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Executive Summary

Ever since US regulations prohibiting direct-to-consumer advertising were relaxed in August of 1997, pharmaceutical companies have been spending a lot of time, and billions of dollars, reaching out to average Americans. Increasingly, the Internet is their medium of choice. But in Europe, companies are at a distinct e-disadvantage. Drug firms are still forbidden to communicate with consumers about prescription medical products in almost any meaningful way. They are not allowed to mention brand names, nor to say specifically what a product does. Firms can, however, let consumers know that they are working in a general disease area. And they can encourage consumers to go see their doctors. For some companies--specifically, those with dominant market shares--such vague communications may be worthwhile. Pfizer, the manufacturer of Viagra, seems to think it will be. The American firm has reportedly budgeted $30 million for a Europe-wide ad campaign to educate consumers about the symptoms of erectile disfunction. Pfizer stands to benefit, because at the moment, Viagra is the only orally administered impotence drug on the market. It effectively has no competition. Other Big Pharma firms with major market shares in Europe have also begun communicating to consumers, encouraging them to see their doctor, knowing that doing so increases the odds that patients will emerge from consultations with prescriptions. For these firms, dominating markets such as contraceptive products, certain vaccines and insulin, the issue is how to get European consumers to the web sites that present their messages. But general-awareness campaigns aren't likely to help companies selling products in crowded markets such as hypertension, and might actually benefit competitors. Given the restrictions on DTC communication, it's little wonder that most drug marketers in Europe are directing their Net efforts to physicians, with whom they can communicate directly about prescription medicines. But frustration with the European restrictions is growing, and governments--who say the regulations prohibiting DTC advertising are meant to protect consumers-- recognize that European citizens are already accessing medical information and being exposed to product advertising via the Internet. Many industry observers expect Europe's anti-DTC regulations to be relaxed eventually. Companies leery of irritating bureacrats that might retaliate in some way are thinking what they can do within the bounds of current law.

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Reconfiguring DTC with Patient Behavior in Mind

While DTC ads work when the end consumer is an able judge of product performance, as with medications for seasonal allergies, sexual dysfunction, or hair loss, they don't work nearly as well for asymptomatic illnesses. For these conditions, DTC may help increase patient acquisition and trial, but often fails to improve long-term use, thus under-performing both clinical expectations for patients and financial expectations for manufacturers. Optimal DTC programs should integrate patient acquisition strategies with direct-to-patient support strategies such as, disease-state web sites, refill reminder programs, and financial incentives able to drive ongoing product use.

When the Consumer Drives Demand

Empowered consumers are playing a more proactive role in almost all treatment decisions. For consumer-driven and lifestyle drugs, a fast-growing portion of pharma's portfolio, marketers still focus on physician detailing but must resist the temptation to rely only on physicians to interpret consumers' needs. Consumers have their own approach to evaluating the risks and rewards of a lifestyle-oriented drug. The fact that it outperforms placebo in clinical trials matters little: they expect it to be significantly better, and without unpleasant side effects. Companies must weigh these expectations early in the development process. Adjusting the paradigm where the physician is king is a major challenge. The perception that traditional detailing efforts generate the dollars, while consumer marketing only spends them, remains hard to change.

Branding Goes Global

Until recently, most pharma firms handed drugs to a network of partners for marketing, or let their local divisions figure out sales strategies. These days, companies are increasingly working from headquarters to devise a single strategy they can apply across world markets. The point of global branding is leverage. Companies hope to increase sales while decreasing costs associated with marketing, and so get maximum value from drugs, throughout carefully planned life cycles. Medical marketers are studying how consumer-goods marketers craft consistent images and messages that help products become internationally desirable brands. Firms are thinking and acting earlier, with more coordination, than ever before. Some major companies have undergone fundamental restructuring to become more effective at global branding. They're meeting frequently, defining best practices, paying more attention to pre-launch efforts and to Phase IV studies that may support claims. No one knows which practices work best. Some experts say the industry should behave more like consumer marketers, others say less. It's possible that global branding can widen corporate development choices.


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