maybe it's because bad things can happen to people who do not take their medication and it's better to show that with icons.

Take, for example, the balloon people in Enablex ads who explode due to overactive bladders, which happened to this poor gal at a high school reunion:

Harsh! (see "Pharma Marketers Sometimes View Patients Merely as Symptoms to be Treated").

Of course, all ends well for the balloon people who ask their doctors about Enablex and fill their prescriptions for the drug, which doctors will prescribe 80% of the time that they are asked about brand name drugs.

Here's Mr. and Mrs. Balloon enjoying a quiet evening at home, where all seems well:


BUT, most DTC watchers would be surprised to see what's happening upstairs behind the closed door of Ms. teenager Balloon who is entertaining her boy friends. Luckily, even balloons wear protection:

Hat tip to PharmaGossip for the "Squeaky" video.

Pharm Exec Encourages Drug Industry to be More Daring?

"The cover of this month's Pharm Exec may look as if it's about disaster, but that's not the way we meant it," says Patrick Clinton, Editor-in-chief, of Pharmaceutical Executive Magazine (see "Getting Across").

I wonder if Patrick was anticipating that I would again spoof Pharma Exec's cover image in this blog as I did last month (see "Pharmaceutical Executive Magazine's Drug "Pipeline" Looks More Like a Money Drain!")?

As you can see, the cover depicts a dare devil motorcyclist reminiscent of Evel Knievel attempting a jump over the "patent cliff," which represents the drop off in sales of Rx brand drugs when many of them will go off patent in the coming years.

"It's not about falling off a cliff," writes Patrick, "it's about crossing a bridge that extends from yesterday, and an old, failing way of doing things, to tomorrow, and a revitalized pursuit of new (still only dimly understood) goals. Admittedly, in our cover illustration the bridge is out. But the point is still to cross the gulf; the absence of a span just means you have to cross with a bit more energy. There's also plenty reason to expend thought and creativity on the subject of landing."

Is Patrick encouraging drug companies to be more daring like Evel Knievel?

Obviously, Patrick is concerned about all the troubled landings of dare devils, as he should be. For more on that, I offer the following YouTube video depicting Evel Knievel's infamous landing during a stunt at Caesar's Palace:



Or this one:

Will Obama Eliminate the Advertising Business-Tax Deduction to Cover His Bailout Nut?

The advertising industry is worried that it will "foot the bill" for President-elect Barack Obama's huge stimulus plan and huge budget deficit, according to an article in AdvertisingAge (see "Why the Ad Industry Shouldn't Foot the Bill for Big-Biz Bailout").

"How much the ad industry will be asked to foot the bill in the form of possible restrictions on the tax deductibility of ad expenditures is an open question right now," says AdAge, "but 'the advertising industry does need to be out front to let folks on Capitol Hill know, and the new administration know, the value that we add to the economy.'"

That's the view of James Edmond Datri, the new president-CEO of the American Advertising Federation, who contends that the role of advertising in our economy isn't "nearly as understood as it should be."

In fact, Datri believes that advertising is a "Big Part of the Solution" to get us out of this mess.

I know...you just can't wait to learn how. But, first, let's focus on the drug industry.

Rahm Emanuel, president-elect Obama's new Chief of Staff, warned advertising industry leaders that the business-tax deduction for DTC spending could be taken away in 2009 tax legislation.

In my "The Future of Rx DTC Advertising" survey, I asked respondents if this deduction be should be eliminated. So far 38% responded "Definitely Yes!" and another 30% said "Maybe. It depends." You can still take this survey here and give me your opinion in this.

Personally, I think advertising is a legitimate business expense and should be deductible from a business's taxable income. It would hurt my business and many other small businesses if the advertising deduction was eliminated. Hurting small business seems to go against Obama's bailout plan, which includes aid to small businesses.

Datri agrees: "If you touch deductibility, you're going to harm every other segment in this economy." That essentially is his argument about how advertising is part of the solution, not the problem.

