INTERNANIONAL: ISSUE - Drugs giants extend the boundaries of pharmaceutical ads/America’s attitude to drug ads could herald a global change, Karen Yates says

It’s regrettable but true that when a little piece of advertising history was made this summer, it was with a commercial for nail fungal treatment. Quietly, almost furtively and with none of the hype usually associated with breakthroughs, the UK screened its first TV ad for a prescription-only drug. In fact, to be accurate, it was not for the drug itself - that’s still illegal in the UK - but for the disease. Mentioning, of course, the drugs company that might help cure it.

It’s regrettable but true that when a little piece of advertising

history was made this summer, it was with a commercial for nail fungal

treatment. Quietly, almost furtively and with none of the hype usually

associated with breakthroughs, the UK screened its first TV ad for a

prescription-only drug. In fact, to be accurate, it was not for the drug

itself - that’s still illegal in the UK - but for the disease.

Mentioning, of course, the drugs company that might help cure it.



The Swiss drugs giant, Novartis, was testing the water after the success

of a similar experiment in the US, where drugs companies have plugged

into a huge source of new customers simply by going over doctors’ heads

and talking directly to consumers about their products.



’Direct-to-consumer (DTC) advertising is probably the most powerful tool

to stimulate demand that drugs companies have,’ Mike Marino, the chief

executive of DMB&B’s healthcare arm, Medicus, explains. ’It has resulted

in logarithmic brand growth in he US. dollars 100 million brands have

become dollars 200 million brands in a very short space of time.



Novartis is heading down a trail first blazed by the American drugs

giants a decade ago. Frustrated by a bottleneck in converting drugs from

prescription-only to over-the-counter products, pharmaceutical companies

began running advertisements in the late 80s designed to simply alert

consumers to the existence of a new drug on the market which could help

their condition.



No brands were named. Instead these so-called ’unbranded help-seeking’

ads identified the name of the drugs company, and told consumers to go

and see their doctor for more information. Thus, for example, Eli Lilly

could tell the public there was a new anti-depressant available, but it

could not mention the name, Prozac.



This type of commercial became more and more frequent in the US until

finally, last summer, the Federal Drugs Authority caved in. It finally

admitted that drugs companies might as well mention the brand name too,

at least for a two-year trial period. Thus the first formal change in

drugs advertising policy in 28 years was born, and the floodgates of DTC

drugs advertising were thrown wide open.



One year later, the total adspend in the US on DTC products in 1998 so

far has soared to dollars 1.2 billion.



According to the American Association of Advertising Agencies, this is

set to rise by another dollars 2 billion over the coming year. If you

compare expenditure this year to overall spending on prescription,

over-the-counter and DTC drugs advertising last year - which came to

about dollars 3.5billion, according to industry estimates - DTC

advertising has become a major player in a short space of time.



Medicus was the first on the scene only hours after the FDA ruling, with

a commercial for Novartis’s anti-histamine drug, Seldane, which it has

followed up with later work for a similar brand, Allegra, and the nail

fungal treatment, Lamasil.



Others were quick to follow suit. Viagra, herpes treatments and a number

of other products began to advertise on US TV. Now the top ten drugs

companies spend more than dollars 200 million on DTC advertising each

quarter.



There are still fairly strict rules on the content of these so-called

’branded indication’ commercials. They must be balanced, talk about

alternatives and cover any possible side effects. But doctors in the US

are still understandably resistant to the new type of advertising and

about 50 per cent are still said not to be in favour of the change in

policy, despite the fact that the trial is half over.



Overall, though, even critics are not in doubt that the FDA will

permanently allow DTC advertising at the end of the experiment next

autumn.



The picture is less straightforward on this side of the Atlantic. Since

the Government must foot most of the bill for any increase in spend on

prescription-only drugs by the National Health Service, it is unlikely

to embrace the idea with any enthusiasm. The Secretary of State for

Health, Frank Dobson, has already gone on the record to say drugs

companies will not be allowed to advertise prescription-only products in

Britain.



On top of that, the practice is also forbidden by a European Union

directive.



And while this comes up for review next year, the preponderance of

state-funded health schemes in Europe makes lobbying for a change in

policy a tough task for the drugs giants. Nevertheless, the pressure is

mounting.



’If I had to put money on it,’ Sheilagh Kelly, the executive director of

the Proprietary Association of Great Britain, says, ’I would say that if

the directive changed, it would allow member states to do what they

wanted in their own country.’



At the moment, this is restricted to permitting commercials to publicise

a condition, in much the same way as Novartis is doing with its

awareness campaign for foot health. This has been running in the press

for three years, initially in trade publications but more lately in

national newspapers.



Novartis is careful to deny the ads are in any way a campaign for a

product.



The group does, however, produce Lamasil, and it does not rule out other

health awareness campaigns in future.



’Should we see an educational need in another disease area, we may

consider supporting a similar campaign - but we have no plans at

present,’ the company told Campaign.



Elsewhere in the UK, a radio campaign is currently describing prostate

conditions and how they might be treated, while in Germany a TV

commercial has recently appeared about the effects and control of high

cholesterol levels. So it seems clear that success in the US has

convinced the drugs giants to take up cudgels over here, with healthcare

advertising executives in the front line.



’I do think it will happen here in the forseeable future,’ Harry Davies,

the chief executive of Leo Burnett’s healthcare arm, Life Brands, says

firmly. ’There will be movements towards DTC advertising and that poses

a number of questions for the European regulatory authorities. Sooner or

later they’ll have to address them.’



WHO IS SPENDING IN DTC IN THE US*

                      % of total        dollars

                     DTC adspend     (millions)

Glaxo Wellcome                22           53

Merck & Co                    13           31.7

Eli Lilly                     11           26

BMS                           10           24

Schering                       8           19

American Home                  7           17.9

HMR                            6           14

Johnson & Johnson              5           12.7

Pfizer                         4           10.7

Zeneca                         4            9.6

*First quarter spending in 1998

Source: Medicus



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