Selling drugs: doctors might not be crazy about the idea, but patients are walking into their offices asking for specific drugs

American Demographics, Jan, 1998 by Patricia Braus

Doctors might not be crazy about the idea, but patients are walking into their offices asking for specific drugs. They have heard about them on TV or read about them in magazines.

Askier travels blissfully down a mountain of ragweed, his skis in perfect position as pollen scatters across a parched mountain landscape. Quick--is this an advertisement for weed killer, a new type of skiing, or an allergy drug?

Unless you've stayed away from magazines and TV this year, you probably know this is an ad for Allegra, an allergy drug manufactured by Hoechst Marion Roussel, Inc. The caption reads: "This allergy season, live with ahhhbandon. Ahhh! Allegra!"

The Allegra print campaign is one of a multitude of highly visible prescription' drug advertisements aimed directly at the public. Ever since federal regulations changed laws governing the advertising of prescription drugs in the 1980s, such advertising efforts have taken off. Manufacturers spent $137 million on direct-to-consumer drug advertising on television alone in 1996, according to IMS America and Nielsen Media Research. Advertising is also extensive in most major consumer magazines. "They're spending a ton of money" says Jack Trout, a marketing expert based in Greenwich, Connecticut, and author of The New Positioning: The Latest on the World's Number 1 Business Strategy. "They're keeping these magazines afloat."

But the increasing presence of such ads has also raised questions about what works best--and what doesn't work--in advertisements selling prescription drugs. The personal and graphic nature of products addressing problems like cracked toenails and sexually transmitted herpes brings up a host of questions. Where's the line between effective and tasteless? How much hype is acceptable? Above all, what is most effective in persuading consumers to request products from their doctors?

The answers are increasingly important to manufacturers of pharmaceutical products, as direct-to-consumer ads claim a greater share of the marketing budget. It is no coincidence that Premarin, one of the best-selling drugs in the country, depends heavily on advertising directly to consumers. How did it get there? How does a new product achieve brand-name recognition? There is no simple formula, but experts suggest that consumers are looking for specific things in a drug ad.

THE KNOWLEDGEABLE CONSUMER

Twenty years ago, patients who thought they might have an allergy problem went to their doctor, discussed their symptoms, and heard about what was available from the doctor. They were unlikely to know what drugs were available for allergies and took their doctor's word. Direct-to-consumer drug ads were considered unethical, reflecting the widely held societal belief that doctors were the only ones qualified to make judgments about something as important as prescription drugs.

The rules have changed. Consumers have become more involved with their health care. And once they became the target of advertising for prescription drugs, they had a new way to find out about what might be wrong with them and how to treat it. In particular, the ads have changed the way doctors and patients talk about medicine, says Mickey Smith, Barnard Distinguished Professor of Pharmacy Administration at the University of Mississippi in Oxford. "For the first time, people are coming into their physician's office knowing what they want. A lot of the mystery is gone"

Many physicians dislike the ads. "Information is given to people in a limited form," says Gillian Shepherd, clinical associate professor of medicine at New York Hospital-Cornell Medical Center and past president of the New York Allergy Society. "People don't know how to incorporate it. Patients are being manipulated. Everything is being presented to them as a wonder drug"

Ads for allergy medicine are particularly dramatic, offering drug users visions of happiness and serenity. One ad for Claritin from Schering features a woman gazing beatifically at a surreal blue and pink sky. Patients often ask for the drug by name, says Shepherd. "They say Claritin. Nothing else. The way the ads are presented to the public, it's like any ad. It's brand recognition."

The best ads incorporate the basics of good advertising. First and foremost, they establish brand recognition in the eyes of the public. Good consumer drug ads also include solid information, clarity, powerful visual images, and a convincing message. But the complicated nature of health care forces advertisers to be extra careful. A major force in drug advertising is federal regulation, which limits the types of messages released to the general public. Drug advertisers typically show their ads to the Food and Drug Administration before broadcasting them on TV to make sure the agency will not consider them false and misleading. The agency also requires that print and TV ads provide information about product risks. Recent guidelines allow TV commercials to provide some of this information in alternate forms, such as Web sites and brochures in pharmacies.