But drug companies are BIG BUSINESSES. And, as the industry always says, Rx drugs are not like packaged goods, tootpaste, and such "safe" products. "But surely he [Datri} can see the value of limiting advertising's right to free speech in the case of products that could prove harmful to your health?" said the author of the AdAge article. he was, of course, referring to Rx drugs.

Here's a section of the article that concerns drug advertising:

"Michael Lee of the International Advertising Association believes it makes sense to relate potentially dangerous (but legal) products to the role of responsible communications. He said, "We cannot be as simplistic as we used to be -- and where we also took a blanket approach to the notion 'if something is legal to sell, it should be legal to advertise.' We have to fast-forward now to current demands and conditions."

"I am of the view that prescription-drug marketers should be very wary about advertising a new product to consumers before potentially dangerous side effects become known. [my emphasis] Jim's position is that commercial speech is "the last thing the heavy hand of government should be involved in." There are other remedies, he said, such as making sure the product is safe before it's introduced.

"He acknowledged that the "slippery slope" argument -- giving in to one thing leads to other concessions -- influences his thinking. But he added that since government is "always anxious to place limitations on commercial speech," the ad industry should be very reluctant to give bureaucrats any ammunition to interfere."

Now I understand better why certain drug company CEOs have been dissin' DTC (see "Wolf(e) at DTC Piggy's Door Huffing and Puffing"). It's not just to head off righteous anti-DTC crusaders like Sydney Wolfe. It's also about saving the tax deduction for DTC advertising and maybe saving professional drug advertising from falling under the same umbrella as far as tax deductions are concerned. Keep in mind that drug companies spend about 4 times as much money promoting drugs to doctors as they do to consumers (if you include sales reps and sample).

Of course, it is ludicrous to believe that taxing ALL advertising would cover the bailout nut of a $1 trillion! What's the total advertising spend in the US anyway? Maybe $150 billion? The most tax revenue that can be gotten from that would be about $40 billion. Hmmm...$40 billion here, $40 billion there...pretty soon we're close...nah! Never happen! You'd have to find 25 other huge tax loopholes to cover a $1 trillion nut!

FDA's New "Good Reprint" Guidance: Off-Label Promotion to Docs is Now Virtually Unregulated

The FDA just issued new guidance on the the distribution to physicians of medical journal articles (reprints) on "unapproved new uses of approved drugs" by Rx drug marketers (see the "FDA Guidance Document").

FDA has detailed many conditions under which this distribution of "off-label" information would be "allowed" by the FDA. For example, reprints must "not be marked, highlighted, summarized, or characterized by the manufacturer in any way," "be accompanied by the approved labeling for the drug," "be distributed separately from information that is promotional in nature," and "be accompanied by a prominently displayed and permanently affixed statement disclosing any author known to the manufacturer as having a financial interest in the product or manufacturer or who is receiving compensation from the manufacturer, along with the affiliation of the author, to the extent known by the manufacturer, and the nature and amount of any such financial interest of the author or compensation received by the author from the manufacturer," among others.

How is the FDA supposed to enforce this guidance? As Senator Waxman pointed out in a letter to the FDA back in November, 2007, "most reprints will be distributed by tens of thousands of drug and device representatives behind closed doors in physicians' offices." Obviously, the FDA is going to have to rely upon drug companies voluntarily complying because the guidance does not require drug companies to submit articles to the FDA prior to distribution.

Even if the FDA were to require pre-approval, it is unlikely that will actually "catch" violations such as the disclosure of authors' financial ties to the drug company. Lack of "policing" seems to be standard operating procedure at the FDA, which government investigators say "does almost nothing to police the financial conflicts of doctors who conduct clinical trials of drugs and medical devices in human subjects." Agency officials don't even think such policing is worth the effort (see "FDA is lax on oversight during trials, inquiry finds").

So, basically, off-label promotion of Rx drugs to physicians is now virtually unregulated as long as it is behind closed doors and via journal reprints (also see "Pharma's New Marketing Partner: Medical Journals").

