Drug marketing is increasingly expensive and decreasingly productive. WebMD Health, the dominant health portal, argues it is not merely another advertising forum, but a more effective influencer of consumer and physician behavior than detail reps and DTC promotion. So far, drug companies remain on the sidelines, having been burned once by similar arguments about the marketing value of neutral channels, represented by PBMs, of which many of WebMD's managers are alumnae.

If ever an industry needed to find new ways of marketing itself, the currently floundering CRO business certainly fills the bill. A number of industry observers and insiders argue that Internet technologies could play a crucial rule in transforming R&D outsourcing from its role as a temporary means of boosting capacity to that of drug development partners. Each of the top three CROs have, in fact, devoted significant resources to building Internet capabilities. But the most publicized and ambitious such effort from Quintiles Transnational Corp., which is attempting to leverage its substantial financial resources, as well as the advantages of having a major commercialization outsourcing business that complements its drug development operations, to create an Internet platform whose scope the competition simply cannot match.

Given the importance of a rapid launch of new products, many pharmaceutical firms are turning to consumer marketing tools to create consumer demand. To date, much of the consumer marketing effort has focused on direct-to-consumer advertising, but more and more drug companies are learning to harness the power of the Internet to push out their product message.Far more than simply establishing a web site, interactive DTC--or iDTC--marketing is a two-way approach whereby companies and consumers exchange information through feedback loops, the end result of which is to develop and deepen customer relationships. To be effective, however, iDTC campaigns must have a clear sense of the bottlenecks to product adoption, establish reasonable goals and expectations, and coordinate with and complement much more traditional launch strategies.

Effective consumer web sites balance straightforward ads with customized disease management--and eventually bring the physician into the corporate-consumer dialog.