Direct-to-Consumer Pharmaceutical Advertising: When to Use Branded Versus Unbranded Campaigns

The United States is among only a handful of countries where direct-to-consumer (DTC) advertising for prescription medications is allowed by the government. Of course, there is a catch: when these ads include both the brand name of the medication and its "indication" (the condition which the drug treats), fair balance must be included. Fair balance generally includes possible side effects as well as "contraindications" (other conditions which patients might have that make the drug more risky to take).

The required presence of fair balance makes pharmaceutical DTC advertisements unique in that they must present negative information about the product alongside the positive selling messages. Only a few other industries (such as tobacco) face this hurdle. Imagine what the world of advertising would be like if similar fair balance was required for other types of products that possess inherent safety risks, such as automobiles, fast food, alcohol or even sporting equipment!

There is an avenue for avoiding fair balance in pharmaceutical DTC advertising. According to FDA guidelines, fair balance is not required for ads that do not mention the drug by name. It is therefore possible to create a campaign that encourages patients to seek treatment for a disease without mentioning a specific brand. These are known as unbranded campaigns.

For many pharmaceutical brands considering DTC, the pursuit of either a branded or unbranded campaign is a critical decision. The best approach can be determined by focusing on several specific factors: the extent to which patients with the disease remain undiagnosed, the amount of fair balance the product requires in a branded ad, and the current market share of the product.

Unbranded efforts often take the form of "disease awareness" campaigns which are designed to drive new patient diagnoses by educating patients about symptoms. Logically, these campaigns are more effective for diseases where a high proportion of patients remain undiagnosed. Since unbranded campaigns do not require the presence of fair balance, they offer a more efficient media buy since 30-second or even 15-second commercials can get the job done. Of course, without the presence of a brand name, patients who are motivated to take action by an unbranded ad are unlikely to request a specific drug by name when speaking with a physician.

If treatment does occur as a result of a discussion generated by an unbranded campaign, physicians will most likely prescribe according to the "fair share" of each product in the market. So, if your drug has a 10% market share, patients activated by an unbranded campaign will only receive your drug 10% of the time. If a competitive drug has a 30% market share, your unbranded campaign will benefit your competitor more than your own product.

In contrast, branded DTC advertising creates specific patient awareness of your brand name and indication. Fair balance must be included. In the current regulatory climate, the required fair balance can often consume 30 seconds (or more!) of air time, meaning that a commercial length of 90 or even 120 seconds is necessary in order to make room for positive selling messages in addition to the side effects and contraindications.

A physician discussion generated by a branded campaign will be more likely to produce a prescription for that product, since (hopefully) patients will mention the brand name and cue the physician to prescribe it. Branded advertising can be especially effective in situations where the disease isn't especially serious, such as so-called "lifestyle drugs" like erectile dysfunction medications or treatments for mild dermatological conditions. In these situations, physicians possess minimal risk in prescribing one product over another, and are more inclined to give patients what they want, resulting in a higher physician "grant rate."

The perfect candidate for an unbranded campaign is a product with strong market share, onerous fair balance requirements, and a high proportion of patients who have the disease yet remain undiagnosed. Branded DTC works well for drugs with more minimal fair balance, those that may not enjoy strong ingoing market share, and those where the physician grant rate is strong due to the less serious nature of the condition.

Many products fall into a grey area where the decision to pursue branded versus unbranded DTC is not quite so obvious. Beyond the basic consideration of the factors outlined above, quantitative analytical methods are available to provide a more detailed assessment of the relative utility of branded versus unbranded DTC. These techniques combine primary quantitative survey research among patients and physicians with mathematical models for predicting DTC ROI, and are recommended for situations where rigorous scrutiny needs to be applied to the selection of the appropriate campaign.