But is there any harm in drug companies distributing off-label information to physicians?

"Of course the media, including those who do puff pieces on Sid Wolfe, will portray off-label use as inherently dangerous," says Robert Goldberg over at Drug Wonks blog. "Most off-label uses wind up become standard therapy," he adds (see "Off Label Gauntlet Tossed Down").

Waxman, on the other hand, points out that "where the unapproved uses are actually ineffective, patients have been denied other, more effective treatments and have been unnecessarily exposed to the ineffective products' known side effects."

Just how ineffective are the drugs that are prescribed off-label?

I came across a 2001 study that found that "Most off-label prescription occurs without scientific support" (see here and chart below; click on the image for an enlarged view).

The authors claim, however, that this is no big deal -- "Many off-label uses are not of great concern," they conclude and "broad, unselective strategies to constrain off-label use would eliminate clinically beneficial evidence-based treatments."

Note: This research was supported by a research grant from the Agency for Healthcare Research and Quality (AHRQ) (R01-HS013405). Merck and Company, Inc. and IMS HEALTH provided access to the data used in analysis. (Not that there's anything wrong with that!)

Meanwhile, if you are interested, please take 2 minutes to answer a few short questions relating to the FDA's Guidance for Good Reprint Practices for the Distribution of Medical Journal Articles... on Unapproved Uses of Medical Products.

Take the survey here.

Wolf(e) at DTC Piggy's Door Huffing and Puffing

I don't know if it's the economy, lack of new drugs, or the new political climate, but 2009 is shaping up to be the year that direct-to-consumer (DTC) advertising will suffer a round of cuts not seen in a long time (I predict DTC ad spending will decrease 11% in 2009; see here for some data).

We are seeing some pharma CEOs publicly acknowledging that the benefits of DTC advertising do not outweigh the costs in terms both of money and industry goodwill.

Death of DTC by One, Two, a Thousand Cuts?
First it was Roche CEO William Burns who called DTC advertising the "single worst decision for the industry." Now Glaxo CEO Andrew Witty says he "think[s] there is too much [DTC]" and that his company will be "cutting back on its U.S. television advertising as it tries to spend its money more wisely and avoid some of the criticism aimed at heavy drug advertising" (see "Glaxo to Pare Ads on U.S. Television").

It appears that Mr. Witty and maybe other drug company CEOs read Pharma Marketing Blog! In a November post to this blog, I calculated that the loss of sales due to an industry-wide ban on DTC for one year would be more than offset by the savings. I also said "it hardly seems worth all the bad publicity for the industry to save DTC" (see "An Experiment: Ban All DTC Broadcast Advertising for One Year").

Others in the Pharma Blogosphere have also suggested that DTC advertising be cut (see here).

It should be understood that some of the comments coming from the industry may be designed to "head 'em off at the pass" -- the Wolf(e), after all, is at the door: Drug-safety crusader Sidney Wolfe has been appointed to a four-year term on the FDA's Drug Safety and Risk Management Committee, which plays a key role in telling the agency which drugs are safe and maybe how DTC advertising should change to add more safety information, which would further add to the pressure that DTC is under (see story).

Not only that, but the "e" option seems much more appealing in troubled economic waters.

What's Your Opinion?
I am hosting a little survey about the Future of DTC adversting and would like your opinion.

• Will DTC spending increase or decrease in 2009 compared to 2008? By how much?
• Should all or some forms of DTC advertising be banned in the US?
• Should there be a moratorium on DTC advertising? Should it be mandatory or voluntary?
• Should the business-tax deduction for DTC spending be taken away by legislation?
• Is there adequate risk information presented in DTC ads? Is it effectively communicated and does it balance benefit information?

Take the survey here.

Results of this survey may be summarized in a future issue of Pharma Marketing News.

Your comments are confidential (anonymous) unless you specifically provide your contact information at the end of the survey and allow us to attribute comments to you personally.

Country Music Superstar Judds Corner the Pharma Celebrity Market!

