UIC study is examining direct-to-consumer drug ads on TV

There are three types of pharmaceutical ads, which are subject to different levels of regulation by the FDA:

1. product claim ads, which include the drug name, an FDA-approved use, and the most significant risks; 
2. reminder ads, which give the name of the drug but not its uses, which do not have to contain risk information; and 
3. help-seeking ads, which describe a disease or condition but do not recommend a specific treatment.

A team at University of Illinois at Chicago is asking, “Do pharmaceutical ads educate patients and improve health -- or merely spur drug sales?”

Researchers at the University of Illinois at Chicago's Institute for Health Research and Policy are conducting the first comprehensive study of televised drug commercials using Nielsen Media Research and health care utilization data.

The research is funded by a $3 million, four-year grant from the National Heart, Lung, and Blood Institute.

The U.S. is the only country that allows televised ads for prescription drugs. Direct-to-consumer drug commercials are the fourth most common category of television advertising.

The increase in the amount of advertising has coincided with huge increases in health care costs, said Sherry Emery, principal investigator of the project at UIC, who notes that advertising has not likely caused the entire rise in health care costs.

On the one hand, the pharmaceutical industry claims that these advertisements provide a public service by educating consumers and giving people information to take to their doctors that might improve their health and ultimately result in lower health care costs, Emery said. But there are a lot of economists who would suggest that you don't advertise a product unless you expect to make money from it -- and these ads might be driving excess demand.

Previous research has not demonstrated either effect conclusively, said Emery, a senior research scientist at the UIC institute, perhaps because such studies have focused on single categories of drugs. Several studies have examined the effect of direct-to-consumer advertising on consumers' behavior and health outcomes, but most have used aggregate spending rather than more refined measures of ad exposure.

It seems reasonable that an advertisement for a cholesterol medication that treats a non-symptomatic condition might be different than an advertisement for an asthma medication, where if you don't adhere to the medication, you may end up in the hospital with a flare-up of your asthma, she said.

Emery and colleagues will use the Nielsen data to examine direct-to-consumer advertising on health care utilization and pharmaceutical sales of eight therapeutic classes of drugs promoted in the top 75 U.S. media markets from 2005-2009. The drugs include those for allergies, asthma, arthritis, depression, erectile dysfunction, hyperlipidemia, sleep disorder, and smoking cessation. Data from millions of patients will be examined for doctor visits, hospitalizations, new prescriptions, and prescription refills. The study will take into account different patient characteristics and regional differences in access to physicians.

The researchers will also evaluate the content of the ads to see how they vary among drug classes -- and whether these differences affect their impact.

There are three types of pharmaceutical ads, which are subject to different levels of regulation by the FDA: product claim ads, which include the drug name, an FDA-approved use, and the most significant risks; reminder ads, which give the name of the drug but not its uses, which do not have to contain risk information; and help-seeking ads, which describe a disease or condition but do not recommend a specific treatment.

It's conceivable that the different types of advertising are used differently by drug class and that they might affect the way people respond to the advertisement in terms of their health-seeking behavior and their demand for the medication, said Emery.

2 pronged approach to DTC: ULORIC campaign

This is an excerpt from a campaign profile by Matthew Arnold, in Medical Marketing & Media.

As the first new product for gout on the market in four decades, the Uloric team had some work to do in educating patients about how the disease works and available treatments.

“Our campaign was really focused on targeting patients who were on treatment but were still experiencing flares,” says Heidi Gillmore, marketing director for Uloric. “There was a big awareness gap because of the fact that there's been no new innovation in the category for decades, and therefore no promotion happening. There was really a lack of credible resources on the Internet.”

While the disease is most often treated by primary care physicians, the market for gout drugs is a niche one, with around eight million adults diagnosed in the US, and just short of three million treated chronically.

Because there's a lot of co-morbidity, the topic often fails to come up during doctor visits, as more immediate health concerns predominate. Around half of those on treatment are still experiencing flares, according to Takeda's research, which also found poor patient understanding of the role of hyperuricemia, the underlying metabolic condition treated by Uloric, in gout.

“So that fed into our strategy behind doing a really broad-based, multichannel, branded and unbranded campaign to both educate on the disease state and introduce the brand as an option to these patients,” says Gillmore. 

Takeda took a two-pronged approach:

1. Unbranded ads that featured a real doctor talking about the role that uric acid plays in gout along with the tagline “Gout can attack silently even between flares.” 
2. Branded ads feature patients lugging around a large flask of liquid that serves as a metaphor for uric acid reduction. 

Both efforts drive viewers to goutinfo.com. The brand is now moving to put more emphasis on relationship marketing.

“Now that we've built this awareness level, we're really trying to drive more dialogue between patients and physicians,” says Gillmore. “So we're starting to step away from the awareness-building vehicles like the TV ads and center more on the action vehicles—online and in-office media.”

Gout is one of the most-searched conditions, says Gillmore, and Takeda research has shown that four out of five patients searching for gout info online are currently suffering a gout attack.

“They're having pain and they're trying to seek out solutions at that time, so we really try and leverage that as much as possible, because that was something we identified at our launch that, because of the lack of innovation in the category, there was a lack of credible resources on the Internet for patients to turn to. So you search on ‘gout' and you're getting a lot of home remedies and those types of things.”

Takeda's Gout.com is the destination for its unbranded efforts, while its Gout Smart program offers interactive discussion guides and other features aimed at getting patients into treatment.

3 new meanings for DTC -- from Bruce Rooke

"DTC is due for some big Invention," writes Bruce Rooke, Chief Creative Officer of GSW Worldwide.

On our agency's Brand Liberators blog, Bruce says, "It'd be a shame if we just stood there and kept putting out the same Beauty and the Beast formula of disease-stricken patient magically transformed into a walking grin, interrupted by 32 seconds of fake doctor-patient interaction while fair balance is read. We have the chance– and responsibility– to respond to the changing landscape with a whole new vocabulary of action."

Direct to Consumer says what it is and where it plays. But effective brands today are built on what they do than what they are. So imagine if DTC stood for:

 

D = Do.

T = Teach.

C = Connect.

 

Read more about what Bruce thinks DTC could mean on the Brand Liberators blog:

www.gsw-w.com/blog