Direct-to-Consumer Advertising

These days, when a patient goes into a doctor's office because of a symptom, illness, or condition, there's a good chance she's coming in with some ideas of her own about what's going on, and what might be done about it. One of her sources for information may well have been direct-to-consumer (DTC) advertising.

Consumer access to health information is rapidly growing. In part due to forces like the Internet, and in part to DTC advertising, patients (more aptly, "patient-consumers") are increasingly contributing to decisions about their care. As a result, patients wield more power than they ever have in influencing the success or failure of new medical drugs, services, and initiatives. So they're important as a primary research audience.

The relatively expensive nature of DTC advertising implies that it should provide returns for companies that use it consistently. Ipsos research suggests that it could work--in the right circumstances. Ipsos has been actively engaged in the study of patient attitudes and behavior ever since the DTC phenomenon started. We evaluate DTC advertising, track monthly household prescription drug purchases, and routinely apply advanced analytic tools to define and understand patient segments.

Over time, we've been able to see what works and what doesn't, and we're able to give our clients guidance to ensure their DTC dollars amount to money well spent.

The Food & Drugs Administration (FDA) permitted companies to run branded DTC in 1997. Companies were initially slow to respond but DTC really accelerated in the last 5 years with spending doubling between 1998 and 2001. Today, about 14% of the promotional spending on drugs is on DTC. More than 50 brands used DTC in 2003.

Marketers have used DTC in many ways. For example, in the insomnia market, Ambien used DTC to successfully defend its position versus a new competitor. In the statin class, three brands, Zocor, Pravachol, and Lipitor vigorously used DTC as an instrument to differentiate themselves and induce brand switch. In allergies, DTC helped prescription brands target a specific segment--severe sufferers. And of course, Viagra used DTC to dispel inhibitions about a sensitive condition and create a market for itself. DTC has also played a key role in raising disease awareness and the incidence of treatment. Compared to few years ago, a larger proportion of patients today are treating their depression, acid reflux, diabetes--or even trying to prevent a second heart attack.

Deciding to invest in DTC

DTC is expensive. It works only in specific situations. So marketers would be well advised to consider all factors when deciding to invest in DTC. Consider your brand's market position and the status of the therapeutic class and the disease/condition. DTC is most effective:

• For chronic and symptomatic diseases
• When awareness/knowledge of disease and its treatment is low
• For new brands
• For patient populations that are large, and undiagnosed
• When several companies are competing with each other

Developing a campaign

In the absence of traditional elements that help branding such as shelving, packaging, and distribution, DTC ads have to do a big job. They must reach and gain the attention of narrowly defined target populations, register unfamiliar brand names, and build awareness quickly. They have to communicate and explain complex messages and benefits and motivate the consumer to action. They have to do all this while following strict FDA guidelines and a long, though predictable, approval process.

Given this challenge--and the cost of a campaign--the marketer should give the DTC project the time, attention, and scrutiny it deserves. Here are some guidelines for marketers embarking on a DTC campaign.

• Understand your "patient-consumer": Pharmaceutical marketers usually characterize their target audience based on epidemiology. Traditional definitions include diagnosed and undiagnosed sufferers, treated vs untreated, at-risk, etc. While these suffice when you are assessing the size of your target group, deeper insights are needed to create effective messages. Patients have beliefs and attitudes and expectations about treatment. Time-tested research methods help understand these and other issues. For example, segmentation studies can lead to the right consumer positioning, appropriate creative strategies, and focused patient relationship programs. Qualitative research into patients' feelings about their condition and relief sought could provide useful cues to creative execution. In markets where drugs are similar, DTC can help you differentiate your brand versus competition.
• Take the best of both worlds: Borrow ideas, experiences, and lessons learned from consumer packaged goods but keep in mind similarities and differences. Ipsos-ASI experience shows that despite differences, DTC is still advertising. To do its job and move the business, an ad must first deliver an impression--and in most cases, the impression has to be associated with the advertiser's brand name. It has to convey a message, directly or implicitly, about what the product is, and does, and means for the consumer. Finally, the ad has to persuade the viewer with a message that changes their attitudes, beliefs, or disposition to behavior.
• Set appropriate goals: The decision to conduct DTC has to be clearly thought through. Goals for the DTC campaign should be specific, measurable, achievable, and consistent with the brand's strategy.
• Combine different communication tools at your disposal: DTC ads work best when combined with other DTC programs. Implement multi-channel efforts with programs, large and small, rapid and slow-build. These could include direct mail, on-line response programs, drug information customized to patient needs, or promotions inside the physicians' office. In particular, choose media appropriately. Ipsos-ASI experience shows that print may be more than just a secondary medium for DTC.
• Use the right evaluative tools: Given the stringent regulatory system, a range of creative alternatives, developed and evaluated early in the process, could help manage risk. The alternatives could typically represent strategies ranging from the most aggressive (and therefore risky) to the most conservative (one that is likely to be approved). Inexpensive and fast turnaround ad screening tools such as Ipsos-ASI's Next*Idea can help understand how each creative delivers against the brand's goals.That way if a creative is not approved or major changes are required, there are fallback options.
• Finally, start earlier than later. Build enough time into the plan. Typically, the entire process from storyboard to final execution can take up to 12 months.