Country music superstars Naomi Judd and her daughter Wynonna Judd have cornered the pharma celebrity marketplace -- at least for now.

Jim Edwards reports that GSK signed Wynonna Judd to endorse Alli, "Its Flagging Weight Loss Drug" (see the story here).

"with the help of alli," says the new alli Web site featuring Wynonna, "wynonna judd started a new, healthier chapter in her life. you can too."

Meanwhile, back on the PhRMA site, Naomi Judd is featured because she will appear on a "Sharing Miracles" Television Program produced by PhRMA (see here).

I stumbled upon this "coincidence" only because I was trying to remember if the the new PhRMA Guidelines on DTC Advertising required celebrities to disclose that they were being paid to endorse the product. Unfortunately, the new code does NOT require any such disclosure.

Is this truly a coincidence or could it be that this is a mother-daughter/PhRMA-GSK collaborative deal? Mom could have brokered the deal by agreeing to appear on the PhRMA TV show if Wynonna got the alli gig, which may help her career.

Unlike her mom, Wynonna has not won a Grammy -- at least from what I can learn from this wikipedia entry. I also learned that "In November 2003, Wynonna appeared on an episode of The Oprah Winfrey Show discussing what she described as a 'severe' dependency on food. She had been working with the show in an effort to lose a significant amount of weight and get to the root of her dependency. In September 2005 Wynonna made a second appearance on the show, discussing how she had lost some weight (but had yet to reach her goal weight)." She was also treated for "food addiction" at the Shades of Hope rehab center in Buffalo Gap, Texas.

I'm sure alli will solve her problem whereas neither Oprah nor rehab did!

Red-Headed Woman
Jim also reported this tidbit: "In its promotional material, the corporation [GSK] features three different characters: Committed Connie who is white, Committed Carmen who is Latina and Committed Cassandra who is African American. At a media presentation in Philadelphia, a GSK spokesperson was careful to add that, when it comes to the African-American community, Alli’s marketing focuses on “health” rather than “weight.” She explained, they find size “a little more attractive.”

I find this interesting because even some white men may find size "a little more attractive," especially in a red-headed woman like Wynonna. In a tribute to that sentiment, I offer the following YouTube video, which features the classic song "Red-Headed Woman" sung by Sonny Burgess:

Emerging Search Engine Technology Drives Digital Integration

Search engine technology is rapidly advancing and your search engine marketing (SEM) strategy can no longer be focused solely on driving people to a Web site, according to two experts I just interviewed in a Pharma Marketing Talk podcast.

The experts are:

• Laura Pfister, VP, Interactive Media & SEM, IGNITE HEALTH
• Buddy Scalera, VP, Interactive Media, QI INTERACTIVE, A COMMONHEALTH COMPANY

Both will be speaking at ExL Pharma's upcoming 3rd Pharmaceutical Search Engine Marketing Strategies Conference that will be held on February 24 - 25, 2009 in Princeton, NJ. Pharma Marketing News is a Media Partner for this event and I plan to be there.

Before you register for this conference, listen to the podcast to receive a code that entitles you to a 15% discount! The link to the podcast can be found at the end of this post.

According to Laura and Buddy, search is evolving to integrate more social networking (ie, consumer-generated content), video, and enhanced media into the results. The future of search engine pharma marketing is to develop and integrate digital assets such as video and maybe even blogs and other social media into the marketing mix. Johnson & Johnson, for example, is doing that with its innovative YouTube channel and ADHD Moms Facebook page (see "J&J, Debbie Phelps, You, Me, Facebook: Is This Social Networking?").

Regardless of whether you believe what J&J is doing is social marketing or not, clearly their strategy is to develop a multichannel digital presence for their corporate brand.

The same should be done, however, for drug brands.

When fewer than 13% of consumers visit drug brand websites, it makes sense to develop these other assets that come up as the result of search. That gives consumers and healthcare professionals looking for health-related videos and blogs the opportunity to see your message in other areas of the web than just the product website. Pfister and Scalera point out that even if they are not looking for video, searchers are attracted to the Youtube video window that is now often part of every search result page. If that's not the brand's YouTube page, it may a Church of Scientology page!

