The Vioxx withdrawal is one of those seminal events that, because of the players involved--the industry's largest companies, some of their most valuable drugs, both the European and American regulatory structures--holds up a mirror to an entire industry. Given the record breaking valuation slides, the market is taking a very critical look at the industry's strategies; so should the people who run it.

A new survey shows top drug executives still question their ability to exploit consumer promotion. They've got good reason: while consumer promotion clearly works in driving patients to doctors, increasing diagnosis rates and increasing patient requests for specific products, large numbers of their switch requests are denied. To give consumers sufficient power to influence their physician's prescribing behavior--Effective Voice-companies need a deeper understanding of physician attitudes towards requests in general, the specific therapeutic area and the product vis-à-vis competition.

In pharmaceutical marketing, three industry/structural conditions have combined so that companies compete by outspending: the R&D monotony of chasing after the same targets in the same markets; monotony of information--using the same market and customer information to make identical prioritization decisions; and application monotony, in which regulatory oversight, consumer privacy issues and established industry practice cause marketers to create similar commercial programs against the same targets. Marketers can outsmart, rather than outspend, by exploiting the belief structures of physician or consumer targets, to develop differentially targeted and segment-tailored campaigns that greatly enhance ROI.