Anyway, the conversation was very informative and I invite you to listen to the 30-minute podcast located here.

Free Health Speech - Marketers, Reach for Your Gun!

"Well-intentioned measures can go very wrong. Time to call out the disturbing hypocrisy directed at healthcare marketers." -- Dmitriy Kruglyak, Trusted.MD Network

After reading a NYT story about PhRMA's recent policy to discourage giving swag to doctors ("No Mug? Drug Makers Cut Out Goodies for Doctors"), Dimitriy was so pissed-off ("appalled" was his phrase) about PhRMA's "easy" "cave to interest-group pressure instead of taking a principled stand for healthcare communications," that he started a new Facebook group with the motto "Free Health Speech: Stand Up to Healthcare Marketing Hypocrisy!" Its mission:

"To educate general public about the value of responsible healthcare communications. To respond to unfair and hypocritical attacks on healthcare marketing. To demonstrate the difference between proper and improper influence."

I joined the group although I am not sure I am one of the "like-minded individuals" that Dmitriy is seeking.

I agree with the first part of Dmitriy's mission statement extolling the value of educating the public about "responsible healthcare communications" because that is what I think I am doing here on Pharma Marketing Blog. I do this by pointing out all the "irresponsible" healthcare communicating that pharmaceutical marketers are doing, explaining how they violate FDA law, industry standards (ie, PhRMA guidelines), and ethical standards.

But Dmitriy starts out right away condemning PhRMA and the drug industry for promulgating standards on interactions with healthcare professionals. Apparently, many people who support the drug industry agree with Dmitriy and think these standards will not benefit patients and the ban on free gifts to physicians makes a mountain out of a mole hill, if a survey I conducted can be believed (see "PhRMA's New Code on Interactions with Healthcare Professionals: Survey Results and Discussion of Issues"):

General Impressions. Respondents were asked, “Please indicate your level of agreement or disagreement with the following general statements regarding the new PhRMA code.” Plotted here are results from the top 2 boxes (Strongly agree/Somewhat agree) and the bottom 2 boxes (Strongly disagree/Somewhat disagree). Click on image for an enlarged view. See more results from the survey here.

Regarding the Prohibition of Gifts to Physicians. Respondents were asked, “Regarding the prohibition of the distribution of gifts to physicians, please indicate which of the following statements you agree with.” Click on image for an enlarged view. See more results from the survey here.

Dmitriy asks (see here):

So where is the hypocrisy in healthcare marketing restrictions?

The idea that healthcare marketing must be severely restricted, with banning gifts to physicians being just one example, is based on several premises. These premises keep getting cited by the proponents in various forms.

He goes on to summarize his "Top 3" myths of what is wrong with that line of thinking.

Myth #1: Paid marketing always causes improper influence

"But if a pen or a cup is there to simply *remind* the doctor about that particular brand available, what is wrong with this if the prescribing decision is still made on merits of patient's case?" asks Dmitriy.

To which I would respond: It's more than a reminder, it's implanting a brand in the physician's head (the first tenet of marketing 101). See "Pens Put Brands in Docs' Brains and Profit in Pharma's Pockets" for more about that.

The distribution of branded tchotchkes may be a legitimate type of marketing, but is it "responsible healthcare communications?" There's simply not any communication going on when a sales rep drops off dozens of pens with brand logos at a doctor's office. Communication happens when the rep talks to the doctor! Let's focus on that rather than bemoaning the loss of free gifts. Many sales reps over at CafePharma have expressed the same sentiment and are thankful to be free from the burden of bearing gifts rather than information.

If you are a doctor and miss the free office supplies, get over it!

Myth #2: Unpaid communication is free of improper influences

I agree with what Dmitriy says under this heading, because it is exactly what I just said above: "The real scandal is that media obsession with little things like cups and pens distracts attention from the real problem: influences are everywhere. Everyone is always influencing everyone else. Physicians interacting with physicians. Patients talking among themselves. Patients-to-physicians and vice versa. Medical journals. Pharma sponsored CMEs. Grants to medical schools. Academic careers staked on this or that concept. Everyone has an agenda and there are far more powerful motivators to do something wrong, that little trinkets. Social and professional pressures could be way stronger than monetary and shifting blame to marketing is an easy cop-out to avoid confronting the real influences."

Dmitriy, you are TOO focused yourself on the trinket issue. Get over it and let's discuss these other issues you bring up. I remind you that the media do not ONLY focus on trinkets like you seem to be doing. The media has lots of stories about all these other issues. Why not address those stories in your analysis?

Myth #3: Marketing is unnecessary and never mixes with health

"Newsflash," says Dmitriy, "we are all marketers! The only difference with *paid* marketing is using money to expand the reach and effectiveness of the message. There is nothing wrong with that as long as the message itself is not improper or deceptive."

Dmitriy's remarks remind me of the Google person who said marketing/advertising is "democratic" (see "Is Advertising Democratic? Girl from Google Thinks So!"). Yes, I am a marketer too. But I cannot compete with drug companies who spend $billions marketing to physicians.

Ever heard the phrase "Money talks, nobody walks?" That's why I think "counter-detailing" efforts are like pissing into the wind (see here).

There's definitely NOT a level playing field when it comes to marketing to physicians. And maybe "leveling" is what all the guidelines, regulations, and laws are all about. When that Utopian ideal is reached, then we might have "responsible healthcare communications" from a variety of sources.

"Corporate Blog" is an Oxymoron

"Corporate Blog" is as much an oxymoron as "Jumbo Shrimp," "Military Intelligence," and "Safe Drugs" (I welcome your best pharma oxymoron in comments to this post).

I realized this after reading a comment made by Alex Savic to my "New Year's Resolutions for Pharma Marketers" post, which noted that at least two pharmaceutical "corporate blogs" -- GSK's alliConnect Blog and Centocor's CNTO411 -- have gone silent.

Alex said: "Probably lots of companies get into blogging because of the hype but don't really buy into it internally."

I don't think so. I think it's more of a personnel problem.

A blog is a personal narrative and when the person leaves, the blog is dead in the water! This is exactly what happened to CNTO411 and alliConnect. Another case in point is Pharmalot, which will fade away without Ed Silverman (see "Pharmalot Nevermore").

One thing's for certain in this current economic atmosphere: people in corporations -- even CEOs -- are expendable. And the most expendable people are probably the ones that are inclined to write blogs!

What about a corporate blog written by a team or committee?

PLUH-EASE!

P.S. Don't worry about Pharma Marketing Blog. It will continue until it is "ripped out of my cold, dead fingers."

Pharmalot Nevermore

I was sorry to hear that Ed Silverman "took the money and ran" in a buyout deal with the Newark Star Ledger and will no longer be writing for Pharmalot, which I assume will fold without him. I will miss Ed's presence in the Pharma Blogosphere, although I am sure he will continue to contribute somehow.

"This is my long goodbye," said Ed in his final post.

"For two glorious years, I have had the privilege and good fortune to run this site. Now, though, the time has come to walk away. This was a difficult decision, but one that is rooted in the turmoil engulfing the newspaper business. Let me explain.

"Three years ago, I suggested a site that could somehow become a go-to destination for news and discussion concerning the pharmaceutical industry. As someone who had covered pharma for a decade, but was itching to do something different, a web site represented not only a next step in gathering and disseminating information, but also an opportunity to get ahead of the curve and move on to another stage in my career.

"Happily, the notion was backed by Jim Willse, the editor of The Star-Ledger of New Jersey, which owns Pharmalot and is the flagship in the Newhouse chain of newspapers. After the usual planning and tinkering, Pharmalot launched exactly two years ago. And since then, the site has become popular and well-known – as of last month, we notched about 11,000 unique daily visitors and some 330,000 monthly pageviews on a 30-day rolling basis. There were accolades from The Financial Times and the Association of Health Care Journalists. I was regularly asked to speak at dinners and conferences.

"Meanwhile, as you know, the newspaper business has been declining rapidly and, last summer, the Ledger offered generous buyouts, sufficiently generous that I was tempted to consider the package. And for various personal reasons, that is what I have chosen to do. Yes, there were discussions to continue with Pharmalot – the Ledger, particularly Willse, recognizes the potential for the site and I thoroughly enjoy the work. The long hours and intense routine may be grueling, but Pharmalot has been an extremely challenging and satisfying preoccupation. In the end, though, we were unable to find a path forward.

"And so, I am now moving on."

New Year's Resolutions for Pharma Marketers

My #1 New Year's Resolution is to stop telling pharmaceutical marketers what to do all the time.

Now, here's my list of resolutions for pharma marketers:

1. Don't Start a Blog and Then Neglect to Update It! At least two drug company blogs launched in 2007 and 2008 have gone silent: GSK's alliConnect Blog (no new posts since September 3, 2008) and Centocor's CNTO411 (no new posts since October 8, 2008). Dudes! That's like disrespectful to your customers!

2. Develop Pharma eMarketing Guidelines Already! In 2008, PhRMA came out with new versions of its guidelines for interacting with healthcare professionals and direct-to-consumer (DTC) advertising. But where the hell are the guidelines for using the Internet? Approximately half of my criticisms of the industry involve shady Internet marketing practices. Now is a good time to develop eMarketing guidelines because everyone is predicting that while there will be cutbacks in personal marketing to physicians and broadcast DTC advertising to consumers, more money will be spent online in 2009. Also, the new FDA Commissioner may be more Internet-savvy and re-awaken the agency's interest in the Internet as a unique marketing platform. Note that we've already seen the first Internet-specific "warning letter" from the FDA: see "Death of the One-Click 'Rule' or 'Received Precedent' or Whatever!"

3. Put Serious Limits on Broadcast DTC. Why continue to spend 60-70% of your marketing budget on TV if you really have no new products and nothing new to say? Cut that budget in half and spend half of what you save on more effective channels, such as the Internet! Or use the money to better understand why most patients stop taking your products after one refill! See "Rethinking the Value of DTC Advertising," "Is DTC Bankrupting Pharma?," and "An Experiment: Ban All DTC Broadcast Advertising for One Year."

4. Develop Some Drugs that Men Want! Allergan got FDA approval to market Lumigan for enhancing eyelashes, something only a woman would want to do ("Allergan's Secret Plan to Thwart Homeland Security and the FDA Approval Process"); Pfizer's Lyrica was approved for fibromyalgia, which seems to affect primarily women ("Women Need More Love, Less Drugs"); and GSK's Paxil may be well on the way to approval for Persistent Genital Arousal Disorder or PGAD, which also mostly affects women (see "PGAD. EGAD! Another Syndrome/Disorder, Whatever!"). If I believe the comments I have received, many women actually suffer from PGAD. OK, fine. But what about us guys? We haven't had a drug marketed specifically for us since Viagra and Cialis were launched way back in the day. Not that we need these drugs -- we just want 'em. (BTW, I suspect many men also have PGAD, but DON'T want a pill for IT.) Personally, I think men need drugs that would help them think with their HEADS rather than with their PENISES! Guys, keep in mind that many women are attracted to smart guys because intelligence is a genetic trait that they value and want for their children. It's so much easier to fake intelligence than genital endowment. So, I'm all for developing new drugs or repurposing old ones for enhancing my intelligence (see "Brain Drugs: This is Your Brain on Adderall") -- IF I WERE IN THE MARKET, WHICH I AM NOT! I'm already happily married, very happily married! But I would still like a bigger, more powerful brain, if you know what I mean!

That's it. Just a few really simple New Year's Resolutions to get you started on your way to a great 2009!